A family case of X-linked Alport syndrome patients with a novel variant in COL4A5

AbstractWe herein report 2 Japanese patients with X-linked Alport syndrome (XLAS), with a novel variant inCOL4A5. Patient 1 was a 16-year-old Japanese girl with a history of microscopic hematuria, without proteinuria, renal dysfunction, deafness, or ocular abnormalities. At 13  years of age, renal biopsy was performed; however, a diagnosis of AS was not considered. When her mother (patient 2) was 40 years of age (3 years after patient 1 underwent a renal biopsy), patient 2 was found to have asymptomatic hematuria, proteinuria, and an increased serum creatinine level, w ithout deafness and ocular abnormalities. Subsequently, immunofluorescence staining for alpha 5 chains of type IV collagen was performed in patient 1. Pathological findings were consistent with AS, and genetic analysis de...

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A family case of X-linked Alport syndrome patients with a novel variant in COL4A5

AbstractWe herein report 2 Japanese patients with X-linked Alport syndrome (XLAS), with a novel variant inCOL4A5. Patient 1 was a 16-year-old Japanese girl with a history of microscopic hematuria, without proteinuria, renal dysfunction, deafness, or ocular abnormalities. At 13  years of age, renal biopsy was performed; however, a diagnosis of AS was not considered. When her mother (patient 2) was 40 years of age (3 years after patient 1 underwent a renal biopsy), patient 2 was found to have asymptomatic hematuria, proteinuria, and an increased serum creatinine level, w ithout deafness and ocular abnormalities. Subsequently, immunofluorescence staining for alpha 5 chains of type IV collagen was performed in patient 1. Pathological findings were consistent with AS, and genetic analysis de...

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Conserved epitopes in variants of amastin protein of Trypanosoma cruzi for vaccine design: A bioinformatics approach

Publication date: Available online 5 October 2018Source: Microbial PathogenesisAuthor(s): Parvez Singh Slathia, Preeti SharmaAbstractChagas disease caused by protozoan parasite Trypanosoma cruzi is endemic disease in South and Central American countries but due to migrating human populations it has shown emergence in Europe, North America and Australia. With only two drugs, benznidazole and nifurtimox for its treatment there is need for newer therapies. In the current study, we have tried to analyse the potential of amastin, a major surface protein as a vaccine target using bioinformatics tools. Using 282 variants of this protein available in NCBI protein database we have found out five conserved potential Tc cell and two TH cell epitopes. These epitopes are conserved in more than 90% of t...

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Conserved epitopes in variants of amastin protein of Trypanosoma cruzi for vaccine design: A bioinformatics approach

Publication date: Available online 5 October 2018Source: Microbial PathogenesisAuthor(s): Parvez Singh Slathia, Preeti SharmaAbstractChagas disease caused by protozoan parasite Trypanosoma cruzi is endemic disease in South and Central American countries but due to migrating human populations it has shown emergence in Europe, North America and Australia. With only two drugs, benznidazole and nifurtimox for its treatment there is need for newer therapies. In the current study, we have tried to analyse the potential of amastin, a major surface protein as a vaccine target using bioinformatics tools. Using 282 variants of this protein available in NCBI protein database we have found out five conserved potential Tc cell and two TH cell epitopes. These epitopes are conserved in more than 90% of t...

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Impact of endodontic post material on longitudinal changes in interproximal bone level: a randomized controlled pilot trial

Abstract

Objectives

Aim was to evaluate the impact of glass fiber versus titanium endodontic posts on the interproximal bone level around severely damaged endodontically treated teeth.

Materials and methods

Thirty-eight participants of a randomized controlled trial on glass fiber (n = 18) and titanium post-endodontic restorations (n = 20) received radiographs at two different times after post placement (T0 = <12 months and T1 = 36–72 months after post placement). A total of 76 radiographs were analyzed with an image-editing software. Medians of changes in mesial and distal interproximal bone level (∆MBL, ∆DBL) were calculated and tested for statistical significance with respect to post material using Mann-Whitney U test (p < 0.05). Impact of post material on bone level changes was assessed in multilevel mixed-effect linear regression models.

Results

The mean observation period was 54 months for glass fiber and 50 months for titanium posts. Interproximal bone loss was small in both groups during the study period with no significant differences between groups (glass-fiber group, ∆MBL = − 0.03 mm and ∆DBL = − 0.06 mm; titanium group, ∆MBL = − 0.07 mm and ∆DBL = − 0.17 mm; both p > 0.05). Overall, impact of post material on bone loss was almost negligible with a nonsignificant difference between materials of 0.10 mm during the entire study period.

