Πέμπτη 27 Σεπτεμβρίου 2018
43rd National AOMSI Conference
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43rd National AOMSI Conference
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xZh0O6
Pharmacokinetics of evocalcet in secondary hyperparathyroidism patients receiving hemodialysis: first-in-patient clinical trial in Japan.
Conclusion: Evocalcet is effective in the short term, has linear pharmacokinetics, and is well tolerated as observed by the low incidence of AEs. PMID: 30254496 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)
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Effect of DACH1 on proliferation and invasion of laryngeal squamous cell carcinoma
To investigate the effect of DACH1 over-expression on proliferation and invasion of laryngeal squamous cell carcinoma (LSCC).
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Pharmacokinetics of evocalcet in secondary hyperparathyroidism patients receiving hemodialysis: first-in-patient clinical trial in Japan.
Conclusion: Evocalcet is effective in the short term, has linear pharmacokinetics, and is well tolerated as observed by the low incidence of AEs. PMID: 30254496 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)
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Effect of DACH1 on proliferation and invasion of laryngeal squamous cell carcinoma
To investigate the effect of DACH1 over-expression on proliferation and invasion of laryngeal squamous cell carcinoma (LSCC).
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Flare-Up Phenomenon of Intradermal Test with Anaphylactic Reaction to Paracetamol (Acetaminophen).
CONCLUSION: We present an anaphylactic shock due to sensitization to paracetamol because of a type I hypersensitivity mechanism, diagnosed by SBOCT and a positive IDT because of flare-up phenomenon, in a patient with previous pyrazolones allergy and with tolerance to other NSAIDs. Some relevant patents are also summarized in this paper. PMID: 30255762 [PubMed - as supplied by publisher] (Source: Recent Patents on Inflammation and Allergy Drug Discovery)
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Flare-Up Phenomenon of Intradermal Test with Anaphylactic Reaction to Paracetamol (Acetaminophen).
CONCLUSION: We present an anaphylactic shock due to sensitization to paracetamol because of a type I hypersensitivity mechanism, diagnosed by SBOCT and a positive IDT because of flare-up phenomenon, in a patient with previous pyrazolones allergy and with tolerance to other NSAIDs. Some relevant patents are also summarized in this paper. PMID: 30255762 [PubMed - as supplied by publisher] (Source: Recent Patents on Inflammation and Allergy Drug Discovery)
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Short Call Abstracts
Thyroid, Volume 28, Issue S1, Page A-169-A-198, October 2018.
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Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
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Short Call Abstracts
Thyroid, Volume 28, Issue S1, Page A-169-A-198, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeTG6q
Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R2DUwy
Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R2DUwy
Short Call Abstracts
Thyroid, Volume 28, Issue S1, Page A-169-A-198, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QeTG6q
Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R2DUwy
Short Call Abstracts
Thyroid, Volume 28, Issue S1, Page A-169-A-198, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Olg00L
Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N6jQGr
Detection of Leukocortical Lesions in Multiple Sclerosis and Their Association with Physical and Cognitive Impairment: A Comparison of Conventional and Synthetic Phase-Sensitive Inversion Recovery MRI [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Cortical lesions are common in multiple sclerosis and are included in the latest diagnostic criteria. The limited sensitivity of cortical MS lesions on conventional MR imaging can be improved by phase-sensitive inversion recovery. Synthetic MR imaging could provide phase-sensitive inversion recovery without additional scanning, but the use of synthetic phase-sensitive inversion recovery remains to be validated. We aimed to compare the ability and clinical value of detecting leukocortical lesions with conventional and synthetic phase-sensitive inversion recovery in MS.
MATERIALS AND METHODS:Twenty-one patients with MS prospectively underwent conventional and synthetic phase-sensitive inversion recovery, 3D T1-weighted, and T2 FLAIR imaging. Two neuroradiologists independently performed blinded phase-sensitive inversion recovery lesion assessments; a consensus rating with all sequences was considered the criterion standard. Lesion volumes were segmented. All participants underwent standardized cognitive and physical examinations and Fatigue Severity Scale assessment. Results were analyzed with multiple linear regressions.
RESULTS:Interrater and criterion standard agreement for leukocortical lesions was excellent for both conventional and synthetic phase-sensitive inversion recovery (intraclass correlation coefficient = 0.79–0.97). Leukocortical lesion volumes for both sequences were associated with lower information-processing speed (P ≤ .01) and verbal fluency (P ≤ .02). Both phase-sensitive inversion recovery sequences showed a positive effect on the association when combining volumes of leukocortical lesions and white matter lesions with information-processing speed (P ≤ .005) and verbal fluency (P ≤ .03). No associations were found between leukocortical lesion volumes and physical disability or fatigue.
CONCLUSIONS:Synthetic and conventional phase-sensitive inversion recovery have a sensitivity similar to that of leukocortical MS lesions. The detected leukocortical lesions are associated with cognitive dysfunction and thus provide clinically relevant information, which encourages assessment of cortical MS involvement at conventional field strengths.
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Vessel Wall MRI for Targeting Biopsies of Intracranial Vasculitis [ADULT BRAIN]
SUMMARY:
Central nervous system vasculitides are elusive diseases that are challenging to diagnose because brain biopsies have high false-negative rates. We sought to test the ability of contrast-enhanced, high-resolution 3D vessel wall MR imaging to identify vascular inflammation and direct open biopsies of intracranial target vessels and adjacent brain parenchyma. Eight of 9 specimens revealed vascular inflammation. We conclude that vessel wall MR imaging can identify inflamed intracranial vessels, enabling precise localization of biopsy targets.
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Low Wall Shear Stress Is Associated with Local Aneurysm Wall Enhancement on High-Resolution MR Vessel Wall Imaging [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Some retrospective studies have found that the aneurysm wall enhancement on high-resolution MR vessel wall postgadolinium T1WI has the potential to distinguish unstable aneurysms. This study aimed to identify hemodynamic characteristics that differ between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.
MATERIALS AND METHODS:TOF-MRA and high-resolution MR vessel wall T1WI of 25 patients were fused to localize the enhanced area of the aneurysm wall. Using computational fluid dynamics, we studied the aneurysm models. Mean static pressure, mean wall shear stress, and oscillatory shear index were compared between the enhanced and nonenhanced areas.
RESULTS:The aneurysmal enhanced area had lower wall shear stress (P < .05) and a lower oscillatory shear index (P = .021) than the nonenhanced area. In addition, the whole aneurysm had lower wall shear stress (P < .05) and a higher oscillatory shear index (P = .007) than the parent artery.
CONCLUSIONS:This study suggests that there are hemodynamic differences between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.
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Corticopallidal Connectome of the Globus Pallidus Externus in Humans: An Exploratory Study of Structural Connectivity Using Probabilistic Diffusion Tractography [FUNCTIONAL]
BACKGROUND AND PURPOSE:
Electrophysiologic abnormalities of the globus pallidus externus have been shown in several disease processes including Parkinson disease, dystonia, and Huntington disease. However, the connectivity, nuclear structure, and function of the globus pallidus externus are still not well-understood. Increasing evidence for the existence of direct corticopallidal connections challenges traditional understanding of the connectivity of the globus pallidus externus; nevertheless, these corticopallidal connections have yet to be fully characterized in humans. The objective of this study was to assess the corticopallidal connections of the globus pallidus externus by means of probabilistic diffusion-weighted MR imaging tractography using high-resolution, multishell data.
MATERIALS AND METHODS:Imaging data from the open-access Human Connectome Project data base were used to perform probabilistic tractography between the globus pallidus externus and the cerebral cortex using 34 distinct cortical regions. Group averages were calculated for normalized percentages of tracts reaching each of the cortical targets, and side-to-side comparison was made.
RESULTS:Cortical connectivity was demonstrated between the globus pallidus externus and multiple cortical regions, including direct connection to putative sensorimotor, associative, and limbic areas. Connectivity patterns were not significantly different between the right and left hemispheres with the exception of the frontal pole, which showed a greater number of connections on the right (P = .004).
CONCLUSIONS:Our in vivo study of the human globus pallidus externus using probabilistic tractography supports the existence of extensive corticopallidal connections and a tripartite functional division, as found in animal studies. A better understanding of the connectivity of the globus pallidus externus may help to understand its function and elucidate the effects of programming the higher contacts in pallidal deep brain stimulation.
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Expanding the Distinctive Neuroimaging Phenotype of ACTA2 Mutations [PEDIATRICS]
BACKGROUND AND PURPOSE:
Arg179His mutations in ACTA2 are associated with a distinctive neurovascular phenotype characterized by a straight course of intracranial arteries, absent basal Moyamoya collaterals, dilation of the proximal internal carotid arteries, and occlusive disease of the terminal internal carotid arteries. We now add to the distinctive neuroimaging features in these patients by describing their unique constellation of brain malformative findings that could flag the diagnosis in cases in which targeted cerebrovascular imaging has not been performed.
MATERIALS AND METHODS:Neuroimaging studies from 13 patients with heterozygous Arg179His mutations in ACTA2 and 1 patient with pathognomonic clinicoradiologic findings for ACTA2 mutation were retrospectively reviewed. The presence and localization of brain malformations and other abnormal brain MR imaging findings are reported.
RESULTS:Characteristics bending and hypoplasia of the anterior corpus callosum, apparent absence of the anterior gyrus cinguli, and radial frontal gyration were present in 100% of the patients; flattening of the pons on the midline and multiple indentations in the lateral surface of the pons were demonstrated in 93% of the patients; and apparent "squeezing" of the cerebral peduncles in 85% of the patients.
CONCLUSIONS:Because α-actin is not expressed in the brain parenchyma, only in vascular tissue, we speculate that rather than a true malformative process, these findings represent a deformation of the brain during development related to the mechanical interaction with rigid arteries during the embryogenesis.
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Usefulness of Vessel Wall MR Imaging for Follow-Up after Stent-Assisted Coil Embolization of Intracranial Aneurysms [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Follow-up with MRA for intracranial aneurysms after stent-assisted coiling is complicated by imaging artifacts. We evaluated the usefulness of an alternative method: vessel wall MR imaging.
