Purpose: The aim of this study was to examine the ultrastructural features of the nasolacrimal duct (NLD) openings in the inferior meatus. Methods: Five openings of the NLD in the inferior meati from 5 sagittal head sections of 3 cadavers were studied. Each of the openings were completely excised with 2 mm margins on all sides and transported to the laboratory in 2.5% glutaraldehyde. The analysis was performed using the standard protocols of scanning electron microscopy. The ends, edges, and surfaces were studied along with the mucosal folds, if any, guarding the edge of the openings. Results: Of the 5 NLD openings studied, 4 were of the sulcus variety and 1 was of the shape of a fissure. The fissure opening had a guarding anterior edge mucosal fold. The luminal surfaces of the openings were mostly smooth with focal defined glandular structures. Occasional heterogenous areas with prominent and extensive well-defined glands lined by ciliated columnar epithelium were noted. There were presence of mucosal folds on the floor of the sulci of the openings giving an appearance of a subsulcus. Conclusions: The luminal surfaces of the NLD openings in the inferior meati shows mucosal folds reflected on themselves and cavernous vessels throughout the expanse of the openings. Tear rheology at the NLD opening and the physiologic role of subsulci need to be investigated further. Accepted for publication July 3, 2018. M.J.A. receives royalties from Springer for his treatises "Principles and Practice of Lacrimal Surgery" and "Atlas of Lacrimal Drainage Disorders." The author has no conflicts of interest to disclose. Address correspondence and reprint requests to Mohammad Javed Ali, F.R.C.S., Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad 500034, Telangana, India. E-mail: drjaved007@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
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Παρασκευή 7 Σεπτεμβρίου 2018
Color Doppler Flow Imaging of Retrobulbar Ocular Blood Flow Changes in Retinal Artery Occlusions Caused by Cosmetic Facial Filler Injections
Purpose: This study aimed to evaluate the effects of retinal artery occlusions caused by cosmetic facial filler injections on the retrobulbar blood flow parameters. Methods: This was a retrospective, noncomparative case series. Ten consecutive patients with fundus artery occlusions caused by facial filler injections were evaluated using color Doppler flow imaging (CDFI). The peak systolic velocity and end diastolic velocity of the ophthalmic artery, central retinal artery, and posterior ciliary arteries were determined. The clinical features, including the filler material, injection site, best-corrected visual acuity, fundus fluorescein angiography, and associated ocular and systemic manifestations were also collected. Results: Injected materials included autologous fat (7 cases) and hyaluronic acid (3 cases). In 6 of the patients with ophthalmic artery occlusions, the CDFI showed no or drastic declines in the retrobulbar blood flow in the ophthalmic artery, central retinal artery, and posterior ciliary arteries. In 3 of the patients with central retinal artery occlusions, the CDFI showed no or a grossly decreased retrobulbar blood flow in the central retinal artery. In one patient with anterior ischemic optic neuropathy, the CDFI showed decreased end diastolic velocities and increased pulsatility and resistance indices in the central retinal artery, posterior ciliary arteries, and ophthalmic artery. During the follow-up period, the retrobulbar blood flow recovered to some degree. Overall, ophthalmic artery occlusion patients receiving autologous fat may have neurologic complications. Conclusions: The results suggest that the retrobulbar ocular blood flows measured with CDFI were distinctly different in the different types of ophthalmic artery occlusion. Color Doppler flow imaging could provide a practicable and convenient method for the diagnosis and follow up of retinal artery occlusions caused by cosmetic facial filler injections. Accepted for publication July 8, 2018. The authors have no financial or conflicts of interest to disclose. Dr Xue had full access to all of the data in the study, taking responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design were performed by Dr Xue, A. Liu, P. Huang, and Dr Ren. Acquisition, analysis, or interpretation of the data were carried out by Dr Xue and P. Huang. Drafting of the manuscript was done by P. Huang. Critical revision of the manuscript for important intellectual content was performed by all authors. Statistical analysis was done by P. Huang. Administrative, technical, or material support was given by P. Huang and Dr Ren. Address correspondence and reprint requests to Kang Xue, M.D., Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai 200031, China. E-mail: xuekang@foxmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
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Early Experience With Nonporous Polyethylene Barrier Sheet in Orbital Fracture Repair
Purpose: The aim of this study was to evaluate the efficacy of the nonporous polyethylene barrier sheet as an alternative for nylon foil (SupraFOIL) implants in repair of orbital fractures. Methods: This is a prospective, case series using the Stryker 0.4-mm-thick nonporous polyethylene barrier sheet in all patients over the age of 18 years presenting with orbital fractures from December 2014 to June 2015. Patient's age, location of fracture, etiology of injury, presence of preoperative restriction and diplopia, and postoperative diplopia and/or enophthalmos was recorded. Institutional review board approval was received, and consent was obtained from all participants. Patients were followed for at least 6 months when possible. Scanning electron microscopy was used to compare the thickness, surface characteristics, and porosity of the nonporous polyethylene barrier and nylon foil implants. Beam deflection testing was also performed to compare the biomechanical properties of each implant. Results: Forty-six patients who underwent repair of orbital fractures with the nonporous polyethylene barrier sheet were included in this series. Average age was 43.3 years (range: 18–84 years). Twenty-six of 46 patients (56.5%) were males, and 20 (43.4%) were females. The most common causes of injuries were assault (38.3%), falls (25.5%), motor vehicle accident (14.9%), and sports related (10.5%). Twenty of 46 patients (43.4%) had isolated orbital floor, and 2 patients (4.3%) had isolated medial wall fractures. Fifteen patients (32.6%) had combined floor and medial wall fractures involving the inferomedial orbital strut, and 9 (19.6%) had floor fractures associated with zygomaticomaxillary complex or lateral wall fractures. Twenty-eight patients (60.9%) had preoperative diplopia. Timing of surgery was between 3 and 55 days, with the median of 11.5 days. Five of 46 patients (10.8%) had residual diplopia at their 1-week postoperative visit, 4 of those patients' diplopia had resolved at 2 months postoperatively. One patient had residual diplopia at 6-month follow up. Electron microscopy showed that the 0.4-mm nonporous polyethylene barrier implant was thinner (0.33 mm) than expected and thinner than 0.4-mm SupraFOIL (0.38 mm). Scanning electron microscopy exhibited that the surface of the nonporous polyethylene barrier was smooth and nonporous. Beam deflection testing showed that for small forces (
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Nr5fJX
Scanning Electron Microscopic Features of the Inferior Meatal Nasolacrimal Duct Openings
Purpose: The aim of this study was to examine the ultrastructural features of the nasolacrimal duct (NLD) openings in the inferior meatus. Methods: Five openings of the NLD in the inferior meati from 5 sagittal head sections of 3 cadavers were studied. Each of the openings were completely excised with 2 mm margins on all sides and transported to the laboratory in 2.5% glutaraldehyde. The analysis was performed using the standard protocols of scanning electron microscopy. The ends, edges, and surfaces were studied along with the mucosal folds, if any, guarding the edge of the openings. Results: Of the 5 NLD openings studied, 4 were of the sulcus variety and 1 was of the shape of a fissure. The fissure opening had a guarding anterior edge mucosal fold. The luminal surfaces of the openings were mostly smooth with focal defined glandular structures. Occasional heterogenous areas with prominent and extensive well-defined glands lined by ciliated columnar epithelium were noted. There were presence of mucosal folds on the floor of the sulci of the openings giving an appearance of a subsulcus. Conclusions: The luminal surfaces of the NLD openings in the inferior meati shows mucosal folds reflected on themselves and cavernous vessels throughout the expanse of the openings. Tear rheology at the NLD opening and the physiologic role of subsulci need to be investigated further. Accepted for publication July 3, 2018. M.J.A. receives royalties from Springer for his treatises "Principles and Practice of Lacrimal Surgery" and "Atlas of Lacrimal Drainage Disorders." The author has no conflicts of interest to disclose. Address correspondence and reprint requests to Mohammad Javed Ali, F.R.C.S., Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad 500034, Telangana, India. E-mail: drjaved007@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Nn54PR
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Nn54PR
Early Experience With Nonporous Polyethylene Barrier Sheet in Orbital Fracture Repair
Purpose: The aim of this study was to evaluate the efficacy of the nonporous polyethylene barrier sheet as an alternative for nylon foil (SupraFOIL) implants in repair of orbital fractures. Methods: This is a prospective, case series using the Stryker 0.4-mm-thick nonporous polyethylene barrier sheet in all patients over the age of 18 years presenting with orbital fractures from December 2014 to June 2015. Patient's age, location of fracture, etiology of injury, presence of preoperative restriction and diplopia, and postoperative diplopia and/or enophthalmos was recorded. Institutional review board approval was received, and consent was obtained from all participants. Patients were followed for at least 6 months when possible. Scanning electron microscopy was used to compare the thickness, surface characteristics, and porosity of the nonporous polyethylene barrier and nylon foil implants. Beam deflection testing was also performed to compare the biomechanical properties of each implant. Results: Forty-six patients who underwent repair of orbital fractures with the nonporous polyethylene barrier sheet were included in this series. Average age was 43.3 years (range: 18–84 years). Twenty-six of 46 patients (56.5%) were males, and 20 (43.4%) were females. The most common causes of injuries were assault (38.3%), falls (25.5%), motor vehicle accident (14.9%), and sports related (10.5%). Twenty of 46 patients (43.4%) had isolated orbital floor, and 2 patients (4.3%) had isolated medial wall fractures. Fifteen patients (32.6%) had combined floor and medial wall fractures involving the inferomedial orbital strut, and 9 (19.6%) had floor fractures associated with zygomaticomaxillary complex or lateral wall fractures. Twenty-eight patients (60.9%) had preoperative diplopia. Timing of surgery was between 3 and 55 days, with the median of 11.5 days. Five of 46 patients (10.8%) had residual diplopia at their 1-week postoperative visit, 4 of those patients' diplopia had resolved at 2 months postoperatively. One patient had residual diplopia at 6-month follow up. Electron microscopy showed that the 0.4-mm nonporous polyethylene barrier implant was thinner (0.33 mm) than expected and thinner than 0.4-mm SupraFOIL (0.38 mm). Scanning electron microscopy exhibited that the surface of the nonporous polyethylene barrier was smooth and nonporous. Beam deflection testing showed that for small forces (