Conclusion

The rigidity of endodontic post material has no impact on the level of alveolar bone support of severely damaged endodontically treated teeth.

Clinical relevance

Post-endodontic restorations of severely damaged teeth can achieve steady levels of periodontal bone support as a parameter of periodontal health, irrespective of post material.

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Impact of endodontic post material on longitudinal changes in interproximal bone level: a randomized controlled pilot trial

Abstract

Objectives

Aim was to evaluate the impact of glass fiber versus titanium endodontic posts on the interproximal bone level around severely damaged endodontically treated teeth.

Materials and methods

Thirty-eight participants of a randomized controlled trial on glass fiber (n = 18) and titanium post-endodontic restorations (n = 20) received radiographs at two different times after post placement (T0 = <12 months and T1 = 36–72 months after post placement). A total of 76 radiographs were analyzed with an image-editing software. Medians of changes in mesial and distal interproximal bone level (∆MBL, ∆DBL) were calculated and tested for statistical significance with respect to post material using Mann-Whitney U test (p < 0.05). Impact of post material on bone level changes was assessed in multilevel mixed-effect linear regression models.

Results

The mean observation period was 54 months for glass fiber and 50 months for titanium posts. Interproximal bone loss was small in both groups during the study period with no significant differences between groups (glass-fiber group, ∆MBL = − 0.03 mm and ∆DBL = − 0.06 mm; titanium group, ∆MBL = − 0.07 mm and ∆DBL = − 0.17 mm; both p > 0.05). Overall, impact of post material on bone loss was almost negligible with a nonsignificant difference between materials of 0.10 mm during the entire study period.

Conclusion

The rigidity of endodontic post material has no impact on the level of alveolar bone support of severely damaged endodontically treated teeth.

Clinical relevance

Post-endodontic restorations of severely damaged teeth can achieve steady levels of periodontal bone support as a parameter of periodontal health, irrespective of post material.

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Five decades of orofacial cleft management and research in Brazil

Our research team read with interest the article by Best et al.1 regarding short-term surgical missions for the management of orofacial clefts (OFCs) in South America. We congratulate the authors, but wish to make some observations. The authors stated that Chile has the only health system in South America with government-guaranteed access to surgical care for OFCs, and that the other countries on the continent are left to depend on temporary international or national campaigns or short-term surgical missions.

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Five decades of orofacial cleft management and research in Brazil

Our research team read with interest the article by Best et al.1 regarding short-term surgical missions for the management of orofacial clefts (OFCs) in South America. We congratulate the authors, but wish to make some observations. The authors stated that Chile has the only health system in South America with government-guaranteed access to surgical care for OFCs, and that the other countries on the continent are left to depend on temporary international or national campaigns or short-term surgical missions.

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Expression profiling and functional characterization of galectin-3 of turbot (Scophthalmus maximus L.) in host mucosal immunity

Publication date: Available online 6 October 2018Source: Fish & Shellfish ImmunologyAuthor(s): Mengyu Tian, Ning Yang, Lu Zhang, Qiang Fu, Fenghua Tan, Chao LiAbstractGalectins, a family of evolutionary conserved β-galactoside-binding proteins, have been characterized in wide range of species. Galectin-3 is the only member in the chimera type, which is monomeric lectin with one CRD domain. A growing body of evidence have indicated vital roles of galectin-3 in innate immune responses against infection. Here, one galectin-3 gene was captured in turbot (SmLgals3) contains a 1203 bp open reading frame (ORF). In comparison to other species, SmLgals3 showed the highest similarity and identity to large yellow croaker and medaka, respectively. The genomic structure analysis showed that SmLgals3 h...

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IJERPH, Vol. 15, Pages 2182: Protected Natural Areas: In Sickness and in Health

Authors: Romanillos Maneja Varga Badiella Boada Numerous studies show the benefits that contact with the natural environment have for human health, but there are few studies on the role of Protected Natural Areas (PNAs), either from the preventive point of view or on their potential benefits, on individuals with health problems. A study was made of the relationship between the visitation of Montseny Natural Park and Biosphere Reserve and health, from the perspective of a population group with different diseases. A total of 250 patients resident in the areas near the park were surveyed, recording their beliefs about the benefits of nature, as well as the reasons for visiting and the activities associated with health that they carried out in the park. The pure air is the ...