MATERIALS AND METHODS:We conducted a single-center, retrospective review of medical records of 47 patients who underwent 3D TOF-MRA, vessel wall MRI, and DSA after stent-assisted coiling between March 2016 and January 2018. We evaluated the mean value of the signal intensity in the stented artery and the contralateral normal artery on vessel wall MRI. The quality of visualization was further compared between TOF-MRA and vessel wall MRI. Furthermore, we evaluated the diagnostic accuracy and concordance rate of TOF-MRA and vessel wall MRI for assessing the patency of the stented parent artery. DSA was used as a reference test.
RESULTS:The mean signal intensities of the stented and normal arteries on vessel wall MRI were not significantly different (P = .133). The mean scores for the visualization of the stented parent artery on vessel wall MRI were significantly superior to those of TOF-MRA images (P < .001). Vessel wall MRI reached an excellent positive predictive value (100%). However, TOF-MRA had a poor positive predictive value (11%; 95% CI, 9%–12%). The likelihood ratios of vessel wall MRI and TOF-MRA were 27.36 (P < .001) and 2.98 (P = .225), respectively. The concordance rate of vessel wall MRI and TOF-MRA with DSA for evaluating the state of the stented artery was 100% ( = 1) and 28% ( = 0.038), respectively.
CONCLUSIONS:Vessel wall MRI may be useful in evaluating the patency of stented arteries after stent-assisted coil embolization for intracranial aneurysms.
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Characteristics of MR Neuroimaging Services Billed by Radiologists versus Nonradiologists [PRACTICE PERSPECTIVES]
BACKGROUND AND PURPOSE:
Although most neuroimaging examinations are interpreted by radiologists, many nonradiologists provide interpretation services. We studied day of the week, site of service, and patient complexity differences for common Medicare MR neuroimaging examinations interpreted by radiologists versus nonradiologists.
MATERIALS AND METHODS:Using carrier claims files for a 5% sample of Medicare beneficiaries from 2012 to 2014, we identified all claims for brain and lumbar spine MR imaging examinations. Services were categorized by physician specialty, day of the week, and the site of service. Patient complexity was calculated using Charlson Comorbidity Indices. The 2 was performed to test statistical significance.
RESULTS:A provider specialty could be identified for 568,423 brain and lumbar spine MR imaging examinations. Of weekday examinations, radiologists interpreted 475,288 (92.3%), and nonradiologists, 39,510 (7.7%). Of weekend examinations, radiologists interpreted 52,028 (97.0%) and nonradiologists 1597 (3.0%). Radiologists interpreted 145,904 (98.7%) examinations in the inpatient hospital and emergency department settings versus 1882 (1.3%) by nonradiologists. Of all examinations, 44,547 of those interpreted by radiologists (8.4%) were on the most clinically complex patients versus 2139 (5.2%) for nonradiologists. All interspecialty differences for day of the week, the site of service, and patient complexity were statistically significant (P < .001).
CONCLUSIONS:Although radiologists interpret most common MR neuroimaging examinations for Medicare beneficiaries, in contrast to nonradiologists, they disproportionately render those services on weekends, in higher acuity sites, and on more complex patients. To optimize access and minimize disparities in necessary neuroimaging, quality metrics should consider such service characteristics.
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MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography [SPINE]
BACKGROUND AND PURPOSE:
MR neurography enables high resolution imaging of peripheral nerves. Our aim was to evaluate the utility of MR neurography in lumbosacral radiculopathy and correlate abnormal intraneural signal with history, physical examination, and abnormal electrodiagnostic study findings.
MATERIALS AND METHODS:Retrospective review of lumbosacral MR neurography examinations performed from December 2014 through January 2017 on a 3T scanner was undertaken. MR neurography examinations were independently reviewed in a blinded fashion by 2 radiologists, and the intraneural signal was graded on a 0–2 scale relative to adjacent vasculature. Abnormal nerve signal was correlated with subjective and objective findings from clinical notes in the electronic medical record and compared with results of electrodiagnostic studies (nerve conduction study/electromyography).
RESULTS:Three hundred three lumbosacral MR neurography examinations were performed during the study period, 64 of which met the inclusion criteria, including symptoms of radiculopathy on electromyography performed within 3 months of MR neurography. Twenty-nine (45%) MR neurography examinations had abnormal intraneural signal. There was no statistically significant correlation between subjective clinical findings and intraneural signal abnormality on MR neurography. There was a statistically significant correlation between abnormal intraneural T2 signal and findings of active radiculopathy on electromyography (P < .001).
CONCLUSIONS:Lumbosacral MR neurography appears to demonstrate abnormal intraneural signal in a substantial portion of patients with clinical symptoms of lower extremity radiculopathy and correlates with findings of active radiculopathy on electromyography. This finding further bolsters the growing body of evidence on the utility of MR neurography and suggests that abnormal intraneural signal may provide a useful adjunct to electrodiagnostic testing. Further research is required to evaluate the prognostic value of MR neurography, which may help guide therapeutic decision-making.
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Detection of Leukocortical Lesions in Multiple Sclerosis and Their Association with Physical and Cognitive Impairment: A Comparison of Conventional and Synthetic Phase-Sensitive Inversion Recovery MRI [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Cortical lesions are common in multiple sclerosis and are included in the latest diagnostic criteria. The limited sensitivity of cortical MS lesions on conventional MR imaging can be improved by phase-sensitive inversion recovery. Synthetic MR imaging could provide phase-sensitive inversion recovery without additional scanning, but the use of synthetic phase-sensitive inversion recovery remains to be validated. We aimed to compare the ability and clinical value of detecting leukocortical lesions with conventional and synthetic phase-sensitive inversion recovery in MS.
MATERIALS AND METHODS:Twenty-one patients with MS prospectively underwent conventional and synthetic phase-sensitive inversion recovery, 3D T1-weighted, and T2 FLAIR imaging. Two neuroradiologists independently performed blinded phase-sensitive inversion recovery lesion assessments; a consensus rating with all sequences was considered the criterion standard. Lesion volumes were segmented. All participants underwent standardized cognitive and physical examinations and Fatigue Severity Scale assessment. Results were analyzed with multiple linear regressions.
RESULTS:Interrater and criterion standard agreement for leukocortical lesions was excellent for both conventional and synthetic phase-sensitive inversion recovery (intraclass correlation coefficient = 0.79–0.97). Leukocortical lesion volumes for both sequences were associated with lower information-processing speed (P ≤ .01) and verbal fluency (P ≤ .02). Both phase-sensitive inversion recovery sequences showed a positive effect on the association when combining volumes of leukocortical lesions and white matter lesions with information-processing speed (P ≤ .005) and verbal fluency (P ≤ .03). No associations were found between leukocortical lesion volumes and physical disability or fatigue.
CONCLUSIONS:Synthetic and conventional phase-sensitive inversion recovery have a sensitivity similar to that of leukocortical MS lesions. The detected leukocortical lesions are associated with cognitive dysfunction and thus provide clinically relevant information, which encourages assessment of cortical MS involvement at conventional field strengths.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xVhULf
Vessel Wall MRI for Targeting Biopsies of Intracranial Vasculitis [ADULT BRAIN]
SUMMARY:
Central nervous system vasculitides are elusive diseases that are challenging to diagnose because brain biopsies have high false-negative rates. We sought to test the ability of contrast-enhanced, high-resolution 3D vessel wall MR imaging to identify vascular inflammation and direct open biopsies of intracranial target vessels and adjacent brain parenchyma. Eight of 9 specimens revealed vascular inflammation. We conclude that vessel wall MR imaging can identify inflamed intracranial vessels, enabling precise localization of biopsy targets.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xHeBbw
Low Wall Shear Stress Is Associated with Local Aneurysm Wall Enhancement on High-Resolution MR Vessel Wall Imaging [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Some retrospective studies have found that the aneurysm wall enhancement on high-resolution MR vessel wall postgadolinium T1WI has the potential to distinguish unstable aneurysms. This study aimed to identify hemodynamic characteristics that differ between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.
MATERIALS AND METHODS:TOF-MRA and high-resolution MR vessel wall T1WI of 25 patients were fused to localize the enhanced area of the aneurysm wall. Using computational fluid dynamics, we studied the aneurysm models. Mean static pressure, mean wall shear stress, and oscillatory shear index were compared between the enhanced and nonenhanced areas.
RESULTS:The aneurysmal enhanced area had lower wall shear stress (P < .05) and a lower oscillatory shear index (P = .021) than the nonenhanced area. In addition, the whole aneurysm had lower wall shear stress (P < .05) and a higher oscillatory shear index (P = .007) than the parent artery.
CONCLUSIONS:This study suggests that there are hemodynamic differences between the enhanced and nonenhanced areas of the aneurysm wall on high-resolution MR vessel wall postgadolinium T1WI.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xVQt4d
Expanding the Distinctive Neuroimaging Phenotype of ACTA2 Mutations [PEDIATRICS]
BACKGROUND AND PURPOSE:
Arg179His mutations in ACTA2 are associated with a distinctive neurovascular phenotype characterized by a straight course of intracranial arteries, absent basal Moyamoya collaterals, dilation of the proximal internal carotid arteries, and occlusive disease of the terminal internal carotid arteries. We now add to the distinctive neuroimaging features in these patients by describing their unique constellation of brain malformative findings that could flag the diagnosis in cases in which targeted cerebrovascular imaging has not been performed.
MATERIALS AND METHODS:Neuroimaging studies from 13 patients with heterozygous Arg179His mutations in ACTA2 and 1 patient with pathognomonic clinicoradiologic findings for ACTA2 mutation were retrospectively reviewed. The presence and localization of brain malformations and other abnormal brain MR imaging findings are reported.
RESULTS:Characteristics bending and hypoplasia of the anterior corpus callosum, apparent absence of the anterior gyrus cinguli, and radial frontal gyration were present in 100% of the patients; flattening of the pons on the midline and multiple indentations in the lateral surface of the pons were demonstrated in 93% of the patients; and apparent "squeezing" of the cerebral peduncles in 85% of the patients.