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Effects of 9-cis-retinoic acid on the proliferation and apoptosis of cutaneous T-cell lymphoma cells
The vitamin A derivative 9-cis-retinoic acid (9-cis-RA) has been used for the treatment and prevention of cutaneous T-cell lymphoma (CTCL). However, the precise mechanism by which 9-cis-RA treatment ameliorates CTCL remains elusive. Our research shows that 9-cis-RA inhibits proliferation and induces apoptosis in CTCL cells in a dose-dependent and time-dependent manner. 9-Cis-RA also induced G0/G1 cell cycle arrest by downregulation of cyclin D1. We confirmed that 9-cis-RA significantly decreased phosphorylation of JAK1, STAT3, and STAT5 and downregulated Bcl-xL and cyclin D1, indicating that 9-cis-RA inhibited the activation of JAK/STAT signaling. Meanwhile, 9-cis-RA also activated classical RA-mediated transcription by retinoic acid receptors (RAR) and/or retinoid X receptors (RXR) in a CTCL cell line. Thus, 9-cis-RA may be effective for chemotherapy and may prevent human CTCL by inhibiting proliferation and inducing apoptosis by inhibition of the JAK/STAT pathway and activation of the RAR/RXR pathway. Correspondence to Pengcheng Ma, PhD, Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, 12 Jiangwangmiao Street, Nanjing 210042, China Tel: +86 258 547 8929; fax: +86 258 547 1862; e-mail: mpc815@163.com Received October 28, 2017 Accepted August 6, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Orbital Extension of Conjunctival Pseudoadenomatous Hyperplasia
A 41-year-old woman developed persistent unilateral conjunctivitis following an upper respiratory infection. A white cystic lesion of the inferior fornix was noted on computed tomography scan to extend behind the orbital septum into the anterior portion of the orbit. Following subtotal excision, histopathology showed benign pseudoadenomatous (pseudoglandular) hyperplasia. The case represents the 5th report of this lesion occurring in the conjunctiva and the only instance of its extension into the orbit.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2McqYAC
Re: “Can We Improve the Tolerance of an Ocular Prosthesis by Enhancing Its Surface Finish?”
Cyst Excision and Globe Preservation in a Case of Microphthalmos With a Large Orbital Cyst and Visual Potential
Congenital microphthalmos belongs to a spectrum of diseases ranging from true anophthalmos to congenital clinical anophthalmos to microphthalmos. These conditions are frequently associated with an orbitopalpebral cyst, and pathologically, this represents a failure in the closure of the embryonic fissure at the 7–14 mm stage of gestation. The cyst develops as an outpouching from the eyeball and is generally helpful as it provides a stimulus for the orbit to expand. The general management guideline is to retain the cyst till it provides a stimulus for the orbit to expand and then to consider aspiration and sclerotherapy once orbital expansion is achieved. However, in eyes that have visual potential, sclerotherapy is contraindicated. The authors present an unusual case of a mildly microphthalmic eye with visual potential and a communicating cyst that was excised with a good result. The challenges faced in the excision of the communicating cyst with a wide pedicle and the management of the case are highlighted.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeXghr
Paracanthal “One-Snip” Decompression in a Cadaver Model of Retrobulbar Hemorrhage
Purpose: The authors assess the effectiveness of a modified paracanthal or "one-snip" procedure compared with the traditional lateral canthotomy and inferior cantholysis in the reduction of intraocular pressure (IOP) and proptosis in a human cadaveric model of retrobulbar hemorrhage. Methods: This study comprised a comparative interventional study in a cadaveric model of retrobulbar hemorrhage. Six orbits of 3 fresh cadavers were included in the study. Baseline measurements of IOP and proptosis were recorded for all 6 orbits before and after simulation of retrobulbar hemorrhage as previously described. Right orbits (n = 3) underwent traditional lateral canthotomy and inferior cantholysis. Left orbits (n = 3) underwent modified paracanthal or "one-snip" procedure. The primary outcome measures were reduction in IOP and proptosis between the 2 techniques. Results: Following lateral canthotomy and inferior cantholysis of each right orbit, the average IOP dropped to 14 mm Hg (range of 11–18 mm Hg), corresponding to a mean decrease of 32 mm Hg. Following the "one-snip" procedure of each left orbit, the average IOP dropped to 19 mm Hg with a range of 16 to 23 mm Hg, corresponding to a mean decrease of 22 mm Hg. There was no statistically significant difference in IOP reduction (p = 0.36) or proptosis reduction (p = 0.23) between the 2 treatment groups. Conclusions: Compared with traditional lateral canthotomy xand inferior cantholysis, the modified paracanthal or "one-snip" procedure is effective for IOP reduction and led to mild improvement of proptosis in a cadaveric model of retrobulbar hemorrhage. The authors hope this study helps improve orbital compartment syndrome outcomes by providing an option that more providers will feel comfortable performing and therefore decreasing time to surgical decompression.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M4aMBr
Significance of Early Postoperative Eyelid Position on Late Postoperative Result in Mueller’s Muscle Conjunctival Resection and External Levator Advancement Surgery
Purpose: The purpose of this study was to determine whether advancement of the levator aponeurosis in external levator resection surgery or Mueller's muscle and conjunctiva in Mueller's muscle conjunctival resection (MMCR) surgery has a differential effect on variation in eyelid position during the postoperative period. Methods: In this retrospective observational cohort study, 2 groups of patients were defined. The first underwent MMCR surgery without tarsectomy by surgeon 1. The second underwent external levator resection without dissection posterior to the levator aponeurosis by surgeon 2. Marginal reflex distance (MRD1) was calculated based on digital photographs at baseline, 1 week postoperatively and at 3-month follow up. The primary outcome measure was change in MRD1 over time. The secondary outcome was defined as the proportion of patients with minimal early postoperative change (change of MRD1 less than 0.5 mm at 1 week postoperatively). Repeated measures analysis of variance, t test, and chi-square analyses were performed. Results: Of the 114 eyes in the sample, there were 68 in the MMCR group and 46 in the external levator resection group. A significant interaction between group and time was noted (p 1 mm from the early postoperative to the late postoperative time points. Conclusions: Both external levator resection and MMCR can effectively elevate the eyelid in cases of primary involutional ptosis, and have similar late postoperative results. The authors found that MMCR cases undergo greater change between the early and late postoperative period, suggesting the process of eyelid elevation after MMCR may be dynamic, involving postoperative physiologic modification.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NVPBmN
Sino-Orbital Fungal Infection by Tilletiopsis minor, a Rare Human Pathogen, Diagnosed by Internal Transcribed Spacer Sequencing
Orbital infection can be caused by numerous pathogens, and accurate diagnosis informs appropriate therapy. The authors report a case of a 78-year-old man with well-controlled diabetes mellitus and recurrent sino-orbital infection following multiple surgical procedures with negative microbiologic results. This case presented a diagnostic and treatment challenge and was aided by the use of internal transcribed spacer sequencing for pathogen identification. The fungal pathogen, Tilletiopsis minor, has not previously been described as a human pathogen in the sinus and orbit. This report describes a novel orbital pathogen and highlights the importance of diagnostic diligence and utilizing internal transcribed spacer sequencing in the workup of atypical orbital infection.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QjPDXk
Symmetry of Upper Eyelid Contour After Unilateral Blepharoptosis Repair With a Single-strip Frontalis Suspension Technique
Purpose: To analyze the upper eyelid contour of patients with unilateral congenital ptosis who underwent single-strip frontalis suspension. Methods: The authors compared the upper eyelid shape of the right and left eyes of 10 patients who underwent unilateral frontalis suspension with a single strip of autogenous fascia. At a mean postoperative time of 10.1 ± 4.01 months, the image J software was used to measure the ratio between the nasal and temporal areas of the upper half of the palpebral fissure. The midpupil upper eyelid distance (MRD1) was also measured on the photos with the same software. The nonparametric Wilcoxon signed-rank test was used to compare the data. Results: Postoperative MRD1 ranged from 2.5 to 4.7 mm (median = 3.8) on the affected side. The MRD1 for nonoperated eyelid ranged from 1.8 to 5.0 mm (median = 3.5). On the operated side, the temporal areas ranged from 50.3 to 85.7 mm2 (median 65.2) and nasal areas ranged from 41.5 to 72.3 (the median was 60.1). In the contralateral, nonoperated palpebral fissures, the temporal areas ranged from 42.7 to 94.3 mm2 (median = 54.5) and the nasal areas ranged from 36.8 to 86.1 mm2 (median 52.3). The T/N ratio distributions were almost identical between groups, ranging from 0.9 to 1.2 (median = 1.1) in the operated eyes and from 0.9 to 1.3 (median = 1.1) in the fellow eyes. Conclusions: In autogenous fascia frontalis suspension procedures, the upper eyelid contour of the ptotic eyelids can be adequately normalized with a single area of traction on the tarsal plate.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NVWxAs
Orbital Extension of Conjunctival Pseudoadenomatous Hyperplasia
A 41-year-old woman developed persistent unilateral conjunctivitis following an upper respiratory infection. A white cystic lesion of the inferior fornix was noted on computed tomography scan to extend behind the orbital septum into the anterior portion of the orbit. Following subtotal excision, histopathology showed benign pseudoadenomatous (pseudoglandular) hyperplasia. The case represents the 5th report of this lesion occurring in the conjunctiva and the only instance of its extension into the orbit.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2McqYAC
Re: “Can We Improve the Tolerance of an Ocular Prosthesis by Enhancing Its Surface Finish?”