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Interactions between polycyclic aromatic hydrocarbons and epoxide hydrolase 1 play roles in asthma

AbstractAsthma, as one of the most common chronic diseases in children and adults, is a consequence of complex gene –environment interactions. Polycyclic aromatic hydrocarbons (PAHs), as a group of widespread environmental organic pollutants, are involved in the development, triggering and pathologic changes of asthma. Various previous studies reported the critical roles of PAHs in immune changes, oxidative str ess and environment–gene interactions of asthma.EPHX1 (the gene of epoxide hydrolase 1, an enzyme mediating human PAH metabolism) had a possible association with asthma by influencing PAH metabolism. This review summarized that (1) the roles of PAHs in asthma —work as risk factors; (2) the possible mechanisms involved in PAH-related asthma—through immunologic and oxidative s...

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Expression profiling and functional characterization of galectin-3 of turbot (Scophthalmus maximus L.) in host mucosal immunity

Publication date: Available online 6 October 2018Source: Fish & Shellfish ImmunologyAuthor(s): Mengyu Tian, Ning Yang, Lu Zhang, Qiang Fu, Fenghua Tan, Chao LiAbstractGalectins, a family of evolutionary conserved β-galactoside-binding proteins, have been characterized in wide range of species. Galectin-3 is the only member in the chimera type, which is monomeric lectin with one CRD domain. A growing body of evidence have indicated vital roles of galectin-3 in innate immune responses against infection. Here, one galectin-3 gene was captured in turbot (SmLgals3) contains a 1203 bp open reading frame (ORF). In comparison to other species, SmLgals3 showed the highest similarity and identity to large yellow croaker and medaka, respectively. The genomic structure analysis showed that SmLgals3 h...

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IJERPH, Vol. 15, Pages 2182: Protected Natural Areas: In Sickness and in Health

Authors: Romanillos Maneja Varga Badiella Boada Numerous studies show the benefits that contact with the natural environment have for human health, but there are few studies on the role of Protected Natural Areas (PNAs), either from the preventive point of view or on their potential benefits, on individuals with health problems. A study was made of the relationship between the visitation of Montseny Natural Park and Biosphere Reserve and health, from the perspective of a population group with different diseases. A total of 250 patients resident in the areas near the park were surveyed, recording their beliefs about the benefits of nature, as well as the reasons for visiting and the activities associated with health that they carried out in the park. The pure air is the ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OG6sh0

Interactions between polycyclic aromatic hydrocarbons and epoxide hydrolase 1 play roles in asthma

AbstractAsthma, as one of the most common chronic diseases in children and adults, is a consequence of complex gene –environment interactions. Polycyclic aromatic hydrocarbons (PAHs), as a group of widespread environmental organic pollutants, are involved in the development, triggering and pathologic changes of asthma. Various previous studies reported the critical roles of PAHs in immune changes, oxidative str ess and environment–gene interactions of asthma.EPHX1 (the gene of epoxide hydrolase 1, an enzyme mediating human PAH metabolism) had a possible association with asthma by influencing PAH metabolism. This review summarized that (1) the roles of PAHs in asthma —work as risk factors; (2) the possible mechanisms involved in PAH-related asthma—through immunologic and oxidative s...

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Micron-scale crack propagation in laser-irradiated enamel and dentine studied with nano-CT

Abstract

Objectives

The aim of this study was to see the effect of Er:YAG laser irradiation in dentine and compare this with its effect in enamel. The mechanism of crack propagation in dentine was emphasised and its clinical implications were discussed.

Materials and methods

Coronal sections of sound enamel and dentine were machined to 50-μm thickness using a FEI-Helios Plasma (FIB). The specimen was irradiated for 30 s with 2.94-μm Er:YAG laser radiation in a moist environment, using a sapphire dental probe tip, with the tip positioned 2 mm away from the sample surface. One of the sections was analysed as a control and not irradiated. Samples were analysed using the Zeiss Xradia 810 Ultra, which allows high spatial resolution, nanoscale 3D imaging using X-ray computed tomography (CT).

Results

Dentine: In the peritubular dentine, micro-cracks ran parallel to the tubules whereas in the inter-tubular region, the cracks ran orthogonal to the dentinal tubules. These cracks extended to a mean depth of approximately 10 μm below the surface. On the dentine surface, there was preferential ablation of the less mineralised intertubular dentine, and this resulted in an irregular topography associated with tubules.