CONCLUSIONS:Because α-actin is not expressed in the brain parenchyma, only in vascular tissue, we speculate that rather than a true malformative process, these findings represent a deformation of the brain during development related to the mechanical interaction with rigid arteries during the embryogenesis.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xYxMMW
Usefulness of Vessel Wall MR Imaging for Follow-Up after Stent-Assisted Coil Embolization of Intracranial Aneurysms [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Follow-up with MRA for intracranial aneurysms after stent-assisted coiling is complicated by imaging artifacts. We evaluated the usefulness of an alternative method: vessel wall MR imaging.
MATERIALS AND METHODS:We conducted a single-center, retrospective review of medical records of 47 patients who underwent 3D TOF-MRA, vessel wall MRI, and DSA after stent-assisted coiling between March 2016 and January 2018. We evaluated the mean value of the signal intensity in the stented artery and the contralateral normal artery on vessel wall MRI. The quality of visualization was further compared between TOF-MRA and vessel wall MRI. Furthermore, we evaluated the diagnostic accuracy and concordance rate of TOF-MRA and vessel wall MRI for assessing the patency of the stented parent artery. DSA was used as a reference test.
RESULTS:The mean signal intensities of the stented and normal arteries on vessel wall MRI were not significantly different (P = .133). The mean scores for the visualization of the stented parent artery on vessel wall MRI were significantly superior to those of TOF-MRA images (P < .001). Vessel wall MRI reached an excellent positive predictive value (100%). However, TOF-MRA had a poor positive predictive value (11%; 95% CI, 9%–12%). The likelihood ratios of vessel wall MRI and TOF-MRA were 27.36 (P < .001) and 2.98 (P = .225), respectively. The concordance rate of vessel wall MRI and TOF-MRA with DSA for evaluating the state of the stented artery was 100% ( = 1) and 28% ( = 0.038), respectively.
CONCLUSIONS:Vessel wall MRI may be useful in evaluating the patency of stented arteries after stent-assisted coil embolization for intracranial aneurysms.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xHPzZK
Treatment of Intracranial Aneurysms with Self-Expandable Braided Stents: A Systematic Review and Meta-Analysis [INTERVENTIONAL]
BACKGROUND:
The safety and efficacy of treatment with self-expandable braided stents (LEO and LVIS) required further investigation.
PURPOSE:Our aim was to analyze the outcomes after treatment with braided stents.
DATA SOURCES:A systematic search of 3 databases was performed for studies published from 2006 to 2017.
STUDY SELECTION:According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we included studies reporting patients treated with LEO or LVIS stents.
DATA ANALYSIS:Random-effects meta-analysis was used to pool the following: aneurysm occlusion rate, complications, and neurologic outcomes.
DATA SYNTHESIS:Thirty-five studies evaluating 1426 patients treated with braided stents were included in this meta-analysis. Successful stent delivery and complete aneurysm occlusion were 97% (1041/1095; 95% CI, 95%–98%) (I2 = 44%) and 88.3% (1097/1256; 95% CI, 85%–91%) (I2 = 72%), respectively. Overall, treatment-related complications were 7.4% (107/1317; 95% CI, 5%–9%) (I2 = 44%). Ischemic/thromboembolic events (48/1324 = 2.4%; 95% CI, 1.5%–3.4%) (I2 = 27%) and in-stent thrombosis (35/1324 = 1.5%; 95% CI, 0.6%–1.7%) (I2 = 0%) were the most common complications. Treatment-related morbidity was 1.5% (30/1324; 95% CI, 0.9%–2%) and was comparable between the LEO and LVIS groups. Complication rates between the anterior (29/322 = 8.8%; 95% CI, 3.4%–12%) (I2 = 41%) versus posterior circulation (10/84 = 10.5%; 95% CI, 4%–16%) (I2 = 0%) and distal (30/303 = 8%; 95% CI, 4.5%–12%) (I2 = 48%) versus proximal aneurysms (14/153 = 9%; 95% CI, 3%–13%) (I2 = 46%) were comparable (P > .05).
LIMITATIONS:Limitations were selection and publication biases.
CONCLUSIONS:In this analysis, treatment with the LEO and LVIS stents was relatively safe and effective. The most common complications were periprocedural thromboembolisms and in-stent thrombosis. The rate of complications was comparable among anterior and posterior circulation aneurysms, as well as for proximal and distally located lesions.
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Characteristics of MR Neuroimaging Services Billed by Radiologists versus Nonradiologists [PRACTICE PERSPECTIVES]
BACKGROUND AND PURPOSE:
Although most neuroimaging examinations are interpreted by radiologists, many nonradiologists provide interpretation services. We studied day of the week, site of service, and patient complexity differences for common Medicare MR neuroimaging examinations interpreted by radiologists versus nonradiologists.
MATERIALS AND METHODS:Using carrier claims files for a 5% sample of Medicare beneficiaries from 2012 to 2014, we identified all claims for brain and lumbar spine MR imaging examinations. Services were categorized by physician specialty, day of the week, and the site of service. Patient complexity was calculated using Charlson Comorbidity Indices. The 2 was performed to test statistical significance.
RESULTS:A provider specialty could be identified for 568,423 brain and lumbar spine MR imaging examinations. Of weekday examinations, radiologists interpreted 475,288 (92.3%), and nonradiologists, 39,510 (7.7%). Of weekend examinations, radiologists interpreted 52,028 (97.0%) and nonradiologists 1597 (3.0%). Radiologists interpreted 145,904 (98.7%) examinations in the inpatient hospital and emergency department settings versus 1882 (1.3%) by nonradiologists. Of all examinations, 44,547 of those interpreted by radiologists (8.4%) were on the most clinically complex patients versus 2139 (5.2%) for nonradiologists. All interspecialty differences for day of the week, the site of service, and patient complexity were statistically significant (P < .001).
CONCLUSIONS:Although radiologists interpret most common MR neuroimaging examinations for Medicare beneficiaries, in contrast to nonradiologists, they disproportionately render those services on weekends, in higher acuity sites, and on more complex patients. To optimize access and minimize disparities in necessary neuroimaging, quality metrics should consider such service characteristics.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xMqwVj
MR Neurography of the Lumbosacral Plexus for Lower Extremity Radiculopathy: Frequency of Findings, Characteristics of Abnormal Intraneural Signal, and Correlation with Electromyography [SPINE]
BACKGROUND AND PURPOSE:
MR neurography enables high resolution imaging of peripheral nerves. Our aim was to evaluate the utility of MR neurography in lumbosacral radiculopathy and correlate abnormal intraneural signal with history, physical examination, and abnormal electrodiagnostic study findings.
MATERIALS AND METHODS:Retrospective review of lumbosacral MR neurography examinations performed from December 2014 through January 2017 on a 3T scanner was undertaken. MR neurography examinations were independently reviewed in a blinded fashion by 2 radiologists, and the intraneural signal was graded on a 0–2 scale relative to adjacent vasculature. Abnormal nerve signal was correlated with subjective and objective findings from clinical notes in the electronic medical record and compared with results of electrodiagnostic studies (nerve conduction study/electromyography).
RESULTS:Three hundred three lumbosacral MR neurography examinations were performed during the study period, 64 of which met the inclusion criteria, including symptoms of radiculopathy on electromyography performed within 3 months of MR neurography. Twenty-nine (45%) MR neurography examinations had abnormal intraneural signal. There was no statistically significant correlation between subjective clinical findings and intraneural signal abnormality on MR neurography. There was a statistically significant correlation between abnormal intraneural T2 signal and findings of active radiculopathy on electromyography (P < .001).
CONCLUSIONS:Lumbosacral MR neurography appears to demonstrate abnormal intraneural signal in a substantial portion of patients with clinical symptoms of lower extremity radiculopathy and correlates with findings of active radiculopathy on electromyography. This finding further bolsters the growing body of evidence on the utility of MR neurography and suggests that abnormal intraneural signal may provide a useful adjunct to electrodiagnostic testing. Further research is required to evaluate the prognostic value of MR neurography, which may help guide therapeutic decision-making.
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The First B-Cell Tolerance Checkpoint in Mice and Humans: Control by AID.
Authors: Kuraoka M, Meffre E, Kelsoe G Abstract Activation-induced cytidine deaminase (AID) expression in the germinal center response drives the immunoglobulin class-switch recombination and V(D)J hypermutation necessary for efficacious, high-affinity antibody responses. That AID is expressed in developing lymphocytes is less well known, but represents an evolutionarily conserved pattern of lymphocyte development that is represented in all vertebrate species. Here we review the role of early, developmentally regulated AID expression in mice and humans and its role in establishing the first B-cell tolerance checkpoint. This newly recognized component of central tolerance requires coordinate signaling by poly- or autoreactive B-cell antigen receptors and endosomal Toll-like receptor...
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RAG Chromatin Scanning During V(D)J Recombination and Chromatin Loop Extrusion are Related Processes.
Authors: Lin SG, Ba Z, Alt FW, Zhang Y Abstract An effective adaptive immune system depends on the ability of developing B and T cells to generate diverse immunoglobulin (Ig) and T cell receptor repertoires, respectively. Such diversity is achieved through a programmed somatic recombination process whereby germline V, D, and J segments of antigen receptor loci are assembled to form the variable region V(D)J exons of Ig and TCRs. Studies of this process, termed V(D)J recombination, have provided key insights into our understanding of a variety of general gene regulatory and DNA repair processes over the last several decades. V(D)J recombination is initiated by the RAG endonuclease which generates DNA double-stranded breaks at the borders of V, D, and J segments. In this review, we c...
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The Microglial Response to Neurodegenerative Disease.
Authors: Song WM, Colonna M Abstract Microglia are a subset of tissue macrophages that constitute the major immune cell type of the central nervous system. These cells have long been known to change their morphology and functions in response to various neurological insults. Recently, a plethora of unbiased transcriptomics studies have revealed that across a broad spectrum of neurodegeneration-like disease models, microglia adopt a similar activation signature and perform similar functions. Despite these commonalities in response, the role of microglia has been described as both positive and negative in different murine disease models. In humans, genetic association studies have revealed strong connections between microglia genes and various neurodegenerative diseases, and mechanist...