Continuous Positive Airway Pressure Thresholds for Nasolacrimal Air Regurgitation in a Cadaveric Model
Purpose: To elucidate the mechanisms underlying nasolacrimal air regurgitation (AR) in the setting of continuous positive airway pressure therapy. Methods: Twelve nasolacrimal systems of 6 fresh female human cadavers were evaluated individually for AR using continuous positive airway pressure therapy before any nasolacrimal procedure. Cadavers were then randomly assigned to undergo nasolacrimal duct probing or endoscopic dacryocystorhinostomy and then each hemisystem was again evaluated for AR. The pressure where AR was first observed (discovery pressure) or maximum possible pressure in systems without AR was recorded. In systems that demonstrated AR, the pressure was then gradually decreased to the lowest pressure where regurgitation persisted. This pressure was recorded as the secondary threshold pressure. Results: None of the 12 unoperated nasolacrimal systems or the 6 systems that underwent nasolacrimal duct probing demonstrated AR through the maximum continuous positive airway pressure therapy (30 cm H2O). After endoscopic dacryocystorhinostomy, all 6 nasolacrimal systems demonstrated AR. The mean discovery pressure was 16.0 cm H2O (range, 14.0–18.0 cm H2O) and mean secondary threshold pressure was 7.25 cm H2O (range, 6.5–8.0 cm H2O). Conclusions: Air regurgitation during continuous positive airway pressure therapy in the setting of prior endoscopic dacryocystorhinostomy can be replicated in a cadaver model. The secondary threshold pressures required for AR in this model were similar to AR pressures reported clinically. Prior to dacryocystorhinostomy, patients using continuous positive airway pressure therapy should be counseled on AR, and physicians should consider this phenomenon when evaluating ophthalmic complaints in postoperative patients on positive airway pressure therapy.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M7S9fL
Orbital Extranodal Marginal Zone Lymphoma Following Radiotherapy: A Report of 2 Cases
Purpose: To present 2 patients in whom orbital radiation preceded the development of periorbital extranodal marginal zone lymphoma by more than a decade and to investigate the likelihood of this representing irradiation-induced malignancy. Methods: Retrospective chart review and histopathologic study with immunohistochemistry of 2 cases. Results: The first patient was a 58-year-old woman who developed an orbital mass within the vicinity of the lateral rectus muscle 17 years after external beam proton radiation therapy for an inferotemporal choroidal melanoma. The second patient was a 32-year-old woman who developed a mass in the right lacrimal gland 12 years after external beam photon radiation therapy for chronic inflammatory dacryoadenitis. Histopathologic and immunohistochemical studies confirmed orbital extranodal marginal zone lymphoma in both cases. Retrospective review of older histopathologic slides from the second patient revealed underlying immunoglobulin G4–related disease. Discussion: The unusual sequence of events in these 2 cases raises the question of whether orbital radiation may in rare instances promote the development of orbital extranodal marginal zone lymphoma. The literature pertaining to irradiation-induced secondary malignancy in the orbit is reviewed. Conclusions: Clinicians should consider the possibility of a secondary malignancy when evaluating a patient with an orbital mass and a history of prior local radiation exposure.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O4DjIE
Paracanthal “One-Snip” Decompression in a Cadaver Model of Retrobulbar Hemorrhage
Purpose: The authors assess the effectiveness of a modified paracanthal or "one-snip" procedure compared with the traditional lateral canthotomy and inferior cantholysis in the reduction of intraocular pressure (IOP) and proptosis in a human cadaveric model of retrobulbar hemorrhage. Methods: This study comprised a comparative interventional study in a cadaveric model of retrobulbar hemorrhage. Six orbits of 3 fresh cadavers were included in the study. Baseline measurements of IOP and proptosis were recorded for all 6 orbits before and after simulation of retrobulbar hemorrhage as previously described. Right orbits (n = 3) underwent traditional lateral canthotomy and inferior cantholysis. Left orbits (n = 3) underwent modified paracanthal or "one-snip" procedure. The primary outcome measures were reduction in IOP and proptosis between the 2 techniques. Results: Following lateral canthotomy and inferior cantholysis of each right orbit, the average IOP dropped to 14 mm Hg (range of 11–18 mm Hg), corresponding to a mean decrease of 32 mm Hg. Following the "one-snip" procedure of each left orbit, the average IOP dropped to 19 mm Hg with a range of 16 to 23 mm Hg, corresponding to a mean decrease of 22 mm Hg. There was no statistically significant difference in IOP reduction (p = 0.36) or proptosis reduction (p = 0.23) between the 2 treatment groups. Conclusions: Compared with traditional lateral canthotomy xand inferior cantholysis, the modified paracanthal or "one-snip" procedure is effective for IOP reduction and led to mild improvement of proptosis in a cadaveric model of retrobulbar hemorrhage. The authors hope this study helps improve orbital compartment syndrome outcomes by providing an option that more providers will feel comfortable performing and therefore decreasing time to surgical decompression.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M4aMBr
Mild Complications or Unusual Persistence of Porcine Collagen and Hyaluronic Acid Gel Following Periocular Filler Injections
The purpose of this study was to describe the histopathologic appearance of dermal eyelid fillers that were unexpectedly encountered in ophthalmic plastic surgery samples from patients with mild eyelid disfigurements, and to review eyelid cases with complications that had previously been described in the literature. A retrospective histopathologic study with Alcian blue, elastic, and Masson trichrome stains of 2 cases that were submitted to the Ocular Pathology Department was conducted, and a critical review of previously published cases of the histopathologic characteristics of dermal filler material in the periocular region was also conducted. Two periocular tissue samples were found to contain dermal filler material. In one case, porcine collagen appeared as amorphous or indistinctly microfibrillar aggregates that stained light blue with the Masson trichrome method. In the other case, hyaluronic acid gel appeared as vivid blue amorphous pools of material in extracellular locules after staining with the Alcian blue method. An inflammatory response was not observed in either case. Patients who undergo facial filler procedures may, at a later time, require a surgical excisional procedure from which a specimen is generated. Previously injected dermal filler that the patient neglected to mention may be present in the pathologic sample, potentially perplexing the unsuspecting pathologist. Both ophthalmic plastic surgeons and ocular pathologists should be aware of the histopathologic features of dermal fillers. It is helpful if a surgeon who submits a specimen to the pathology service makes note of any known prior use of facial filler material or is alert to its possible presence when unfamiliar foreign material is discovered in the dermis of the eyelids.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaRnSJ
Significance of Early Postoperative Eyelid Position on Late Postoperative Result in Mueller’s Muscle Conjunctival Resection and External Levator Advancement Surgery
Purpose: The purpose of this study was to determine whether advancement of the levator aponeurosis in external levator resection surgery or Mueller's muscle and conjunctiva in Mueller's muscle conjunctival resection (MMCR) surgery has a differential effect on variation in eyelid position during the postoperative period. Methods: In this retrospective observational cohort study, 2 groups of patients were defined. The first underwent MMCR surgery without tarsectomy by surgeon 1. The second underwent external levator resection without dissection posterior to the levator aponeurosis by surgeon 2. Marginal reflex distance (MRD1) was calculated based on digital photographs at baseline, 1 week postoperatively and at 3-month follow up. The primary outcome measure was change in MRD1 over time. The secondary outcome was defined as the proportion of patients with minimal early postoperative change (change of MRD1 less than 0.5 mm at 1 week postoperatively). Repeated measures analysis of variance, t test, and chi-square analyses were performed. Results: Of the 114 eyes in the sample, there were 68 in the MMCR group and 46 in the external levator resection group. A significant interaction between group and time was noted (p 1 mm from the early postoperative to the late postoperative time points. Conclusions: Both external levator resection and MMCR can effectively elevate the eyelid in cases of primary involutional ptosis, and have similar late postoperative results. The authors found that MMCR cases undergo greater change between the early and late postoperative period, suggesting the process of eyelid elevation after MMCR may be dynamic, involving postoperative physiologic modification.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NVPBmN
Sino-Orbital Fungal Infection by Tilletiopsis minor, a Rare Human Pathogen, Diagnosed by Internal Transcribed Spacer Sequencing
Orbital infection can be caused by numerous pathogens, and accurate diagnosis informs appropriate therapy. The authors report a case of a 78-year-old man with well-controlled diabetes mellitus and recurrent sino-orbital infection following multiple surgical procedures with negative microbiologic results. This case presented a diagnostic and treatment challenge and was aided by the use of internal transcribed spacer sequencing for pathogen identification. The fungal pathogen, Tilletiopsis minor, has not previously been described as a human pathogen in the sinus and orbit. This report describes a novel orbital pathogen and highlights the importance of diagnostic diligence and utilizing internal transcribed spacer sequencing in the workup of atypical orbital infection.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QjPDXk
Gelatin-Based Hemostatic Agents: Histopathologic Differences