Enamel: The irradiated enamel surface showed a characteristic 'rough' morphology suggesting some preferential ablation along certain microstructure directions. There appears to be very little subsurface damage, with the prismatic structure remaining intact.

Conclusions

A possible mechanism is that laser radiation is transmitted down the dentinal tubules causing micro-cracks to form in the dentinal tubule walls that tend to be limited to this region.

Clinical relevance

Crack might be a source of fracture as it represents a weak point and subsequently might lead to a failure in restorative dentistry.

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Micron-scale crack propagation in laser-irradiated enamel and dentine studied with nano-CT

Abstract

Objectives

The aim of this study was to see the effect of Er:YAG laser irradiation in dentine and compare this with its effect in enamel. The mechanism of crack propagation in dentine was emphasised and its clinical implications were discussed.

Materials and methods

Coronal sections of sound enamel and dentine were machined to 50-μm thickness using a FEI-Helios Plasma (FIB). The specimen was irradiated for 30 s with 2.94-μm Er:YAG laser radiation in a moist environment, using a sapphire dental probe tip, with the tip positioned 2 mm away from the sample surface. One of the sections was analysed as a control and not irradiated. Samples were analysed using the Zeiss Xradia 810 Ultra, which allows high spatial resolution, nanoscale 3D imaging using X-ray computed tomography (CT).

Results

Dentine: In the peritubular dentine, micro-cracks ran parallel to the tubules whereas in the inter-tubular region, the cracks ran orthogonal to the dentinal tubules. These cracks extended to a mean depth of approximately 10 μm below the surface. On the dentine surface, there was preferential ablation of the less mineralised intertubular dentine, and this resulted in an irregular topography associated with tubules.

Enamel: The irradiated enamel surface showed a characteristic 'rough' morphology suggesting some preferential ablation along certain microstructure directions. There appears to be very little subsurface damage, with the prismatic structure remaining intact.

Conclusions

A possible mechanism is that laser radiation is transmitted down the dentinal tubules causing micro-cracks to form in the dentinal tubule walls that tend to be limited to this region.

Clinical relevance

Crack might be a source of fracture as it represents a weak point and subsequently might lead to a failure in restorative dentistry.

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Topical formulation containing Ilex Paraguariensis extract increases metalloproteinases and myeloperoxidase activities in mice exposed to UVB radiation

Publication date: Available online 5 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Camila Helena Ferreira Cuelho, Georgia de Assis Dias Alves, Marina Ortiz Lovatto, Iuri França Bonilha, Fernanda Barbisan, Ivana Beatrice Manica da Cruz, Sara Marchesan Oliveira, Roselei Fachinetto, Gizele Scotti do Canto, Melânia Palermo ManfronAbstractUltraviolet B radiation represents 10% of the total UV radiation that reaches the Earth's surface, being the primary responsible for the biological effects related to skin cancer and photoaging. Ilex Paraguariensis A. St. Hil., known as Yerba mate (YM), is a native tree of South America whose polyphenols in its leaves are described to exhibit photochemoprotective effect and are employed in the treatment of cancer. Additi...

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Categorial shift and morphological differentiation

Publication date: Available online 6 October 2018Source: Language SciencesAuthor(s): Livio GaetaAbstractMorphological differentiation is defined as the development of morphological variants which can be considered by speakers to shape the transition to a new, different category. After discussing different cases of morphological differentiation, the paper will focus on the accompanying changes that facilitate the process of category formation. This reflects an active Principle of Maximal Differentiation, which helps speakers distinguish the units belonging to the new categories from the others. (Source: Language Sciences)

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Relaxation processes accompanying electron stabilization in the quinone acceptor part of Rb. sphaeroides reaction centers

Publication date: Available online 5 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): P.P. Knox, E.P. Lukashev, V.V. Gorokhov, N.Kh. Seifullina, V.Z. PaschenkoAbstractThe temperature dependence of the dark recombination rate in photooxidized bacteriochlorophyll (P) and photoreduced quinone acceptors (ubiquinones) QA and QB of photosynthetic reaction centers of purple bacteria Rhodobacter sphaeroides (Rb. sphaeroides) was studied. Photoinduced changes in the absorption were detected in the Qx absorption band of photooxidized bacteriochlorophyll at 600 nm and in the bands corresponding to the redox changes of ubiquinones at 335 and 420–450 nm. Kinetic analysis was used to evaluate the activation energy and the characteristic time of the transient proc...

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Targeting EGFR and uPAR on human rhabdomyosarcoma, osteosarcoma, and ovarian adenocarcinoma with a bispecific ligand-directed toxin.