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Omalizumab dampens type 2 inflammation in a group of long term treated asthma patients and detaches IgE from Fc εRI.
This article is protected by copyright. All rights reserved. PMID: 30252930 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
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Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells.
This article is protected by copyright. All rights reserved. PMID: 30252934 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
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Lymphocytes are a major source of circulating soluble dipeptidyl peptidase 4.
Authors: Casrouge A, Sauer AV, Barreira da Silva R, Tejera-Alhambra M, Sánchez-Ramón S, ICAReB, Cancrini C, Ingersoll MA, Aiuti A, Albert ML Abstract Dipeptidyl peptidase 4 (DPP4, CD26) is a serine protease that is expressed constitutively by many haematopoietic and non-haematopoietic tissues. It exists as a membrane-associated protein, as well as in an active, soluble form (herein called sDPP4), present at high concentrations in bodily fluids. Despite the proposed use of sDPP4 as a biomarker for multiple diseases, its cellular sources are not well defined. Here, we report that individuals with congenital lymphocyte immunodeficiency had markedly lower serum concentrations of sDPP4, which were restored upon successful treatment and restoration of lymphocyte haematopoiesis. Using i...
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MiR-155 inhibition ameliorates 2, 4, 6-Trinitrobenzenesulfonic acid (TNBS)-induced experimental colitis in rat via influencing the differentiation of Th17 cells by Jarid2.
This study suggests that miR-155 inhibition ameliorates TNBS-induced colitis by regulating the Th17 cells differentiation and function and Jarid2/notch1 is closely related with the process. PMID: 30253332 [PubMed - as supplied by publisher] (Source: International Immunopharmacology)
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MYD88 L265P mutation promoted malignant B cell resistance against T cell-mediated cytotoxicity via upregulating the IL-10/STAT3 cascade.
Authors: Qiu H, Gong S, Xu L, Cheng H, Gao L, Chen J, Hu X, Yang J Abstract The myeloid differentiation factor 88 (MYD88) signaling plays critical roles in the developments of B cells. Recent studies demonstrated that in the activated B cell subtype of diffuse large B cell lymphoma (DLBCL), approximately one-third of the patients harbored somatically acquired MyD88 L265P mutation in their lymphomas. It remains unclear whether B cell lymphomas with MYD88 L265P mutation respond differently toward CD8+ T cell-mediated cytotoxicity. Here, we demonstrated that, when incubated with autologous CD8+ T cells, the MYD88 L265P mutant lymphomas were more resistant to granzyme B- and perforin-mediated killing than MYD88 wild-type (WT) lymphomas. Interestingly, in the absence of autologous lymph...
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miR-181a regulates Th17 cells distribution via up-regulated BCL-2 in primary biliary cholangitis.
CONCLUSION: Down-regulated miR-181a in CD4+ T cells may decrease apoptosis of Th17 cells via up-regulated BCL-2 in the pathogenesis of PBC. PMID: 30253330 [PubMed - as supplied by publisher] (Source: International Immunopharmacology)
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SIKE of black carp is a substrate of TBK1 and suppresses TBK1-mediated antiviral signaling.
In this study, SIKE homologue (bcSIKE) of black carp (Mylopharyngodon piceus) has been cloned and characterized. The transcription of bcSIKE varied in host cells in response to the stimulation of LPS, poly (I:C) and viruses. bcSIKE migrated around 27 KDa in immunoblot assay and distributed in both cytoplasm and nucleus of host cell in immunofluorescent (IF) staining test. bcSIKE showed no IFN-inducing ability in reporter assay and EPC cells expressing bcSIKE showed no enhanced antiviral ability against either grass carp reovirus (GCRV) or spring viremia of carp virus (SVCV). However, bcSIKE obviously dampened the IFN-inducing ability of RLR signaling members in reporter assay when bcSIKE was co-expressed with these molecules in EPC cells. The association between bcSIKE and bcTBK1 has bee...
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Perceptions of vaccination within a Christian homeschooling community in Pennsylvania.
CONCLUSIONS: Homeschooling families have diverse vaccination practices. Pediatricians and other healthcare practitioners should not make assumptions about health beliefs in this community, and should instead engage parents in conversations about their risk perceptions and vaccine decisions. PMID: 30253888 [PubMed - as supplied by publisher] (Source: Vaccine)
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The First B-Cell Tolerance Checkpoint in Mice and Humans: Control by AID.
Authors: Kuraoka M, Meffre E, Kelsoe G Abstract Activation-induced cytidine deaminase (AID) expression in the germinal center response drives the immunoglobulin class-switch recombination and V(D)J hypermutation necessary for efficacious, high-affinity antibody responses. That AID is expressed in developing lymphocytes is less well known, but represents an evolutionarily conserved pattern of lymphocyte development that is represented in all vertebrate species. Here we review the role of early, developmentally regulated AID expression in mice and humans and its role in establishing the first B-cell tolerance checkpoint. This newly recognized component of central tolerance requires coordinate signaling by poly- or autoreactive B-cell antigen receptors and endosomal Toll-like receptor...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Iklvat
RAG Chromatin Scanning During V(D)J Recombination and Chromatin Loop Extrusion are Related Processes.
Authors: Lin SG, Ba Z, Alt FW, Zhang Y Abstract An effective adaptive immune system depends on the ability of developing B and T cells to generate diverse immunoglobulin (Ig) and T cell receptor repertoires, respectively. Such diversity is achieved through a programmed somatic recombination process whereby germline V, D, and J segments of antigen receptor loci are assembled to form the variable region V(D)J exons of Ig and TCRs. Studies of this process, termed V(D)J recombination, have provided key insights into our understanding of a variety of general gene regulatory and DNA repair processes over the last several decades. V(D)J recombination is initiated by the RAG endonuclease which generates DNA double-stranded breaks at the borders of V, D, and J segments. In this review, we c...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zBknwr
The Microglial Response to Neurodegenerative Disease.
Authors: Song WM, Colonna M Abstract Microglia are a subset of tissue macrophages that constitute the major immune cell type of the central nervous system. These cells have long been known to change their morphology and functions in response to various neurological insults. Recently, a plethora of unbiased transcriptomics studies have revealed that across a broad spectrum of neurodegeneration-like disease models, microglia adopt a similar activation signature and perform similar functions. Despite these commonalities in response, the role of microglia has been described as both positive and negative in different murine disease models. In humans, genetic association studies have revealed strong connections between microglia genes and various neurodegenerative diseases, and mechanist...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IkL9fe
Omalizumab dampens type 2 inflammation in a group of long term treated asthma patients and detaches IgE from Fc εRI.
This article is protected by copyright. All rights reserved. PMID: 30252930 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zB37HM
Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells.
This article is protected by copyright. All rights reserved. PMID: 30252934 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IleWEN
Lymphocytes are a major source of circulating soluble dipeptidyl peptidase 4.
Authors: Casrouge A, Sauer AV, Barreira da Silva R, Tejera-Alhambra M, Sánchez-Ramón S, ICAReB, Cancrini C, Ingersoll MA, Aiuti A, Albert ML Abstract Dipeptidyl peptidase 4 (DPP4, CD26) is a serine protease that is expressed constitutively by many haematopoietic and non-haematopoietic tissues. It exists as a membrane-associated protein, as well as in an active, soluble form (herein called sDPP4), present at high concentrations in bodily fluids. Despite the proposed use of sDPP4 as a biomarker for multiple diseases, its cellular sources are not well defined. Here, we report that individuals with congenital lymphocyte immunodeficiency had markedly lower serum concentrations of sDPP4, which were restored upon successful treatment and restoration of lymphocyte haematopoiesis. Using i...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zA8pDt
MiR-155 inhibition ameliorates 2, 4, 6-Trinitrobenzenesulfonic acid (TNBS)-induced experimental colitis in rat via influencing the differentiation of Th17 cells by Jarid2.
This study suggests that miR-155 inhibition ameliorates TNBS-induced colitis by regulating the Th17 cells differentiation and function and Jarid2/notch1 is closely related with the process. PMID: 30253332 [PubMed - as supplied by publisher] (Source: International Immunopharmacology)
MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IkYDYw
MYD88 L265P mutation promoted malignant B cell resistance against T cell-mediated cytotoxicity via upregulating the IL-10/STAT3 cascade.
Authors: Qiu H, Gong S, Xu L, Cheng H, Gao L, Chen J, Hu X, Yang J Abstract The myeloid differentiation factor 88 (MYD88) signaling plays critical roles in the developments of B cells. Recent studies demonstrated that in the activated B cell subtype of diffuse large B cell lymphoma (DLBCL), approximately one-third of the patients harbored somatically acquired MyD88 L265P mutation in their lymphomas. It remains unclear whether B cell lymphomas with MYD88 L265P mutation respond differently toward CD8+ T cell-mediated cytotoxicity. Here, we demonstrated that, when incubated with autologous CD8+ T cells, the MYD88 L265P mutant lymphomas were more resistant to granzyme B- and perforin-mediated killing than MYD88 wild-type (WT) lymphomas. Interestingly, in the absence of autologous lymph...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zBng0u
miR-181a regulates Th17 cells distribution via up-regulated BCL-2 in primary biliary cholangitis.
CONCLUSION: Down-regulated miR-181a in CD4+ T cells may decrease apoptosis of Th17 cells via up-regulated BCL-2 in the pathogenesis of PBC. PMID: 30253330 [PubMed - as supplied by publisher] (Source: International Immunopharmacology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IlABg1
SIKE of black carp is a substrate of TBK1 and suppresses TBK1-mediated antiviral signaling.
In this study, SIKE homologue (bcSIKE) of black carp (Mylopharyngodon piceus) has been cloned and characterized. The transcription of bcSIKE varied in host cells in response to the stimulation of LPS, poly (I:C) and viruses. bcSIKE migrated around 27 KDa in immunoblot assay and distributed in both cytoplasm and nucleus of host cell in immunofluorescent (IF) staining test. bcSIKE showed no IFN-inducing ability in reporter assay and EPC cells expressing bcSIKE showed no enhanced antiviral ability against either grass carp reovirus (GCRV) or spring viremia of carp virus (SVCV). However, bcSIKE obviously dampened the IFN-inducing ability of RLR signaling members in reporter assay when bcSIKE was co-expressed with these molecules in EPC cells. The association between bcSIKE and bcTBK1 has bee...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zBnc0I
Perceptions of vaccination within a Christian homeschooling community in Pennsylvania.