Purpose: To delineate the histopathologic appearance of gelatin-based hemostatic agents, Surgiflo, Gelfoam, and Floseal, which are used by ophthalmic plastic surgeons, and which may incidentally be found as foreign materials in histopathologic tissue samples. Methods: Histopathologic analysis was performed with hematoxylin-eosin, periodic acid-Schiff, Masson trichrome, and elastin staining on tissue samples in which gelatin-based agents were found. To better characterize these materials, similar analyses were performed on in vitro samples of commonly used gelatin-based hemostatic agents. Results: Surgiflo and Gelfoam are composed of small stellate pieces of gelatin with a smooth, homogeneous quality. In tissues, they are faintly positive with periodic acid-Schiff staining, amphophilic with Masson trichrome staining, and ink-black with elastin staining. Floseal has a distinctly different morphology of large rectangular sheets, yet almost identical in vitro staining properties. Discussion: While the morphology of the gelatin-based hemostatic agents is consistent under various conditions, the staining properties of these materials differ based on whether they have been in contact with human tissue. Conclusions: Gelatin-derived hemostatic agents are best identified based on their morphologic characteristics. Elastin staining highlights these materials prominently within tissue samples and may be helpful in distinguishing them from other foreign materials.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M4aACd
Orbital Apex Syndrome in Pseudomonas Sinusitis After Functional Endoscopic Sinus Surgery
Sinusitis complicated by orbital apex syndrome is rare. The majority of cases are due to mucormycosis in immunocompromised patients. The authors report a case of orbital apex syndrome secondary to Pseudomonas sinusitis. The patient was a 79-year-old Type 2 diabetic woman who underwent left-sided functional endoscopic sinus surgery. Three months postprocedure, she presented with a 3-week history of gradual vision loss and constant temporal headache on the ipsilateral side. Examination revealed light perception vision, a relative afferent pupillary defect, absent corneal reflex, and disc pallor. Imaging revealed opacification of the posterior ethmoidal air cells extending to involve the orbital apex. Urgent orbital and sinonasal decompression was performed. Intraoperative specimens grew Pseudomonas aeruginosa. The patient was treated with liposomal amphotericin B, posaconazole, and piperacillin/tazobactam. The patient recovered with no visual sequelae. Pseudomonas is an important mimicker to consider in sinusitis causing orbital apex syndrome, and it may occur following functional endoscopic sinus surgery.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qgq7ls
Conjunctival Dirofilariasis Causing Symptoms for 1 Day
No abstract availablefrom #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaRj5r
Medial Buttressing in Orbital Blowout Fractures
Purpose: To study whether ethmoidectomy predisposes the orbit to medial wall fracture with lesser trauma. Methods: An interventional cadaver study of 5 heads (10 orbits); the left or right orbit was randomized to undergo endoscopic complete ethmoidectomy with the fellow orbit as control. Fractures were induced with direct globe trauma, and heads underwent CT scanning. Energy to induce fracture, peak orbital pressure at time of fracture, fracture pattern, and volume of herniated tissue were measured and analyzed. Results: Fractures were induced in both orbits of all cadavers. Experimental orbits after ethmoidectomy sustained orbital fracture at less energy required (2.14 ± 0.66 vs. 3.10 ± 0.19 J, mean difference: −0.96 ± 0.33 J, pfrom #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M8HAt9
An Eye for an Eye and a Tooth for a Tooth!
No abstract availablefrom #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qgq0X4
Aesthetic Abstracts and Citations
Orbital Extranodal Marginal Zone Lymphoma Following Radiotherapy: A Report of 2 Cases
Purpose: To present 2 patients in whom orbital radiation preceded the development of periorbital extranodal marginal zone lymphoma by more than a decade and to investigate the likelihood of this representing irradiation-induced malignancy. Methods: Retrospective chart review and histopathologic study with immunohistochemistry of 2 cases. Results: The first patient was a 58-year-old woman who developed an orbital mass within the vicinity of the lateral rectus muscle 17 years after external beam proton radiation therapy for an inferotemporal choroidal melanoma. The second patient was a 32-year-old woman who developed a mass in the right lacrimal gland 12 years after external beam photon radiation therapy for chronic inflammatory dacryoadenitis. Histopathologic and immunohistochemical studies confirmed orbital extranodal marginal zone lymphoma in both cases. Retrospective review of older histopathologic slides from the second patient revealed underlying immunoglobulin G4–related disease. Discussion: The unusual sequence of events in these 2 cases raises the question of whether orbital radiation may in rare instances promote the development of orbital extranodal marginal zone lymphoma. The literature pertaining to irradiation-induced secondary malignancy in the orbit is reviewed. Conclusions: Clinicians should consider the possibility of a secondary malignancy when evaluating a patient with an orbital mass and a history of prior local radiation exposure.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O4DjIE
Carboplatin and Pembrolizumab Chemoimmunotherapy Achieves Remission in Recurrent, Metastatic Sebaceous Carcinoma
A 72-year-old Caucasian woman who had recurrent sebaceous carcinoma of the right orbit with bilateral cervical lymph node involvement 24 months after orbital exenteration was treated with carboplatin (area under the curve of 5) and pembrolizumab (2 mg/kg) for 6 cycles, followed by maintenance pembrolizumab. She obtained a complete pathological remission and remains free of local, regional, and systemic disease at 15 months.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeQjgA
Deep Orbital Sub-Q Hyaluronic Acid Filler Injection for Enophthalmic Sighted Eyes in Parry–Romberg Syndrome
Purpose: The authors present a consecutive series of deep orbital Sub-Q injections to treat enophthalmic sighted eyes in Parry–Romberg syndrome patients. Methods: Retrospective, interventional case series in 2 centers. Data were collected on patient demographics, Parry–Romberg syndrome onset age, previous orbital and eyelid surgeries, diplopia, ocular movement restriction before and after the injection, number of injections, interval between injections, indication for any top-up or dissolution of filler, and any other complications. In all cases, the hyaluronic acid gel used was Restylane Sub-Q + Lidocaine. Results: A total of 8 injections on 3 patients with Parry–Romberg syndrome, and significant enophthalmos is reported. All injections were with deep orbital Sub-Q filler. All patients were females, aged 32, 24, and 52 years old while their symptoms started at 15, 16, and 30 years old, respectively. None had orbital surgery prior to the injection. Follow up period was 2, 7, and 5 years respectively. All presented a significant enophthalmos of 4 mm which reduced to 1 mm after the injection, and duration effect was 18, 24, and 20 months, respectively. We observed a significant improvement in enophthalmos, lagophthalmos, exposure keratopathy, and even ocular motility. Lagophthalmos improved from 1, 4, and 7 mm to 0, 1, and 2 mm post injection. Ocular motility improved with no onset of new limitation or diplopia. Lower eyelid retraction increased in 1 patient after orbital injection. No other complications occurred. Conclusions: Deep orbital Sub-Q hyaluronic injection for treatment of enophthalmos in Parry–Romberg syndrome is an useful option in sighted eyes.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NTuaTk
Epithelial–Myoepithelial Carcinoma Presenting as a Pseudo Veno-Lymphatic Malformation
A 41-year-old woman presented with several days of right eye pain and blurred vision. Examination and radiologic workup were consistent with a veno-lymphatic malformation, including demonstration of cystic fluid–fluid levels on imaging. Histopathology supported the presence of cystic spaces but revealed the final diagnosis of lacrimal epithelial–myoepithelial carcinoma, a rare neoplasm typically associated with the salivary gland. This represents the first reported case of lacrimal epithelial–myoepithelial carcinoma presenting with pain and evidence of intralesional cysts on radiographic and histopathologic evaluation. Better characterization will enable recognition, complete surgical excision, and potential adjuvant radiation therapy.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qgq9d4
Gelatin-Based Hemostatic Agents: Histopathologic Differences
Purpose: To delineate the histopathologic appearance of gelatin-based hemostatic agents, Surgiflo, Gelfoam, and Floseal, which are used by ophthalmic plastic surgeons, and which may incidentally be found as foreign materials in histopathologic tissue samples. Methods: Histopathologic analysis was performed with hematoxylin-eosin, periodic acid-Schiff, Masson trichrome, and elastin staining on tissue samples in which gelatin-based agents were found. To better characterize these materials, similar analyses were performed on in vitro samples of commonly used gelatin-based hemostatic agents. Results: Surgiflo and Gelfoam are composed of small stellate pieces of gelatin with a smooth, homogeneous quality. In tissues, they are faintly positive with periodic acid-Schiff staining, amphophilic with Masson trichrome staining, and ink-black with elastin staining. Floseal has a distinctly different morphology of large rectangular sheets, yet almost identical in vitro staining properties. Discussion: While the morphology of the gelatin-based hemostatic agents is consistent under various conditions, the staining properties of these materials differ based on whether they have been in contact with human tissue. Conclusions: Gelatin-derived hemostatic agents are best identified based on their morphologic characteristics. Elastin staining highlights these materials prominently within tissue samples and may be helpful in distinguishing them from other foreign materials.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M4aACd
Orbital Apex Syndrome in Pseudomonas Sinusitis After Functional Endoscopic Sinus Surgery
Sinusitis complicated by orbital apex syndrome is rare. The majority of cases are due to mucormycosis in immunocompromised patients. The authors report a case of orbital apex syndrome secondary to Pseudomonas sinusitis. The patient was a 79-year-old Type 2 diabetic woman who underwent left-sided functional endoscopic sinus surgery. Three months postprocedure, she presented with a 3-week history of gradual vision loss and constant temporal headache on the ipsilateral side. Examination revealed light perception vision, a relative afferent pupillary defect, absent corneal reflex, and disc pallor. Imaging revealed opacification of the posterior ethmoidal air cells extending to involve the orbital apex. Urgent orbital and sinonasal decompression was performed. Intraoperative specimens grew Pseudomonas aeruginosa. The patient was treated with liposomal amphotericin B, posaconazole, and piperacillin/tazobactam. The patient recovered with no visual sequelae. Pseudomonas is an important mimicker to consider in sinusitis causing orbital apex syndrome, and it may occur following functional endoscopic sinus surgery.from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qgq7ls
An Eye for an Eye and a Tooth for a Tooth!