Conclusion: The results of our study are promising, and further studies will be necessary to confirm the applicability of eBAT as a supplementary therapy for a variety of sarcomas, carcinomas, and possibly other refractory malignancies that express EGFR and uPAR. PMID: 30288129 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)

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Clear cell renal cell carcinoma: CT-based radiomics features for the prediction of Fuhrman Grade

Publication date: Available online 5 October 2018

Source: European Journal of Radiology

Author(s): Jun Shu, Yongqiang Tang, Jingjing Cui, Ruwu Yang, Xiaoli Meng, Zhengting Cai, Jingsong Zhang, Wanni Xu, Didi Wen, Hong Yin

Abstract

Objectives

To discriminate low grade (Fuhrman I/II) and high grade (Fuhrman III/IV) clear cell renal cell carcinoma (CCRCC) by using CT-based radiomic features.

Methods

161 and 99 patients diagnosed with low and high grade CCRCCs from January 2011 to May 2018 were enrolled in this study. 1029 radiomic features were extracted from corticomedullary (CMP), and nephrographic phase (NP) CT images of all patients. We used interclass correlation coefficient (ICC) and the least absolute shrinkage and selection operator (LASSO) regression method to select features, then the selected features were constructed three classification models (CMP, NP and with their combination) to discriminate high and low grades CCRCC. These three models were built by logistic regression method using 5-fold cross validation strategy, evaluated with receiver operating characteristics curve (ROC) and compared using DeLong test.

Results

We found 11 and 24 CMP and NP features were independently significantly associated with the Fuhrman grades. The model of CMP, NP and Combined model using radiomic feature set showed diagnostic accuracy of 0.719 (AUC [area under the curve], 0.766; 95% CI [confidence interval]: 0.709-0.816; sensitivity, 0.602; specificity, 0.838), 0.738 (AUC, 0.818; 95% CI:0.765-0.838; sensitivity, 0.693; specificity, 0.838), 0.777(AUC, 0.822; 95% CI: 0.769-0.866; sensitivity, 0.677; specificity, 0.839). There were significant differences in AUC between CMP model and Combined model (P = 0.0208), meanwhile, the differences between CMP model and NP model, NP model and Combined model reached no significant (P = 0.0844, 0.7915).

Conclusions

Radiomic features could be used as biomarker for the preoperative evaluation of the CCRCC Fuhrman grades.

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Grayscale Ultrasonic and Shear Wave Elastographic Characteristics of the Achilles’ Tendon in Patients with Familial Hypercholesterolemia: A Pilot Study

Publication date: Available online 5 October 2018

Source: European Journal of Radiology

Author(s): Lei Zhang, Qiang Yong, Tianning Pu, Chao Zheng, Mingyue Wang, Sujun Shi, Liang Li

Abstract

Objective

To investigate the feasibility of grayscale ultrasound and quantitative shear wave elastography (SWE) for assessing the image features and stiffness of the Achilles tendon in patients with familial hypercholesterolemia (FH) compared with healthy controls.

Methods

A total of 38 Achilles tendons from healthy control participants and 94 from patients with FH were examined with grayscale ultrasound and SWE. Each Achilles tendon examination was performed on 3 different segments (proximal, middle, and distal). The thickness, grayscale image features and elasticity modulus of each segment was measured on longitudinal views.

Results

In Achilles tendons of healthy control participants, the thicknesses of the proximal, middle, and distal segments were (4.46 ± 0.68) mm, (5.41 ± 1.01) mm, and (4.41 ± 0.57) mm, respectively. The grayscale features were diffusely hypoechoic with parallel linear hyperechoic striations. The mean elasticity modulus of the proximal, middle, and distal sites was (418.08 ± 43.13) kPa, (425.78 ± 47.14) kPa, and (407.79 ± 38.74) kPa, respectively. In the FH group, the thicknesses of the proximal, middle, and distal segments were (7.65 ± 3.09) mm, (11.46 ± 4.84) mm, and (8.14 ± 2.90) mm, respectively. The grayscale features were hypoechoic with linear hyperechoic disordered fibre distribution (92/94). Two of 94 Achilles tendons had considerable focal hypoechogenicity. Seventeen of 94 Achilles tendons had calcifications. In the FH group, the mean elasticity modulus of the proximal, middle, and distal segments were (294.86 ± 58.13) kPa, (280.93 ± 63.58) kPa, and (282.41 ± 56.47) kPa, respectively. Statistically significant differences were found between the Achilles tendons of healthy control participants and FH patients in the thicknesses and mean elasticity modulus at the proximal, middle and distal segments of the Achilles tendons (all P < 0.001).