CONCLUSIONS: Homeschooling families have diverse vaccination practices. Pediatricians and other healthcare practitioners should not make assumptions about health beliefs in this community, and should instead engage parents in conversations about their risk perceptions and vaccine decisions. PMID: 30253888 [PubMed - as supplied by publisher] (Source: Vaccine)
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Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk
Abstract
Background
Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-depth characterization of humoral and cellular immune responses in children with cow's milk (CM)-FPIES and investigated whether there is a FPIES metabolomic signature.
Methods
Children with CM-FPIES and control subjects with an IgE-mediated CM allergy (IgE-CMA), both avoiding CM, were recruited on the day of an oral food challenge. Blood samples were collected before the challenge. Total and specific levels of IgE, IgG1-4, IgA, IgM and IgD to various whey and casein allergens and to their gastroduodenal digestion products were measured in plasma, using plasma from CM-tolerant peanut allergic patients (IgE-PA, not avoiding CM) as additional controls. Cytokine secretion and cellular proliferation were analyzed after stimulation of PBMC with different CM allergens. Metabolomic profiles were obtained for plasma samples using liquid chromatography coupled to high-resolution mass spectrometry.
Results
Nine children with CM-FPIES and 12 control subjects (6 IgE-CMA and 6 IgE-PA) were included. In children with CM-FPIES, total Ig concentrations were lower than in control subjects, specific Ig against CM components were weak to undetectable, and no specific IgE against CM digestion products were detected. Moreover, in CM-FPIES patients, we did not find any Th cell proliferation or associated cytokine secretion after allergen reactivation, whereas such responses were clearly found in children with IgE-CMA. Plasma metabolic profiles were different between CM allergic patients, with significantly lower concentrations of various fatty acids and higher concentrations of primary metabolites such as amino acids in CM-FPIES compared to IgE-CMA patients.
Conclusions
In CM-FPIES, both humoral and cellular specific immune responses are weak or absent, and this is not related to CM avoidance. A metabolomic signature was identified in patients with CM-FPIES that may be useful for the diagnosis and management of this disease.
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Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk
Abstract
Background
Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-depth characterization of humoral and cellular immune responses in children with cow's milk (CM)-FPIES and investigated whether there is a FPIES metabolomic signature.
Methods
Children with CM-FPIES and control subjects with an IgE-mediated CM allergy (IgE-CMA), both avoiding CM, were recruited on the day of an oral food challenge. Blood samples were collected before the challenge. Total and specific levels of IgE, IgG1-4, IgA, IgM and IgD to various whey and casein allergens and to their gastroduodenal digestion products were measured in plasma, using plasma from CM-tolerant peanut allergic patients (IgE-PA, not avoiding CM) as additional controls. Cytokine secretion and cellular proliferation were analyzed after stimulation of PBMC with different CM allergens. Metabolomic profiles were obtained for plasma samples using liquid chromatography coupled to high-resolution mass spectrometry.
Results
Nine children with CM-FPIES and 12 control subjects (6 IgE-CMA and 6 IgE-PA) were included. In children with CM-FPIES, total Ig concentrations were lower than in control subjects, specific Ig against CM components were weak to undetectable, and no specific IgE against CM digestion products were detected. Moreover, in CM-FPIES patients, we did not find any Th cell proliferation or associated cytokine secretion after allergen reactivation, whereas such responses were clearly found in children with IgE-CMA. Plasma metabolic profiles were different between CM allergic patients, with significantly lower concentrations of various fatty acids and higher concentrations of primary metabolites such as amino acids in CM-FPIES compared to IgE-CMA patients.
Conclusions
In CM-FPIES, both humoral and cellular specific immune responses are weak or absent, and this is not related to CM avoidance. A metabolomic signature was identified in patients with CM-FPIES that may be useful for the diagnosis and management of this disease.
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Asthma control and quality of life in a real-life setting: a cross-sectional study of adult asthma patients in Japan (ACQUIRE-2).
CONCLUSIONS: Asthma was not well-controlled in the majority of patients in this study. To achieve better asthma control, improvements in symptom monitoring and management may be required. PMID: 30252543 [PubMed - as supplied by publisher] (Source: Journal of Asthma)
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Asthma control and quality of life in a real-life setting: a cross-sectional study of adult asthma patients in Japan (ACQUIRE-2).
CONCLUSIONS: Asthma was not well-controlled in the majority of patients in this study. To achieve better asthma control, improvements in symptom monitoring and management may be required. PMID: 30252543 [PubMed - as supplied by publisher] (Source: Journal of Asthma)
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Histoplasmosis of the head and neck in the immunocompetent patient: Report of 2 cases
Abstract Histoplasmosis of the head and neck is rarely seen in immunocompetent patients. We report 2 new cases of histoplasmosis of the head and neck in immunocompetent patients, one an 80-year-old man and the other a 57-year-old man. The older man presented with oral cavity histoplasmosis; his symptoms included pain, dysphagia, and ulcerative lesions. The younger man had laryngeal histoplasmosis, which resulted in hoarseness and dyspnea. We discuss the methods of diagnosis and the classic findings in histoplasmosis, including the microscopic appearance of caseating granulomas, the results of periodic acid-Schiff staining and Gomori staining, and antibody detection of histoplasmosis. We also review the treatment options with antifungals, including amphotericin B and the oral conazole drugs. With an accurate diagnosis and proper treatment, both of our patients recovered well and their symptoms resolved. Because their symptoms overlapped with those of other, more common disease processes, an accurate diagnosis of these patients was essential to treating their infection.
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Histoplasmosis of the head and neck in the immunocompetent patient: Report of 2 cases
Abstract Histoplasmosis of the head and neck is rarely seen in immunocompetent patients. We report 2 new cases of histoplasmosis of the head and neck in immunocompetent patients, one an 80-year-old man and the other a 57-year-old man. The older man presented with oral cavity histoplasmosis; his symptoms included pain, dysphagia, and ulcerative lesions. The younger man had laryngeal histoplasmosis, which resulted in hoarseness and dyspnea. We discuss the methods of diagnosis and the classic findings in histoplasmosis, including the microscopic appearance of caseating granulomas, the results of periodic acid-Schiff staining and Gomori staining, and antibody detection of histoplasmosis. We also review the treatment options with antifungals, including amphotericin B and the oral conazole drugs. With an accurate diagnosis and proper treatment, both of our patients recovered well and their symptoms resolved. Because their symptoms overlapped with those of other, more common disease processes, an accurate diagnosis of these patients was essential to treating their infection.
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Acute infectious laryngitis: A case series
Abstract Although acute laryngitis is common, it is often managed by primary physicians. Therefore, video images documenting its signs are scarce. This series includes 7 professional voice users who previously had undergone baseline strobovideolaryngscopy (SVL) during routine examinations or during evaluations for other complaints and who returned with acute laryngitis. Sequential SVL showed not only the expected erythema, edema, cough, and dysphonia, but also new masses in 5 of the 7 subjects. All the signs returned to baseline. This series is reported to highlight the reversible structural changes that can be expected in patients with acute laryngitis and the value of conservative management.
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News and Announcements
The following award recipients were recognized at the 2018 AAOMS Annual Meeting on October 10 in Chicago, IL:
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News and Announcements
The following award recipients were recognized at the 2018 AAOMS Annual Meeting on October 10 in Chicago, IL:
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OVuh1g
Mouse Model for Human Vitiligo.
This article discusses the first mouse model of vitiligo that develops epidermal depigmentation, similar to disease in human patients. To achieve epidermal depigmentation, mice are genetically engineered to retain melanocytes in the skin epidermis. Induction of disease occurs by adoptive transfer of melanocyte-specific CD8+ T cells into recipient mice and the subsequent activation of these T cells using a viral vector. Depigmentation of the epidermis occurs within 5 to 7 weeks in a patchy pattern similar to patients with vitiligo. This article describes the methods of vitiligo induction, quantification of lesion progression and regression, processing of the skin for detailed analysis, and how to use this model to inform clinical studies. © 2018 by John Wiley & Sons, Inc. PMID: 302...
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LC3-Associated Phagocytosis and Antigen Presentation.
Authors: Ligeon LA, Loi M, Münz C Abstract LC3-associated phagocytosis (LAP) is an unconventional form of autophagy that relies on parts of the canonical autophagy machinery for its function. LAP is triggered upon receptor-mediated phagocytosis and is characterized by the formation of a single-membrane vesicle decorated with the autophagy protein LC3. In professional phagocytic cells, such as macrophages, the role of LAP in immune processes has been characterized, although how LAP functions at the molecular level remains poorly defined. It is important to point out that as for all autophagic pathways, the study of LAP is still challenging for the scientific community because it is a dynamic and complex process, requiring interactions among several proteins. Here, we describe the m...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xUiwkw
Mouse Model for Human Vitiligo.
This article discusses the first mouse model of vitiligo that develops epidermal depigmentation, similar to disease in human patients. To achieve epidermal depigmentation, mice are genetically engineered to retain melanocytes in the skin epidermis. Induction of disease occurs by adoptive transfer of melanocyte-specific CD8+ T cells into recipient mice and the subsequent activation of these T cells using a viral vector. Depigmentation of the epidermis occurs within 5 to 7 weeks in a patchy pattern similar to patients with vitiligo. This article describes the methods of vitiligo induction, quantification of lesion progression and regression, processing of the skin for detailed analysis, and how to use this model to inform clinical studies. © 2018 by John Wiley & Sons, Inc. PMID: 302...
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LC3-Associated Phagocytosis and Antigen Presentation.