No abstract availablefrom #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qgq0X4
MicroRNAs predict recurrence risk of head and neck tumors
| MicroRNAs predict recurrence risk of head and neck tumors Medical XpressFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NWPFT8
Rapid Assessment Clinic opens at Chris O'Brien Lifehouse
| Rapid Assessment Clinic opens at Chris O'Brien Lifehouse Daily TelegraphFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NWJn61
Optim Partners with 21st Century Oncology as the Preferred Vendor for Head and Neck Cancer Endoscopy
| Optim Partners with 21st Century Oncology as the Preferred Vendor for Head and Neck Cancer Endoscopy Markets InsiderFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q8zHah
Japan recognizes first death related to Fukushima cleanup
| Japan recognizes first death related to Fukushima cleanup WFMZ AllentownFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CypKAa
13 Thyroid Facts Everyone Should Know
| 13 Thyroid Facts Everyone Should Know Reader's DigestFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wVmw4k
'Cancer' or 'lesion?' The optics of papillary thyroid cancer
| 'Cancer' or 'lesion?' The optics of papillary thyroid cancer MD LinxFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MY04BS
Wording Used May Affect Thyroid Cancer Patients' Anxiety, Choices
| Wording Used May Affect Thyroid Cancer Patients' Anxiety, Choices Endocrinology AdvisorFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CvF5S8
TOOTH TALK: Spotting oral cancer
| TOOTH TALK: Spotting oral cancer Lockport Union-Sun & JournalFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wULeRF
Late Hard-Nosed Media Buff Proved 'Slick Voice' of Arab TV Reporting
| Late Hard-Nosed Media Buff Proved 'Slick Voice' of Arab TV Reporting Al-BawabaFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CuD748
Japan recognizes first death related to Fukushima cleanup
| Japan recognizes first death related to Fukushima cleanup WFMZ AllentownFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CypKAa
13 Thyroid Facts Everyone Should Know
| 13 Thyroid Facts Everyone Should Know Reader's DigestFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wVmw4k
'Cancer' or 'lesion?' The optics of papillary thyroid cancer
| 'Cancer' or 'lesion?' The optics of papillary thyroid cancer MD LinxFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MY04BS
Wording Used May Affect Thyroid Cancer Patients' Anxiety, Choices
| Wording Used May Affect Thyroid Cancer Patients' Anxiety, Choices Endocrinology AdvisorFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CvF5S8
How not saying 'cancer' for low-risk thyroid cancer may affect treatment preferences, patient anxiety
| How not saying 'cancer' for low-risk thyroid cancer may affect treatment preferences, patient anxiety EurekAlert (press release)Full coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1PFlf
TOOTH TALK: Spotting oral cancer
| TOOTH TALK: Spotting oral cancer Lockport Union-Sun & JournalFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wULeRF
Late Hard-Nosed Media Buff Proved 'Slick Voice' of Arab TV Reporting
| Late Hard-Nosed Media Buff Proved 'Slick Voice' of Arab TV Reporting Al-BawabaFull coverage |
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CuD748
Pancreaticojejunostomy with or without reinforcement after pancreaticoduodenectomy: surgical technique of ligamentum teres hepatis wrap around pancreaticojejunostomy
In a previous issue of the Journal, Zhong et al. reported a retrospective study that compared the perioperative outcomes of the mesh-reinforced pancreaticojejunostomy with conventional pancreaticojejunostomy. ...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M461YB
Pancreaticojejunostomy with or without reinforcement after pancreaticoduodenectomy: surgical technique of ligamentum teres hepatis wrap around pancreaticojejunostomy
In a previous issue of the Journal, Zhong et al. reported a retrospective study that compared the perioperative outcomes of the mesh-reinforced pancreaticojejunostomy with conventional pancreaticojejunostomy. ...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M461YB
Prognostic significance of cell cycle-associated proteins p16, pRB, cyclin D1 and p53 in resected oropharyngeal carcinoma
Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has an improved outcome and may allow for treatment de-escalation. High-risk HPV (HR-HPV) infection is associated with deregulat...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeP40F
Co-evolution networks of HIV/HCV are modular with direct association to structure and function
by Ahmed Abdul Quadeer, David Morales-Jimenez, Matthew R. McKay Mutational correlation patterns found in population-level sequence data for the Human Immunodeficiency Virus (HIV) and the Hepatitis C Virus (HCV) have been demonstrated to be informative of viral fitness. Such patterns can be seen as footprints of the intrinsic functional constraints placed on vi ral evolution under diverse selective pressures. Here, considering multiple HIV and HCV proteins, we demonstrate that these mutational correlations encode a modular co-evolutionary structure that is tightly linked to the structural and functional properties of the respective proteins. Specifically, by introducing a robust statistical method based on sparse principal component analysis, we identify near-disjoint sets of collectively-...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wSli97
Correction: Suppression of GATA-3 Nuclear Import and Phosphorylation: A Novel Mechanism of Corticosteroid Action in Allergic Disease
by Kittipong Maneechotesuwan, Xin Yao, Kazuhiro Ito, Elen Jazrawi, Omar S. Usmani, Ian M. Adcock, Peter J. Barnes (Source: PLoS Medicine)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QjFMRk
Prognostic significance of cell cycle-associated proteins p16, pRB, cyclin D1 and p53 in resected oropharyngeal carcinoma
Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has an improved outcome and may allow for treatment de-escalation. High-risk HPV (HR-HPV) infection is associated with deregulat...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeP40F
Co-evolution networks of HIV/HCV are modular with direct association to structure and function
by Ahmed Abdul Quadeer, David Morales-Jimenez, Matthew R. McKay Mutational correlation patterns found in population-level sequence data for the Human Immunodeficiency Virus (HIV) and the Hepatitis C Virus (HCV) have been demonstrated to be informative of viral fitness. Such patterns can be seen as footprints of the intrinsic functional constraints placed on vi ral evolution under diverse selective pressures. Here, considering multiple HIV and HCV proteins, we demonstrate that these mutational correlations encode a modular co-evolutionary structure that is tightly linked to the structural and functional properties of the respective proteins. Specifically, by introducing a robust statistical method based on sparse principal component analysis, we identify near-disjoint sets of collectively-...