Conclusions

Our results suggest that the grayscale features and SWE characteristics of the Achilles tendon provided complementary biomechanical information for quantitative assessment the Achilles tendon in patients with FH.

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Topical formulation containing Ilex Paraguariensis extract increases metalloproteinases and myeloperoxidase activities in mice exposed to UVB radiation

Publication date: Available online 5 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Camila Helena Ferreira Cuelho, Georgia de Assis Dias Alves, Marina Ortiz Lovatto, Iuri França Bonilha, Fernanda Barbisan, Ivana Beatrice Manica da Cruz, Sara Marchesan Oliveira, Roselei Fachinetto, Gizele Scotti do Canto, Melânia Palermo ManfronAbstractUltraviolet B radiation represents 10% of the total UV radiation that reaches the Earth's surface, being the primary responsible for the biological effects related to skin cancer and photoaging. Ilex Paraguariensis A. St. Hil., known as Yerba mate (YM), is a native tree of South America whose polyphenols in its leaves are described to exhibit photochemoprotective effect and are employed in the treatment of cancer. Additi...

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Categorial shift and morphological differentiation

Publication date: Available online 6 October 2018Source: Language SciencesAuthor(s): Livio GaetaAbstractMorphological differentiation is defined as the development of morphological variants which can be considered by speakers to shape the transition to a new, different category. After discussing different cases of morphological differentiation, the paper will focus on the accompanying changes that facilitate the process of category formation. This reflects an active Principle of Maximal Differentiation, which helps speakers distinguish the units belonging to the new categories from the others. (Source: Language Sciences)

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Relaxation processes accompanying electron stabilization in the quinone acceptor part of Rb. sphaeroides reaction centers

Publication date: Available online 5 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): P.P. Knox, E.P. Lukashev, V.V. Gorokhov, N.Kh. Seifullina, V.Z. PaschenkoAbstractThe temperature dependence of the dark recombination rate in photooxidized bacteriochlorophyll (P) and photoreduced quinone acceptors (ubiquinones) QA and QB of photosynthetic reaction centers of purple bacteria Rhodobacter sphaeroides (Rb. sphaeroides) was studied. Photoinduced changes in the absorption were detected in the Qx absorption band of photooxidized bacteriochlorophyll at 600 nm and in the bands corresponding to the redox changes of ubiquinones at 335 and 420–450 nm. Kinetic analysis was used to evaluate the activation energy and the characteristic time of the transient proc...

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Targeting EGFR and uPAR on human rhabdomyosarcoma, osteosarcoma, and ovarian adenocarcinoma with a bispecific ligand-directed toxin.

Conclusion: The results of our study are promising, and further studies will be necessary to confirm the applicability of eBAT as a supplementary therapy for a variety of sarcomas, carcinomas, and possibly other refractory malignancies that express EGFR and uPAR. PMID: 30288129 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)

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Clear cell renal cell carcinoma: CT-based radiomics features for the prediction of Fuhrman Grade

Publication date: Available online 5 October 2018

Source: European Journal of Radiology

Author(s): Jun Shu, Yongqiang Tang, Jingjing Cui, Ruwu Yang, Xiaoli Meng, Zhengting Cai, Jingsong Zhang, Wanni Xu, Didi Wen, Hong Yin

Abstract

Objectives

To discriminate low grade (Fuhrman I/II) and high grade (Fuhrman III/IV) clear cell renal cell carcinoma (CCRCC) by using CT-based radiomic features.

Methods

161 and 99 patients diagnosed with low and high grade CCRCCs from January 2011 to May 2018 were enrolled in this study. 1029 radiomic features were extracted from corticomedullary (CMP), and nephrographic phase (NP) CT images of all patients. We used interclass correlation coefficient (ICC) and the least absolute shrinkage and selection operator (LASSO) regression method to select features, then the selected features were constructed three classification models (CMP, NP and with their combination) to discriminate high and low grades CCRCC. These three models were built by logistic regression method using 5-fold cross validation strategy, evaluated with receiver operating characteristics curve (ROC) and compared using DeLong test.