Authors: Ligeon LA, Loi M, Münz C Abstract LC3-associated phagocytosis (LAP) is an unconventional form of autophagy that relies on parts of the canonical autophagy machinery for its function. LAP is triggered upon receptor-mediated phagocytosis and is characterized by the formation of a single-membrane vesicle decorated with the autophagy protein LC3. In professional phagocytic cells, such as macrophages, the role of LAP in immune processes has been characterized, although how LAP functions at the molecular level remains poorly defined. It is important to point out that as for all autophagic pathways, the study of LAP is still challenging for the scientific community because it is a dynamic and complex process, requiring interactions among several proteins. Here, we describe the m...
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The Role of Autoimmune Regulator (AIRE) in Peripheral Tolerance.
Authors: Zhao B, Chang L, Fu H, Sun G, Yang W Abstract Autoimmune regulator (AIRE), whose gene mutation is considered to be a causative factor of autoimmune polyglandular syndrome type 1 (APS1), is an important transcriptional regulator. Studies on the role of AIRE in the central immune system have demonstrated that AIRE can eliminate autoreactive T cells by regulating the expression of a series of tissue specific antigens promiscuously in medullary thymic epithelial cells (mTECs) and induce regulatory T cell (Treg) production to maintain central immune tolerance. However, the related research of AIRE in peripheral tolerance is few. In order to understand the current research progress on AIRE in peripheral tolerance, this review mainly focuses on the expression and distribution of ...
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Neuroinflammation Quantification for Spinal Cord Injury.
Authors: Amo-Aparicio J, Martínez-Muriana A, Sánchez-Fernández A, López-Vales R Abstract Spinal cord injury (SCI) leads to irreversible devastating neurological disabilities. Accumulated evidence in the literature indicates that the inflammatory response that occurs in the spinal cord following injury contributes importantly to spread tissue damage to healthy regions adjacent to the lesion site, and consequently, to increase neurological deficits. Therefore, targeting inflammation could lead to the development of new therapies to prevent tissue damage and neurological impairments after SCI. Inflammation is regulated, in part, by the expression of pro-inflammatory and anti-inflammatory cytokines synthesized, mainly, by glial cells. Hence, methodologies that could ease the quanti...
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Immune and Inflammatory-Mediated Disorders: From Bench to Bedside.
Authors: Reale M, Conti L, Velluto D PMID: 30255108 [PubMed - in process] (Source: Journal of Immunology Research)
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The Role of Autoimmune Regulator (AIRE) in Peripheral Tolerance.
Authors: Zhao B, Chang L, Fu H, Sun G, Yang W Abstract Autoimmune regulator (AIRE), whose gene mutation is considered to be a causative factor of autoimmune polyglandular syndrome type 1 (APS1), is an important transcriptional regulator. Studies on the role of AIRE in the central immune system have demonstrated that AIRE can eliminate autoreactive T cells by regulating the expression of a series of tissue specific antigens promiscuously in medullary thymic epithelial cells (mTECs) and induce regulatory T cell (Treg) production to maintain central immune tolerance. However, the related research of AIRE in peripheral tolerance is few. In order to understand the current research progress on AIRE in peripheral tolerance, this review mainly focuses on the expression and distribution of ...
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Altered NKp30, NKp46, NKG2D, and DNAM-1 Expression on Circulating NK Cells Is Associated with Tumor Progression in Human Gastric Cancer.
Authors: Han B, Mao FY, Zhao YL, Lv YP, Teng YS, Duan M, Chen W, Cheng P, Wang TT, Liang ZY, Zhang JY, Liu YG, Guo G, Zou QM, Zhuang Y, Peng LS Abstract Natural killer (NK) cell activity is influenced by a complex integration of signaling pathways activated downstream of both activating and inhibitory surface receptors. The tumor microenvironment can suppress NK cell activity, and there is a great clinical interest in understanding whether modulating tumor-mediated NK cell suppression and/or boosting preexisting NK cell numbers in cancer patients is therapeutically viable. To this light, we characterized the surface receptor phenotypes of peripheral blood NK cells and examined their clinical relevance to human gastric cancer (GC). We found that the proportion of peripheral blood NK...
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Immune and Inflammatory-Mediated Disorders: From Bench to Bedside.
Authors: Reale M, Conti L, Velluto D PMID: 30255108 [PubMed - in process] (Source: Journal of Immunology Research)
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The Proportion of Regulatory T Cells in Patients with Systemic Lupus Erythematosus: A Meta-Analysis.
Conclusions: The Treg proportions varied by the cellular identification method used. The proportions of Tregs that were accurately identified and functionally validated fell among patients with SLE. Stricter definitions of Tregs are necessary when evaluating the status of such patients. PMID: 30255107 [PubMed - in process] (Source: Journal of Immunology Research)
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Altered NKp30, NKp46, NKG2D, and DNAM-1 Expression on Circulating NK Cells Is Associated with Tumor Progression in Human Gastric Cancer.
Authors: Han B, Mao FY, Zhao YL, Lv YP, Teng YS, Duan M, Chen W, Cheng P, Wang TT, Liang ZY, Zhang JY, Liu YG, Guo G, Zou QM, Zhuang Y, Peng LS Abstract Natural killer (NK) cell activity is influenced by a complex integration of signaling pathways activated downstream of both activating and inhibitory surface receptors. The tumor microenvironment can suppress NK cell activity, and there is a great clinical interest in understanding whether modulating tumor-mediated NK cell suppression and/or boosting preexisting NK cell numbers in cancer patients is therapeutically viable. To this light, we characterized the surface receptor phenotypes of peripheral blood NK cells and examined their clinical relevance to human gastric cancer (GC). We found that the proportion of peripheral blood NK...
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Fetal and Maternal Outcomes of Planned Pregnancy in Patients with Systemic Lupus Erythematosus: A Retrospective Multicenter Study.
Conclusion: Planned pregnancy improved fetal and maternal outcomes, presenting as a lower rate of fetal loss, more favorable outcomes for preterm infants, and less severe disease flares during pregnancy. PMID: 30255104 [PubMed - in process] (Source: Journal of Immunology Research)
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The Proportion of Regulatory T Cells in Patients with Systemic Lupus Erythematosus: A Meta-Analysis.
Conclusions: The Treg proportions varied by the cellular identification method used. The proportions of Tregs that were accurately identified and functionally validated fell among patients with SLE. Stricter definitions of Tregs are necessary when evaluating the status of such patients. PMID: 30255107 [PubMed - in process] (Source: Journal of Immunology Research)
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Natural Killer Cells in Liver Disease and Hepatocellular Carcinoma and the NK Cell-Based Immunotherapy.
Authors: Liu P, Chen L, Zhang H Abstract Nature killer (NK) cells play a critical role in host innate and adaptive immune defense against viral infections and tumors. NK cells are enriched in liver hematopoietic cells with unique NK repertories and functions to safeguard liver cells against hepatitis virus infection or malignancy transformation. However, accumulating evidences were found that the NK cells were modulated by liver diseases and liver cancers including hepatocellular carcinoma (HCC) and showed impaired functions failing to activate the elimination of the viral-infected cells or tumor cells and were further involved in the pathogenesis of liver injury and inflammation. The full characterization of circulation and intrahepatic NK cell phenotype and function in liver dise...
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The Lung Microvasculature Is a Functional Immune Niche.
Authors: Granton E, Kim JH, Podstawka J, Yipp BG Abstract Lung capillaries, best known for vital gas exchange, also contribute to neutrophil margination, a phenomenon resulting in large numbers of pulmonary vascular neutrophils. Importantly, the functional relevance of neutrophil margination is unknown. Recent advances in microscopy have altered our understanding of why neutrophils marginate. Specifically, data show that lung capillaries provide a unique anatomical site for neutrophils to capture bloodstream pathogens, which contrasts the conventional monophagocytic-dominated vascular host defense of the spleen and liver. Moreover, lung capillaries provide an efficient site for direct cell-cell communication required for the induction of apoptosis in aged neutrophils. These new ide...
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Natural Killer Cells in Liver Disease and Hepatocellular Carcinoma and the NK Cell-Based Immunotherapy.
Authors: Liu P, Chen L, Zhang H Abstract Nature killer (NK) cells play a critical role in host innate and adaptive immune defense against viral infections and tumors. NK cells are enriched in liver hematopoietic cells with unique NK repertories and functions to safeguard liver cells against hepatitis virus infection or malignancy transformation. However, accumulating evidences were found that the NK cells were modulated by liver diseases and liver cancers including hepatocellular carcinoma (HCC) and showed impaired functions failing to activate the elimination of the viral-infected cells or tumor cells and were further involved in the pathogenesis of liver injury and inflammation. The full characterization of circulation and intrahepatic NK cell phenotype and function in liver dise...
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The Lung Microvasculature Is a Functional Immune Niche.
Authors: Granton E, Kim JH, Podstawka J, Yipp BG Abstract Lung capillaries, best known for vital gas exchange, also contribute to neutrophil margination, a phenomenon resulting in large numbers of pulmonary vascular neutrophils. Importantly, the functional relevance of neutrophil margination is unknown. Recent advances in microscopy have altered our understanding of why neutrophils marginate. Specifically, data show that lung capillaries provide a unique anatomical site for neutrophils to capture bloodstream pathogens, which contrasts the conventional monophagocytic-dominated vascular host defense of the spleen and liver. Moreover, lung capillaries provide an efficient site for direct cell-cell communication required for the induction of apoptosis in aged neutrophils. These new ide...
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Molecular diagnostics improves diagnosis and treatment of respiratory allergy and food allergy with economic optimization and cost saving.
CONCLUSION: There is moderate agreement concerning prescription of AIT and self-injectable adrenaline before and after performing CRD: this highlights the usefulness of CRD, at least in polysensitized patients, in indicating the risk assessment and therefore the correct therapy of respiratory and food allergy, which results in a cost-saving approach. PMID: 30245286 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Molecular diagnostics improves diagnosis and treatment of respiratory allergy and food allergy with economic optimization and cost saving.
CONCLUSION: There is moderate agreement concerning prescription of AIT and self-injectable adrenaline before and after performing CRD: this highlights the usefulness of CRD, at least in polysensitized patients, in indicating the risk assessment and therefore the correct therapy of respiratory and food allergy, which results in a cost-saving approach. PMID: 30245286 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Prevalence of self-reported drug hypersensitivity reactions among Lithuanian children and adults.