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wSli97
Correction: Suppression of GATA-3 Nuclear Import and Phosphorylation: A Novel Mechanism of Corticosteroid Action in Allergic Disease
by Kittipong Maneechotesuwan, Xin Yao, Kazuhiro Ito, Elen Jazrawi, Omar S. Usmani, Ian M. Adcock, Peter J. Barnes (Source: PLoS Medicine)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QjFMRk
Dangers of Increased Earwax With Age
Earwax protects our delicate hearing mechanism from dirt and other airborne particles. And any audiologist or physician will tell you there's typically no need for most people to clean the goop out of our ears. (In fact, improper cleaning could injure the eardrum and ear canal.) However, as people get older, the chances of potentially harmful earwax (cerumen) buildup increase. According to an article from CNN, approximately two-thirds of the more than 2 million people living in skilled nursing and assisted living facilities in the U.S. might have a severe buildup of earwax called impaction. "The excessive amount [of earwax] can cause hearing loss or ringing in your ears, says audiologist Jackie Clark in the article. "Some people experience vertigo, which increases the risk o...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M9tdVe
Dangers of Increased Earwax With Age
Earwax protects our delicate hearing mechanism from dirt and other airborne particles. And any audiologist or physician will tell you there's typically no need for most people to clean the goop out of our ears. (In fact, improper cleaning could injure the eardrum and ear canal.) However, as people get older, the chances of potentially harmful earwax (cerumen) buildup increase. According to an article from CNN, approximately two-thirds of the more than 2 million people living in skilled nursing and assisted living facilities in the U.S. might have a severe buildup of earwax called impaction. "The excessive amount [of earwax] can cause hearing loss or ringing in your ears, says audiologist Jackie Clark in the article. "Some people experience vertigo, which increases the risk o...
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M9tdVe
Dangers of Increased Earwax With Age
Earwax protects our delicate hearing mechanism from dirt and other airborne particles. And any audiologist or physician will tell you there's typically no need for most people to clean the goop out of our ears. (In fact, improper cleaning could injure the eardrum and ear canal.) However, as people get older, the chances of potentially harmful earwax (cerumen) buildup increase. According to an article from CNN, approximately two-thirds of the more than 2 million people living in skilled nursing and assisted living facilities in the U.S. might have a severe buildup of earwax called impaction. "The excessive amount [of earwax] can cause hearing loss or ringing in your ears, says audiologist Jackie Clark in the article. "Some people experience vertigo, which increases the risk o...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M9tdVe
Dangers of Increased Earwax With Age
Earwax protects our delicate hearing mechanism from dirt and other airborne particles. And any audiologist or physician will tell you there's typically no need for most people to clean the goop out of our ears. (In fact, improper cleaning could injure the eardrum and ear canal.) However, as people get older, the chances of potentially harmful earwax (cerumen) buildup increase. According to an article from CNN, approximately two-thirds of the more than 2 million people living in skilled nursing and assisted living facilities in the U.S. might have a severe buildup of earwax called impaction. "The excessive amount [of earwax] can cause hearing loss or ringing in your ears, says audiologist Jackie Clark in the article. "Some people experience vertigo, which increases the risk o...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2M9tdVe
RUDN biochemists described a new mechanism for autoimmunity suppression
(RUDN University) RUDN biochemists suggested a new mechanism following which a human body prevents the development of autoimmune diseases (i.e. conditions caused by the damaging influence of the immune system on a body's own organs and tissues), allergies, and implant rejection. It turned out that regulatory T-cells are able to suppress the reproduction of autoimmune cells. The work was published in the Molecular Immunology journal. (Source: EurekAlert! - Medicine and Health)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Maj0bk
RUDN biochemists described a new mechanism for autoimmunity suppression
(RUDN University) RUDN biochemists suggested a new mechanism following which a human body prevents the development of autoimmune diseases (i.e. conditions caused by the damaging influence of the immune system on a body's own organs and tissues), allergies, and implant rejection. It turned out that regulatory T-cells are able to suppress the reproduction of autoimmune cells. The work was published in the Molecular Immunology journal. (Source: EurekAlert! - Medicine and Health)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Maj0bk
RUDN biochemists described a new mechanism for autoimmunity suppression
(RUDN University) RUDN biochemists suggested a new mechanism following which a human body prevents the development of autoimmune diseases (i.e. conditions caused by the damaging influence of the immune system on a body's own organs and tissues), allergies, and implant rejection. It turned out that regulatory T-cells are able to suppress the reproduction of autoimmune cells. The work was published in the Molecular Immunology journal. (Source: EurekAlert! - Medicine and Health)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Maj0bk
RUDN biochemists described a new mechanism for autoimmunity suppression
(RUDN University) RUDN biochemists suggested a new mechanism following which a human body prevents the development of autoimmune diseases (i.e. conditions caused by the damaging influence of the immune system on a body's own organs and tissues), allergies, and implant rejection. It turned out that regulatory T-cells are able to suppress the reproduction of autoimmune cells. The work was published in the Molecular Immunology journal. (Source: EurekAlert! - Medicine and Health)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Maj0bk
Regulatory T cell deficiency and autoimmune skin disease: beyond scurfy mouse and IPEX
(Source: Journal of Allergy and Clinical Immunology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wOs7bT
Transfusion Practice in Neonates.
Authors: Kim DH Abstract Neonates, especially extremely low-birth-weight infants are one of the most heavily transfused groups among all patients. Because they are exposed to higher specific risks of transfusion compared to other age groups, many special considerations are required for transfusion therapy in neonates. The risks of transfusion in neonates include adverse outcomes specific for preterm infants as well as increased metabolic, immunologic, and infectious complications. To reduce the risks of transfusion-transmitted cytomegalovirus infection and transfusion-associated graft versus host, leukoreduced and irradiated cellular blood products should be used for all neonates. This review summarizes the risks of neonatal transfusion therapy and specific methods to reduce them. ...
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Transient and asymptomatic meningitis in human immunodeficiency virus-1 subtype C: a case study of genetic compartmentalization and biomarker dynamics
This report describes a patient with HIV subtype C who developed a transient episode of asymptomatic HIV meningitis with compartmentalization of HIV in the CSF that resolved independently of ARV therapy. Extensive CSF studies were performed as part of an ongoing longitudinal study, which revealed CNS immune abnormalities. This case presents evidence of HIV-1 subtype C neurotropism and compartmentalization. (Source: Journal of NeuroVirology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Cxo7Tm
Comparison of patient characteristics, clinical management, infectious specialist consultation, and outcome in men and women with methicillin-sensitive Staphylococcus aureus bacteremia: a propensity-score adjusted retrospective study
ConclusionPatient characteristics, clinical management, ISC guidance, bacteremia relapse, and outcome did not differ in men and women with MS-SAB. (Source: Infection)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2oN6dCe
Varicella-zoster virus CNS vasculitis and RNA polymerase III gene mutation in identical twins
Conclusions Altogether, these cases add genetic and immunologic evidence to the novel association between defects in sensing of AT-rich DNA present in the VZV genome and increased susceptibility to severe manifestations of VZV infection in the CNS in humans. (Source: Neurology Neuroimmunology and Neuroinflammation)
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Clinical Decision Support Systems for Drug Allergy Checking: Systematic Review
Conclusions: Accurate and comprehensive recording of drug allergies is required for good use of CDSS for drug allergy screening. We found considerable variation in the way drug allergy are recorded in EHRs. It remains difficult to reduce drug allergy alert overload while maintaining patient safety as the highest priority. Future research should focus on improving alert specificity, thereby reducing override rates and alert fatigue. Also, the effect on patient outcomes and cost-effectiveness should be evaluated. (Source: Journal of Medical Internet Research)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2oOXdfP
Transient and asymptomatic meningitis in human immunodeficiency virus-1 subtype C: a case study of genetic compartmentalization and biomarker dynamics
This report describes a patient with HIV subtype C who developed a transient episode of asymptomatic HIV meningitis with compartmentalization of HIV in the CSF that resolved independently of ARV therapy. Extensive CSF studies were performed as part of an ongoing longitudinal study, which revealed CNS immune abnormalities. This case presents evidence of HIV-1 subtype C neurotropism and compartmentalization. (Source: Journal of NeuroVirology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Cxo7Tm
Comparison of patient characteristics, clinical management, infectious specialist consultation, and outcome in men and women with methicillin-sensitive Staphylococcus aureus bacteremia: a propensity-score adjusted retrospective study
ConclusionPatient characteristics, clinical management, ISC guidance, bacteremia relapse, and outcome did not differ in men and women with MS-SAB. (Source: Infection)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2oN6dCe
Varicella-zoster virus CNS vasculitis and RNA polymerase III gene mutation in identical twins
Conclusions Altogether, these cases add genetic and immunologic evidence to the novel association between defects in sensing of AT-rich DNA present in the VZV genome and increased susceptibility to severe manifestations of VZV infection in the CNS in humans. (Source: Neurology Neuroimmunology and Neuroinflammation)
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CylpwV
Clinical Decision Support Systems for Drug Allergy Checking: Systematic Review
Conclusions: Accurate and comprehensive recording of drug allergies is required for good use of CDSS for drug allergy screening. We found considerable variation in the way drug allergy are recorded in EHRs. It remains difficult to reduce drug allergy alert overload while maintaining patient safety as the highest priority. Future research should focus on improving alert specificity, thereby reducing override rates and alert fatigue. Also, the effect on patient outcomes and cost-effectiveness should be evaluated. (Source: Journal of Medical Internet Research)
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The accuracy of virtual-surgical-planning-assisted treatment of hemifacial microsomia in adult patients: distraction osteogenesis vs. orthognathic surgery
Hemifacial microsomia (HFM) is a common congenital craniofacial deformity with a high prevalence. Orthognathic surgery and distraction osteogenesis are two conventionally used treatments of HFM. The main objective of this retrospective study was to evaluate the accuracy of two treatments with the help of virtual surgical planning in adult HFM patients. Sixty-eight adult patients with unilateral HFM were enrolled in this study. Preoperative surgical planning and simulation were performed on three-dimensional computed tomography models. (Source: International Journal of Oral and Maxillofacial Surgery)
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The accuracy of virtual-surgical-planning-assisted treatment of hemifacial microsomia in adult patients: distraction osteogenesis vs. orthognathic surgery
Hemifacial microsomia (HFM) is a common congenital craniofacial deformity with a high prevalence. Orthognathic surgery and distraction osteogenesis are two conventionally used treatments of HFM. The main objective of this retrospective study was to evaluate the accuracy of two treatments with the help of virtual surgical planning in adult HFM patients. Sixty-eight adult patients with unilateral HFM were enrolled in this study. Preoperative surgical planning and simulation were performed on three-dimensional computed tomography models. (Source: International Journal of Oral and Maxillofacial Surgery)
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Strategies for an HIV Cure 2018 (Day 2)
The Division of AIDS (DAIDS) at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), is sponsoring a program-driven meeting focused on the development of innovative strategies to cure HIV infection. The meeting will cover a comprehensive range of topics spanning basic and translational research, drug discovery and development, and clinical research. The purpose of this meeting is to bring together researchers studying HIV persistence and cure strategies, including the NIH-funded Martin Delaney Collaboratories, investigators in complementary disciplines, and community members, to share scientific results and engage in active discussion about the merits of various approaches under investigation. These discussions are intended to stimulate ne...