Results

We found 11 and 24 CMP and NP features were independently significantly associated with the Fuhrman grades. The model of CMP, NP and Combined model using radiomic feature set showed diagnostic accuracy of 0.719 (AUC [area under the curve], 0.766; 95% CI [confidence interval]: 0.709-0.816; sensitivity, 0.602; specificity, 0.838), 0.738 (AUC, 0.818; 95% CI:0.765-0.838; sensitivity, 0.693; specificity, 0.838), 0.777(AUC, 0.822; 95% CI: 0.769-0.866; sensitivity, 0.677; specificity, 0.839). There were significant differences in AUC between CMP model and Combined model (P = 0.0208), meanwhile, the differences between CMP model and NP model, NP model and Combined model reached no significant (P = 0.0844, 0.7915).

Conclusions

Radiomic features could be used as biomarker for the preoperative evaluation of the CCRCC Fuhrman grades.

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Grayscale Ultrasonic and Shear Wave Elastographic Characteristics of the Achilles’ Tendon in Patients with Familial Hypercholesterolemia: A Pilot Study

Publication date: Available online 5 October 2018

Source: European Journal of Radiology

Author(s): Lei Zhang, Qiang Yong, Tianning Pu, Chao Zheng, Mingyue Wang, Sujun Shi, Liang Li

Abstract

Objective

To investigate the feasibility of grayscale ultrasound and quantitative shear wave elastography (SWE) for assessing the image features and stiffness of the Achilles tendon in patients with familial hypercholesterolemia (FH) compared with healthy controls.

Methods

A total of 38 Achilles tendons from healthy control participants and 94 from patients with FH were examined with grayscale ultrasound and SWE. Each Achilles tendon examination was performed on 3 different segments (proximal, middle, and distal). The thickness, grayscale image features and elasticity modulus of each segment was measured on longitudinal views.

Results

In Achilles tendons of healthy control participants, the thicknesses of the proximal, middle, and distal segments were (4.46 ± 0.68) mm, (5.41 ± 1.01) mm, and (4.41 ± 0.57) mm, respectively. The grayscale features were diffusely hypoechoic with parallel linear hyperechoic striations. The mean elasticity modulus of the proximal, middle, and distal sites was (418.08 ± 43.13) kPa, (425.78 ± 47.14) kPa, and (407.79 ± 38.74) kPa, respectively. In the FH group, the thicknesses of the proximal, middle, and distal segments were (7.65 ± 3.09) mm, (11.46 ± 4.84) mm, and (8.14 ± 2.90) mm, respectively. The grayscale features were hypoechoic with linear hyperechoic disordered fibre distribution (92/94). Two of 94 Achilles tendons had considerable focal hypoechogenicity. Seventeen of 94 Achilles tendons had calcifications. In the FH group, the mean elasticity modulus of the proximal, middle, and distal segments were (294.86 ± 58.13) kPa, (280.93 ± 63.58) kPa, and (282.41 ± 56.47) kPa, respectively. Statistically significant differences were found between the Achilles tendons of healthy control participants and FH patients in the thicknesses and mean elasticity modulus at the proximal, middle and distal segments of the Achilles tendons (all P < 0.001).

Conclusions

Our results suggest that the grayscale features and SWE characteristics of the Achilles tendon provided complementary biomechanical information for quantitative assessment the Achilles tendon in patients with FH.

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Association of pleasant sensations at cigarette smoking initiation with subsequent tobacco product use among U.S. adolescents

Publication date: Available online 6 October 2018

Source: Addictive Behaviors

Author(s): JuHan Lee, Catherine W. Striley, Carlo Custodero, Harold A. Rocha, Ramzi G. Salloum

Abstract

Approximately 20% of high school students and 7% of middle school students in the United States used tobacco products in 2016. One factor that may contribute to tobacco use is pleasant sensations – typically characterized as physiological reinforcement such as a dopamine response, or as social reinforcement such as social acceptance. In the present study, the Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study was analyzed to examine the influence of pleasant sensations at cigarette smoking initiation on current use of other tobacco products among adolescents. While those who reported higher unpleasant sensations at cigarette smoking initiation were less likely to report current use of any tobacco product(s) (Odds Ratio [OR] = 0.70), those who reported higher pleasant sensations at cigarette initiation were more likely to report current use of any tobacco product(s) (OR = 2.12) – including: cigarettes (OR = 2.09), cigars (OR = 1.58), hookah (OR = 1.37), and e-cigarettes (OR = 1.37). Based on these findings, interventions for smoking education and further surveillance may benefit adolescents who report higher pleasant sensations at cigarette smoking initiation.