CONCLUSIONS: The prevalence of self-reported DHRs in Lithuania is higher among adults than children. Drug-induced skin reactions were the predominant symptom in both groups. Besides female gender and age, a positive family history of DHR and presence of pollen or food allergy may be associated with DHR. PMID: 30245285 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Prevalence of self-reported drug hypersensitivity reactions among Lithuanian children and adults.
CONCLUSIONS: The prevalence of self-reported DHRs in Lithuania is higher among adults than children. Drug-induced skin reactions were the predominant symptom in both groups. Besides female gender and age, a positive family history of DHR and presence of pollen or food allergy may be associated with DHR. PMID: 30245285 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)
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Dentofacial deformities and implications on quality of life: a pre-surgical multifactorial analysis in patients seeking orthognathic surgical treatment
To perform a quality of life survey in patients with skeletal malocclusion before undergoing orthognathic surgery, as well as delineate the sociodemographic profile and detect factors that may alter the quality of life.
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Treatment of urticarial vasculitis: A systematic review
Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review.
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Treatment of urticarial vasculitis: A systematic review
Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review.
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The anatomy of the superficial temporal artery in patients with unilateral microtia.
This is a retrospective study that evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in unilateral microtia patients undergoing reconstruction. We aimed to determine if embryologic arrest of pharyngeal arch development would lead to aberrant STA which impedes reliable harvest of the TPF flap in patients requiring microtia repair.
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A skewed pool of resident T cells triggers psoriasis-associated tissue responses in never-lesional psoriasis skin
In psoriasis patients, the skin that has not yet experienced the disease harbours resident T cells with the potential to drive psoriasiform tissue responses.
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The anatomy of the superficial temporal artery in patients with unilateral microtia.
This is a retrospective study that evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in unilateral microtia patients undergoing reconstruction. We aimed to determine if embryologic arrest of pharyngeal arch development would lead to aberrant STA which impedes reliable harvest of the TPF flap in patients requiring microtia repair.
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The Clock Keeps on Ticking: Emerging Roles for Circadian Regulation in the Control of Fungal Physiology and Pathogenesis.
Authors: Larrondo LF, Canessa P Abstract Tic-tac, tic-tac, the sound of time is familiar to us, yet, it also silently shapes daily biological processes conferring 24-hour rhythms in, among others, cellular and systemic signaling, gene expression, and metabolism. Indeed, circadian clocks are molecular machines that permit temporal control of a variety of processes in individuals, with a close to 24-hour period, optimizing cellular dynamics in synchrony with daily environmental cycles. For over three decades, the molecular bases of these clocks have been extensively described in the filamentous fungus Neurospora crassa, yet, there have been few molecular studies in fungi other than Neurospora, despite evidence of rhythmic phenomena in many fungal species, including pathogenic ones. T...
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The Clock Keeps on Ticking: Emerging Roles for Circadian Regulation in the Control of Fungal Physiology and Pathogenesis.
Authors: Larrondo LF, Canessa P Abstract Tic-tac, tic-tac, the sound of time is familiar to us, yet, it also silently shapes daily biological processes conferring 24-hour rhythms in, among others, cellular and systemic signaling, gene expression, and metabolism. Indeed, circadian clocks are molecular machines that permit temporal control of a variety of processes in individuals, with a close to 24-hour period, optimizing cellular dynamics in synchrony with daily environmental cycles. For over three decades, the molecular bases of these clocks have been extensively described in the filamentous fungus Neurospora crassa, yet, there have been few molecular studies in fungi other than Neurospora, despite evidence of rhythmic phenomena in many fungal species, including pathogenic ones. T...
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Preoperative dexamethasone for acute post-thoracotomy analgesia: a randomized, double-blind, placebo-controlled study
Abstract
Background
The analgesic effects of dexamethasone have been reported previously, and the present study determined the effects of preoperative dexamethasone on postoperative pain in patients who received thoracotomy.
Methods
Forty patients participated in this randomized, double-blind study. All patients received either dexamethasone via a 0.1 mg/kg intravenous bolus before anesthetic induction or an equal volume of saline. Postoperative analgesia was provided to both groups via epidural patient-controlled analgesia (PCA), which consisted of 250 μg of sufentanil in 250 mL of ropivacaine (0.18%) for 72 h. The primary outcome was the cumulative consumption of epidural PCA at postoperative 24 and 72 h. The secondary outcomes were the pain intensity scores during resting and coughing at postoperative 24 and 72 h, quality of recovery, total amount of rescue analgesics required, and length of hospital stay.
Results
No significant differences was observed in the consumption of epidural PCA between the control and dexamethasone infusion groups at 24 h (63.6 [55.9–72.7] vs. 68.5 [60.2–89.0] ml, P = 0.281) and 72 h (199.4 [172.4–225.1] vs. 194.7 [169.1–252.2] ml, P = 0.890). Moreover, there was no significant difference in the pain intensity scores during resting and coughing at postoperative 24 and 72 h, quality of recovery, total amount of rescue analgesics required, and length of hospital stay.
Conclusion
A single intravenous administration of dexamethasone during the preoperative period does not reduce opioid consumption and post-thoracotomy pain.
Trial registration
The study was registered at http://cris.nih.go.kr (KCT0000359) and was conducted from December 2011 to October 2012.
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Preoperative dexamethasone for acute post-thoracotomy analgesia: a randomized, double-blind, placebo-controlled study
Abstract
Background
The analgesic effects of dexamethasone have been reported previously, and the present study determined the effects of preoperative dexamethasone on postoperative pain in patients who received thoracotomy.
Methods
Forty patients participated in this randomized, double-blind study. All patients received either dexamethasone via a 0.1 mg/kg intravenous bolus before anesthetic induction or an equal volume of saline. Postoperative analgesia was provided to both groups via epidural patient-controlled analgesia (PCA), which consisted of 250 μg of sufentanil in 250 mL of ropivacaine (0.18%) for 72 h. The primary outcome was the cumulative consumption of epidural PCA at postoperative 24 and 72 h. The secondary outcomes were the pain intensity scores during resting and coughing at postoperative 24 and 72 h, quality of recovery, total amount of rescue analgesics required, and length of hospital stay.
Results
No significant differences was observed in the consumption of epidural PCA between the control and dexamethasone infusion groups at 24 h (63.6 [55.9–72.7] vs. 68.5 [60.2–89.0] ml, P = 0.281) and 72 h (199.4 [172.4–225.1] vs. 194.7 [169.1–252.2] ml, P = 0.890). Moreover, there was no significant difference in the pain intensity scores during resting and coughing at postoperative 24 and 72 h, quality of recovery, total amount of rescue analgesics required, and length of hospital stay.
Conclusion
A single intravenous administration of dexamethasone during the preoperative period does not reduce opioid consumption and post-thoracotomy pain.
Trial registration
The study was registered at http://cris.nih.go.kr (KCT0000359) and was conducted from December 2011 to October 2012.
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Effect of topical ropivacaine on the response to endotracheal tube during emergence from general anesthesia: a prospective randomized double-blind controlled study
Abstract
Background
The airway reflex such as cough is common accompanied with severe fluctuations of hemodynamics during emergence. This prospective double-blind randomized controlled trial tested the hypothesis that topical ropivacaine may reduce extubation response and postoperative sore throat.
Methods
Fifty-four patients undergoing thyroidectomy were randomly assigned to two groups. The patients in Group R were received 0.75% ropivacaine, which was sprayed on the tracheal mucosa, epiglottis, tongue base, and glottis to achieve uniform surface anesthesia. As control, patients in Group C were received the same volume saline. The primiary outcome was the incidence and grade of cough during peri-extubation.
Results
The incidence (34.62% vs. 76.92%, P = 0.002) of cough during extubation were lower in Group R compared to Group C. Meanwhile, the sore throat visual acuity score at 12 h after surgery was lower in Group R than that in Group C (2.00 vs. 3.50, P = 0.040).
Conclusion
Topical anesthesia with 0.75% ropivacaine before intubation can significantly reduce the incidence of cough during peri-extubation. Meanwhile, it reduced hemodynamic fluctuations and postoperative throat pain without influence patients recovery.
Trial registration
Chinese Clinical Trial Registry, ChiCTR1800014412 (date of registration January 2018).
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Effect of topical ropivacaine on the response to endotracheal tube during emergence from general anesthesia: a prospective randomized double-blind controlled study
Abstract
Background
The airway reflex such as cough is common accompanied with severe fluctuations of hemodynamics during emergence. This prospective double-blind randomized controlled trial tested the hypothesis that topical ropivacaine may reduce extubation response and postoperative sore throat.
Methods
Fifty-four patients undergoing thyroidectomy were randomly assigned to two groups. The patients in Group R were received 0.75% ropivacaine, which was sprayed on the tracheal mucosa, epiglottis, tongue base, and glottis to achieve uniform surface anesthesia. As control, patients in Group C were received the same volume saline. The primiary outcome was the incidence and grade of cough during peri-extubation.
Results
The incidence (34.62% vs. 76.92%, P = 0.002) of cough during extubation were lower in Group R compared to Group C. Meanwhile, the sore throat visual acuity score at 12 h after surgery was lower in Group R than that in Group C (2.00 vs. 3.50, P = 0.040).
Conclusion
Topical anesthesia with 0.75% ropivacaine before intubation can significantly reduce the incidence of cough during peri-extubation. Meanwhile, it reduced hemodynamic fluctuations and postoperative throat pain without influence patients recovery.
Trial registration
Chinese Clinical Trial Registry, ChiCTR1800014412 (date of registration January 2018).
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A prospective pilotstudy comparing the anesthetic effects of an alpha-2 agonist during holmium laser resection of the prostate and transurethral resection for prostate surgery for benign prostatic hyperplasia patients using selective alpha-1 blockers
Abstract
Background
To examine the response to an α2receptor agonist used as a sedative for patients using long-term selective α1 blockers.