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Strategies for an HIV Cure 2018 (Day 3)
The Division of AIDS (DAIDS) at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), is sponsoring a program-driven meeting focused on the development of innovative strategies to cure HIV infection. The meeting will cover a comprehensive range of topics spanning basic and translational research, drug discovery and development, and clinical research. The purpose of this meeting is to bring together researchers studying HIV persistence and cure strategies, including the NIH-funded Martin Delaney Collaboratories, investigators in complementary disciplines, and community members, to share scientific results and engage in active discussion about the merits of various approaches under investigation. These discussions are intended to stimulate ne...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O0dee9
Strategies for an HIV Cure 2018 (Day 2)
The Division of AIDS (DAIDS) at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), is sponsoring a program-driven meeting focused on the development of innovative strategies to cure HIV infection. The meeting will cover a comprehensive range of topics spanning basic and translational research, drug discovery and development, and clinical research. The purpose of this meeting is to bring together researchers studying HIV persistence and cure strategies, including the NIH-funded Martin Delaney Collaboratories, investigators in complementary disciplines, and community members, to share scientific results and engage in active discussion about the merits of various approaches under investigation. These discussions are intended to stimulate ne...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Nw44bY
Strategies for an HIV Cure 2018 (Day 3)
The Division of AIDS (DAIDS) at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), is sponsoring a program-driven meeting focused on the development of innovative strategies to cure HIV infection. The meeting will cover a comprehensive range of topics spanning basic and translational research, drug discovery and development, and clinical research. The purpose of this meeting is to bring together researchers studying HIV persistence and cure strategies, including the NIH-funded Martin Delaney Collaboratories, investigators in complementary disciplines, and community members, to share scientific results and engage in active discussion about the merits of various approaches under investigation. These discussions are intended to stimulate ne...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O0dee9
Metabonomics delineates allergic reactions induced by Shuang-huang-lian injection in rats using ultra performance liquid chromatography-mass spectrometry
Publication date: August 2018Source: Chinese Journal of Natural Medicines, Volume 16, Issue 8Author(s): Yuan-Yuan GU, Lang SHI, Dan-Dan ZHANG, Xin HUANG, Da-Zhong CHENAbstractShuang-huang-lian Injection (SHLI) is the first successfully developed drug from traditional Chinese medicine (TCM) powder for injection, since its use for the treatment of acute respiratory tract infection, pneumonia, influenza, etc. At the same time, its allergic reactions have also emerged, which limits clinical applications. However, few scholars pay attention to the mechanism of allergic reactions. In this present study, metabonomics technology was used to explore the changes in endogenous metabolites in urine of the rat model of SHLI induced allergic reaction; we and analyzed the metabolites, metabolic pathway, ...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wTofqh
Assessing the Role of DNA Methylation-Derived Neutrophil-to-Lymphocyte Ratio in Rheumatoid Arthritis.
Authors: Ambatipudi S, Sharp GC, Clarke SLN, Plant D, Tobias JH, Evans DM, Barton A, Relton CL Abstract Rheumatoid arthritis (RA) is a disease of chronic systemic inflammation (SI). In the present study, we used four datasets to explore whether methylation-derived neutrophil-to-lymphocyte ratio (mdNLR) might be a marker of SI in new onset, untreated, and treated prevalent RA cases and/or a marker of treatment response to the tumour necrosis factor inhibitor (TNFi) etanercept. mdNLR was associated with increased odds of being a new onset RA case (OR = 2.32, 95% CI = 1.95-2.80, P < 2 × 10-16) and performed better in distinguishing new onset RA cases from controls compared to covariates: age, gender, and smoking status. In untreated preclinical RA cases and controls, mdNLR...
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Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010.
Conclusions: This is the first report that the frequency of hospitalized infection significantly decreased when the patients were treated with a bDMARD or tsDMARD after 2010. Our results indicate that the updated announcement of diagnosis and treatment criteria might contribute to a reduced risk of hospitalized infection and a better understanding of the use of bDMARDs/tsDMARDs by rheumatologists. PMID: 30186881 [PubMed - in process] (Source: Journal of Immunology Research)
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Effects of Systemic Simvastatin on the Concentrations of Visfatin, Tumor Necrosis Factor- α, and Interleukin-6 in Gingival Crevicular Fluid in Patients with Type 2 Diabetes and Chronic Periodontitis.
Conclusion: Periodontal destruction and diabetes have a synergistic effect on the elevation of inflammatory cytokine levels. Simvastatin may be beneficial in improving periodontal health among diabetic patients. PMID: 30186882 [PubMed - in process] (Source: Journal of Immunology Research)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wVXSje
Expression of the Vesicular Monoamine Transporter Gene Solute Carrier Family 18 Member 1 (SLC18A1) in Lung Cancer
Conclusion: Most never-smokers with lung cancer do not respond to immune checkpoint inhibitors (ICIs). But for unknown reasons, a small proportion do show clinical benefit from the ICI pembrolizumab. Because of the good response of this group, it may be worthwhile assessing their SLC18A1 expression pre-treatment as a marker for potential clinical benefit. If SLC18A1 expression is low, a never-smoker may respond well to ICIs. High levels of expression would indicate a C5 tumor less likely to respond to ICIs. SLC18A1 might complement other biomarkers currently under study in relation to programmed cell death protein 1/programmed cell death protein ligand 1 inhibition. (Source: Cancer Genomics and Proteomics)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wQwHHg
Metabonomics delineates allergic reactions induced by Shuang-huang-lian injection in rats using ultra performance liquid chromatography-mass spectrometry
Publication date: August 2018Source: Chinese Journal of Natural Medicines, Volume 16, Issue 8Author(s): Yuan-Yuan GU, Lang SHI, Dan-Dan ZHANG, Xin HUANG, Da-Zhong CHENAbstractShuang-huang-lian Injection (SHLI) is the first successfully developed drug from traditional Chinese medicine (TCM) powder for injection, since its use for the treatment of acute respiratory tract infection, pneumonia, influenza, etc. At the same time, its allergic reactions have also emerged, which limits clinical applications. However, few scholars pay attention to the mechanism of allergic reactions. In this present study, metabonomics technology was used to explore the changes in endogenous metabolites in urine of the rat model of SHLI induced allergic reaction; we and analyzed the metabolites, metabolic pathway, ...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wTofqh
Assessing the Role of DNA Methylation-Derived Neutrophil-to-Lymphocyte Ratio in Rheumatoid Arthritis.
Authors: Ambatipudi S, Sharp GC, Clarke SLN, Plant D, Tobias JH, Evans DM, Barton A, Relton CL Abstract Rheumatoid arthritis (RA) is a disease of chronic systemic inflammation (SI). In the present study, we used four datasets to explore whether methylation-derived neutrophil-to-lymphocyte ratio (mdNLR) might be a marker of SI in new onset, untreated, and treated prevalent RA cases and/or a marker of treatment response to the tumour necrosis factor inhibitor (TNFi) etanercept. mdNLR was associated with increased odds of being a new onset RA case (OR = 2.32, 95% CI = 1.95-2.80, P < 2 × 10-16) and performed better in distinguishing new onset RA cases from controls compared to covariates: age, gender, and smoking status. In untreated preclinical RA cases and controls, mdNLR...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wNZVqv
Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010.