Methods
Sixty-nine consecutive patients undergoing transurethral prostate resection or holmium laser resection of the prostateunder spinal anesthesia were divided into two groups; group N (n = 37), which did not receive α1 blockers, and group T (n = 32), which was administered tamsulosin for at least 1 month before the study. Bispectral index scores, Modified Observer's Assessment of Alertness/Sedation scale scores, heart rate, and mean blood pressure were obtained under sedation using dexmedetomidine for 30 min during surgery.
Results
The only significant difference found between the groups were mean bloodpressure 15 min after the first loading dose injection of dexmedetomidine. Differencesbetween both groupswere noted at 15 min(group T: 100.2 ± 12.9 mmHg; group N: 90.0 ± 17.5 mmHg; P = 0.08), 20 min (group T: 99.8 ± 12.3 mmHg; group N: 87.4 ± 15.0 mmHg; P < 0.00), 25 min (group T: 99.3 ± 13.4 mmHg; group N: 85.4 ± 13.8 mmHg; P < 0.00), and 30 min (group T: 98.8 ± 13.1 mmHg; group N: 84.5 ± 13.5 mmHg; P < 0.00).
Conclusions
The use of α2 agonists is appropriate during surgery for benign prostatic hyperplasia patients using tamsulosin, and there is no need to alter the dose. Alertness with anesthesia involving α2 agents was maintained for patients using long-term tamsulosin and patients who did not use tamsulosin.
Trial registration
The study was retrospectively registered with the Clinical Research Informational Service (KCT0002967, July 2, 2018).
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A prospective pilotstudy comparing the anesthetic effects of an alpha-2 agonist during holmium laser resection of the prostate and transurethral resection for prostate surgery for benign prostatic hyperplasia patients using selective alpha-1 blockers
Abstract
Background
To examine the response to an α2receptor agonist used as a sedative for patients using long-term selective α1 blockers.
Methods
Sixty-nine consecutive patients undergoing transurethral prostate resection or holmium laser resection of the prostateunder spinal anesthesia were divided into two groups; group N (n = 37), which did not receive α1 blockers, and group T (n = 32), which was administered tamsulosin for at least 1 month before the study. Bispectral index scores, Modified Observer's Assessment of Alertness/Sedation scale scores, heart rate, and mean blood pressure were obtained under sedation using dexmedetomidine for 30 min during surgery.
Results
The only significant difference found between the groups were mean bloodpressure 15 min after the first loading dose injection of dexmedetomidine. Differencesbetween both groupswere noted at 15 min(group T: 100.2 ± 12.9 mmHg; group N: 90.0 ± 17.5 mmHg; P = 0.08), 20 min (group T: 99.8 ± 12.3 mmHg; group N: 87.4 ± 15.0 mmHg; P < 0.00), 25 min (group T: 99.3 ± 13.4 mmHg; group N: 85.4 ± 13.8 mmHg; P < 0.00), and 30 min (group T: 98.8 ± 13.1 mmHg; group N: 84.5 ± 13.5 mmHg; P < 0.00).
Conclusions
The use of α2 agonists is appropriate during surgery for benign prostatic hyperplasia patients using tamsulosin, and there is no need to alter the dose. Alertness with anesthesia involving α2 agents was maintained for patients using long-term tamsulosin and patients who did not use tamsulosin.
Trial registration
The study was retrospectively registered with the Clinical Research Informational Service (KCT0002967, July 2, 2018).
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Comparison of Osseointegration between 5 Different Titanium Implant Surfaces
The surface properties of an implant plays the most important role in osseointegration. Titanium dental implants are produced applying different methods such as grit blasting, acid etching, coating, and combination of these techniques yielding materials with roughened surfaces. Those techniques are used to optimize the surface characteristics and to enhance biocompatibility and bioactivity with bone tissue.
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Ultra-Short Implants for Rehabilitation of the Edentulous Posterior Mandible: Outcomes after 2 Years
Rehabilitation of the posterior mandible when limited bone is present is one of the more difficult challenges in implant dentistry. Several techniques have been proposed to vertically augment bone. However, these techniques are unpredictable in the hands of the majority of the clinicians and associated with more trauma and a high incidence of failure. The use of short implants (6-8 mm) has been very well-documented in the literature. Recently, ultra-short implants (4 mm) became available and are 1 more option for rehabilitation of patients with vertical defects in the posterior mandible.
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Comparison of Osseointegration between 5 Different Titanium Implant Surfaces
The surface properties of an implant plays the most important role in osseointegration. Titanium dental implants are produced applying different methods such as grit blasting, acid etching, coating, and combination of these techniques yielding materials with roughened surfaces. Those techniques are used to optimize the surface characteristics and to enhance biocompatibility and bioactivity with bone tissue.
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Ultra-Short Implants for Rehabilitation of the Edentulous Posterior Mandible: Outcomes after 2 Years
Rehabilitation of the posterior mandible when limited bone is present is one of the more difficult challenges in implant dentistry. Several techniques have been proposed to vertically augment bone. However, these techniques are unpredictable in the hands of the majority of the clinicians and associated with more trauma and a high incidence of failure. The use of short implants (6-8 mm) has been very well-documented in the literature. Recently, ultra-short implants (4 mm) became available and are 1 more option for rehabilitation of patients with vertical defects in the posterior mandible.
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Chronotolerance for cisplatin ototoxicity in the rat.
The objective of the study was to determine the sensitivity of cisplatin ototoxicity to circadian time. Fifty-seven Fischer 344/NHsd rats were exposed to 12 mg/kg cisplatin by intra-peritoneal injection at one of six time points on a 12 h light-12 h dark cycle: 2, 6, or 10 h after light onset or 2, 6, or 10 h after light offset. Cochlear injury was evaluated using auditory brainstem response threshold shifts and postmortem outer hair cell counts. All animals experienced threshold shift in the highest frequencies tested (30 and 40 kHz). The animals exposed to cisplatin at 6 h after light onset (the inactive period) had significantly higher mid-frequency threshold shifts and outer hair cell losses than the groups exposed during the dark hours. The results indicate that cisplati...
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Rapamycin but not acarbose decreases age-related loss of outer hair cells in the mouse Cochlea.
Authors: Altschuler RA, Kanicki A, Martin C, Kohrman DC, Miller RA Abstract Adding rapamycin or acarbose to diet at 9-10 months of age has been shown to significantly increase life span in both male and female UM-HET3 mice. The current study examined cochleae of male and female UM-HET3 mice at 22 months of age to determine if either treatment also influenced age-related loss of cochlear hair cells. A large loss of cochlear outer hair cells was observed at 22 months of age in untreated mice in both apical and basal halves of the cochlear spiral. Addition of acarbose to diet had no significant effect on the amount of outer hair cell loss at 22 months of age or in its pattern, with large loss in both apical and basal halves. The addition of rapamycin to diet, however, significantly re...
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Rapamycin but not acarbose decreases age-related loss of outer hair cells in the mouse Cochlea.
Authors: Altschuler RA, Kanicki A, Martin C, Kohrman DC, Miller RA Abstract Adding rapamycin or acarbose to diet at 9-10 months of age has been shown to significantly increase life span in both male and female UM-HET3 mice. The current study examined cochleae of male and female UM-HET3 mice at 22 months of age to determine if either treatment also influenced age-related loss of cochlear hair cells. A large loss of cochlear outer hair cells was observed at 22 months of age in untreated mice in both apical and basal halves of the cochlear spiral. Addition of acarbose to diet had no significant effect on the amount of outer hair cell loss at 22 months of age or in its pattern, with large loss in both apical and basal halves. The addition of rapamycin to diet, however, significantly re...
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White matter involvement in young non-demented Down’s syndrome subjects: a tract-based spatial statistic analysis
Abstract
Purpose
Cognitive decline in Down syndrome generally shows neurodegenerative aspects similar to what is observed in Alzheimer's disease. Few studies reported information on white matter integrity. The aim of this study was to evaluate white matter alterations in a cohort of young Down subjects, without dementia, by means of DTI technique, compared to a normal control group.
Methods
The study group consisted of 17 right-handed subjects with DS and many control subjects. All individuals participating in this study were examined by MR exam including DTI acquisition (32 non-coplanar directions); image processing and analysis were performed using FMRIB Software Library (FSL version 4.1.9, http://www.fmrib.ox.ac.uk/fsl)) software package. Finally, the diffusion tensor was estimated voxel by voxel and the FA map derived from the tensor. A two-sample t test was performed to assess differences between DS and control subjects.
Results
The FA is decreased in DS subjects, compared to control subjects, in the region of the anterior thalamic radiation, the inferior fronto-occipital fasciculum, the inferior longitudinal fasciculum, and the cortico-spinal tract, bilaterally.
Conclusions
The early white matter damage visible in our DS subjects could have great impact in the therapeutic management, in particular in better adapting the timing of therapies to counteract the toxic effect of the deposition of amyloid that leads to oxidative stress.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xJl31A
White matter involvement in young non-demented Down’s syndrome subjects: a tract-based spatial statistic analysis
Abstract
Purpose
Cognitive decline in Down syndrome generally shows neurodegenerative aspects similar to what is observed in Alzheimer's disease. Few studies reported information on white matter integrity. The aim of this study was to evaluate white matter alterations in a cohort of young Down subjects, without dementia, by means of DTI technique, compared to a normal control group.
Methods
The study group consisted of 17 right-handed subjects with DS and many control subjects. All individuals participating in this study were examined by MR exam including DTI acquisition (32 non-coplanar directions); image processing and analysis were performed using FMRIB Software Library (FSL version 4.1.9, http://www.fmrib.ox.ac.uk/fsl)) software package. Finally, the diffusion tensor was estimated voxel by voxel and the FA map derived from the tensor. A two-sample t test was performed to assess differences between DS and control subjects.
Results
The FA is decreased in DS subjects, compared to control subjects, in the region of the anterior thalamic radiation, the inferior fronto-occipital fasciculum, the inferior longitudinal fasciculum, and the cortico-spinal tract, bilaterally.
Conclusions
The early white matter damage visible in our DS subjects could have great impact in the therapeutic management, in particular in better adapting the timing of therapies to counteract the toxic effect of the deposition of amyloid that leads to oxidative stress.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xJl31A
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