Conclusions: This is the first report that the frequency of hospitalized infection significantly decreased when the patients were treated with a bDMARD or tsDMARD after 2010. Our results indicate that the updated announcement of diagnosis and treatment criteria might contribute to a reduced risk of hospitalized infection and a better understanding of the use of bDMARDs/tsDMARDs by rheumatologists. PMID: 30186881 [PubMed - in process] (Source: Journal of Immunology Research)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wPCYCs
Effects of Systemic Simvastatin on the Concentrations of Visfatin, Tumor Necrosis Factor- α, and Interleukin-6 in Gingival Crevicular Fluid in Patients with Type 2 Diabetes and Chronic Periodontitis.
Conclusion: Periodontal destruction and diabetes have a synergistic effect on the elevation of inflammatory cytokine levels. Simvastatin may be beneficial in improving periodontal health among diabetic patients. PMID: 30186882 [PubMed - in process] (Source: Journal of Immunology Research)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wVXSje
Expression of the Vesicular Monoamine Transporter Gene Solute Carrier Family 18 Member 1 (SLC18A1) in Lung Cancer
Conclusion: Most never-smokers with lung cancer do not respond to immune checkpoint inhibitors (ICIs). But for unknown reasons, a small proportion do show clinical benefit from the ICI pembrolizumab. Because of the good response of this group, it may be worthwhile assessing their SLC18A1 expression pre-treatment as a marker for potential clinical benefit. If SLC18A1 expression is low, a never-smoker may respond well to ICIs. High levels of expression would indicate a C5 tumor less likely to respond to ICIs. SLC18A1 might complement other biomarkers currently under study in relation to programmed cell death protein 1/programmed cell death protein ligand 1 inhibition. (Source: Cancer Genomics and Proteomics)
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Sharp Drop in Portable Oxygen Access Blamed on Provider Pay Changes
(MedPage Today) -- Lung groups call on CMS to abandon competitive bidding (Source: MedPage Today Allergy)
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Home-Based Program Improves Asthma Control in African-American Youth Home-Based Program Improves Asthma Control in African-American Youth
A community-based intervention significantly improved lung function in African-American adolescents with poorly controlled asthma in a randomized controlled trial.Reuters Health Information (Source: Medscape Allergy Headlines)
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Sharp Drop in Portable Oxygen Access Blamed on Provider Pay Changes
(MedPage Today) -- Lung groups call on CMS to abandon competitive bidding (Source: MedPage Today Allergy)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qdnjpl
Home-Based Program Improves Asthma Control in African-American Youth Home-Based Program Improves Asthma Control in African-American Youth
A community-based intervention significantly improved lung function in African-American adolescents with poorly controlled asthma in a randomized controlled trial.Reuters Health Information (Source: Medscape Allergy Headlines)
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Maintaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial
Abstract
Background
Inadvertent intraoperative hypothermia (core temperature < 36 °C) is a common but preventable adverse event. This study aimed to determine whether active intraoperative warming reduced bleeding in patients undergoing major operations: open thoracic surgery and hip replacement surgery.
Methods/Design
The study was a pilot, prospective, parallel two-arm randomized controlled trial. Eligible patients were randomly allocated to two groups: passive warming (PW), with application of a cotton blanket (thermal insulation), or active warming (AW), with a forced-air warming system. The primary endpoint was intraoperative blood loss, and secondary endpoints were surgical-site infection, cardiovascular events, and length of stay in the post-anesthesia care unit, intensive care unit, and hospital.
Results
Sixty-two patients were enrolled. Forced-air active warming maintained intraoperative normothermia in all AW subjects, whereas intraoperative hypothermia occurred in 21/32 (71.8%) of PW patients (p = 0.000). The volume of blood loss was more in the PW group (682 ± 426 ml) than in the AW group (464 ± 324 ml) (p < 0.021), and the perioperative hemoglobin value declined more in the PW group (28.6 ± 17.5 g/L) than in the AW group (21.0 ± 9.9 g/L) (p = 0.045). However, there were no difference in other clinical outcomes between two groups.
Conclusion
Intraoperative active warming is associated with less blood loss than passive warming in open thoracic and hip replacement operations in this pilot study.
Trial registration
This trial was registered with Clinicaltrials.gov (Identifier: NCT02214524) on 27 August 2014.
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Maintaining intraoperative normothermia reduces blood loss in patients undergoing major operations: a pilot randomized controlled clinical trial
Abstract
Background
Inadvertent intraoperative hypothermia (core temperature < 36 °C) is a common but preventable adverse event. This study aimed to determine whether active intraoperative warming reduced bleeding in patients undergoing major operations: open thoracic surgery and hip replacement surgery.
Methods/Design
The study was a pilot, prospective, parallel two-arm randomized controlled trial. Eligible patients were randomly allocated to two groups: passive warming (PW), with application of a cotton blanket (thermal insulation), or active warming (AW), with a forced-air warming system. The primary endpoint was intraoperative blood loss, and secondary endpoints were surgical-site infection, cardiovascular events, and length of stay in the post-anesthesia care unit, intensive care unit, and hospital.
Results
Sixty-two patients were enrolled. Forced-air active warming maintained intraoperative normothermia in all AW subjects, whereas intraoperative hypothermia occurred in 21/32 (71.8%) of PW patients (p = 0.000). The volume of blood loss was more in the PW group (682 ± 426 ml) than in the AW group (464 ± 324 ml) (p < 0.021), and the perioperative hemoglobin value declined more in the PW group (28.6 ± 17.5 g/L) than in the AW group (21.0 ± 9.9 g/L) (p = 0.045). However, there were no difference in other clinical outcomes between two groups.
Conclusion
Intraoperative active warming is associated with less blood loss than passive warming in open thoracic and hip replacement operations in this pilot study.
Trial registration
This trial was registered with Clinicaltrials.gov (Identifier: NCT02214524) on 27 August 2014.
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Variation in the Untranslated Genome and Susceptibility to Infections
Veron Ramsuran, Rodger Ewy, Hoang Nguyen, Smita Kulkarni (Source: Frontiers in Immunology)
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A Patch Testing Initiative for the Investigation of Allergic Contact Dermatitis in a UK Allergy Practice: A Retrospective Study
ConclusionACD was detected in almost 50% of assessed patients and we highlight the importance of assessing relevance. Hydroperoxides of limonene and linalool are notable additions to the prevalence data. Patch testing should be incorporated into more allergy practices, although availability of training is a limiting factor. (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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Implementing Health Care Technology Research into Practice to Improve Adult Asthma Management
Publication date: Available online 7 September 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Peter J. Cvietusa, Glenn K. Goodrich, Jo Ann Shoup, David A. Steffen, Cathy Tacinas, Nicole M. Wagner, Courtney B. Anderson, Debra P. Ritzwoller, Bruce G. Bender (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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B Cells from patients with multiple sclerosis have a pathogenic phenotype and increased LT α and TGFβ1 response
The contribution of B cells to the pathogenesis of relapsing-remitting multiple sclerosis (RRMS) is currently of great interest due to the positive outcomes of treatment with B cell-depleting monoclonal antibodies. In this exploratory study we examined the phenotype and cytokine response of B cells from untreated patients with RRMS and healthy controls.The CNS migration potential of the individual blood B cell subpopulations was evaluated according to the expression of CD49d, ALCAM, CXCR3, and CCR7, and cerebrospinal fluid (CSF) samples were analyzed to establish the phenotype of migrated B cells. (Source: Journal of Neuroimmunology)
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Review: the Role and Mechanisms of Macrophage Autophagy in Sepsis
AbstractSepsis is a systemic inflammatory response syndrome caused by infection. The core mechanism underlying sepsis is immune dysfunction, with macrophages, as important cells of the innate immune system, playing an essential role. Autophagy has been shown to be closely related to inflammation and immunity, and autophagy enhancement in sepsis can play a protective role by negatively regulating abnormal macrophage activation, modulating macrophage polarization phenotype, reducing activation of the inflammasome and release of inflammatory factors, and affecting macrophage apoptosis. However, excessive autophagy may also lead to autophagic death of macrophages, which further aggravates the inflammatory response. The mechanisms underlying these functions are relatively complex and remain unc...
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An admixture mapping meta-analysis implicates genetic variation at 18q21 with asthma susceptibility in Latinos
Asthma is a common but complex disease with racial/ethnic differences in prevalence, morbidity, and response to therapies. (Source: Journal of Allergy and Clinical Immunology)
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The IgE Memory Reservoir in Food Allergy
(Source: Journal of Allergy and Clinical Immunology)
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Sharp Drop in Portable Oxygen Access Blamed on Provider Pay Changes
(MedPage Today) -- Lung groups call on CMS to abandon competitive bidding (Source: MedPage Today Allergy)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qdnjpl
Home-Based Program Improves Asthma Control in African-American Youth Home-Based Program Improves Asthma Control in African-American Youth
A community-based intervention significantly improved lung function in African-American adolescents with poorly controlled asthma in a randomized controlled trial.Reuters Health Information (Source: Medscape Allergy Headlines)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Mbt6c1
Variation in the Untranslated Genome and Susceptibility to Infections
Veron Ramsuran, Rodger Ewy, Hoang Nguyen, Smita Kulkarni (Source: Frontiers in Immunology)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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