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Key personality traits and alcohol use disorder symptoms in first and second year college students: detangling antecedent from consequence

Publication date: Available online 6 October 2018

Source: Addictive Behaviors

Author(s): Lucy R. Nichols, Diana R. Samek, Leanna McConnell

Abstract

Background

Studies have consistently shown that low constraint and high negative emotionality are associated with higher levels of alcohol use and greater alcohol related problems. Less research has examined associations between these traits and alcohol use disorder (AUD) from the first to second year of college, when alcohol use increases rapidly, or has evaluated gender differences in these associations.

Methods

The longitudinal College Experiences Study (N = 209, 60% female, 90% white) was used to detangle antecedent vs. consequence between constraint, negative emotionality, and AUD symptoms using multiple methods (cross-lagged panel analysis, latent difference score approach).

Results

Providing evidence for a scar/complication model, greater AUD symptoms in the first year of college was predictive of rank-order and correlated decreases in constraint in the second year, but only for males. Surprisingly, negative emotionality was not associated with AUD symptoms for either gender. Qualitative analyses show that the vast majority of those that met an AUD diagnosis (90%+) did not consider their drinking to be problematic.

Conclusion

Given the vast majority of college students with AUD do not perceive their drinking to be problematic, results support the potential of using personality-based risk prevention/intervention programs to target at-risk individuals for problematic drinking, rather than targeting problematic drinking alone.

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Willingness as a mediator of the effects of personality on alcohol-related consequences between the first and second years of college: A longitudinal prospective study

Publication date: Available online 5 October 2018

Source: Addictive Behaviors

Author(s): Bradley M. Trager, Kimberly A. Mallett, Rob Turrisi, Nichole M. Sell, Brittney A. Hultgren

Abstract

The present study used a prospective longitudinal design to examine whether willingness to experience negative alcohol-related consequences mediated the effects of personality on consequences (e.g., blacking out, getting into a fight, and regretted sex). Students (N = 2024) were assessed at three time points: fall semester of the students' first year in college (baseline), 6-months post-baseline, and one-year post-baseline. Personality constructs were assessed at baseline (i.e., impulsivity, sensation seeking, self-regulation), willingness to experience negative alcohol-related consequences and negative alcohol-related consequences were examined at baseline and one-year post-baseline. A structural path model was used to examine if willingness mediated the effects of personality on consequences. Covariates assessing baseline drinking and consequences were also included in the model. Results demonstrated willingness to experience consequences significantly mediated the effects of impulsivity, sensation seeking, and self-regulation on consequences. Findings from this study support the idea that consequence-specific cognitions, such as willingness, can explain changes in consequences associated with personality. This suggests that intervention efforts aimed at reducing negative alcohol-related consequences could benefit from the inclusion of consequence-specific cognitions, personality (e.g., impulsivity, sensation seeking, and self-regulation), and drinking.

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Association of pleasant sensations at cigarette smoking initiation with subsequent tobacco product use among U.S. adolescents

Publication date: Available online 6 October 2018

Source: Addictive Behaviors

Author(s): JuHan Lee, Catherine W. Striley, Carlo Custodero, Harold A. Rocha, Ramzi G. Salloum

Abstract

Approximately 20% of high school students and 7% of middle school students in the United States used tobacco products in 2016. One factor that may contribute to tobacco use is pleasant sensations – typically characterized as physiological reinforcement such as a dopamine response, or as social reinforcement such as social acceptance. In the present study, the Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study was analyzed to examine the influence of pleasant sensations at cigarette smoking initiation on current use of other tobacco products among adolescents. While those who reported higher unpleasant sensations at cigarette smoking initiation were less likely to report current use of any tobacco product(s) (Odds Ratio [OR] = 0.70), those who reported higher pleasant sensations at cigarette initiation were more likely to report current use of any tobacco product(s) (OR = 2.12) – including: cigarettes (OR = 2.09), cigars (OR = 1.58), hookah (OR = 1.37), and e-cigarettes (OR = 1.37). Based on these findings, interventions for smoking education and further surveillance may benefit adolescents who report higher pleasant sensations at cigarette smoking initiation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BZ5d5L

Key personality traits and alcohol use disorder symptoms in first and second year college students: detangling antecedent from consequence

Publication date: Available online 6 October 2018

Source: Addictive Behaviors

Author(s): Lucy R. Nichols, Diana R. Samek, Leanna McConnell

Abstract

Background

Studies have consistently shown that low constraint and high negative emotionality are associated with higher levels of alcohol use and greater alcohol related problems. Less research has examined associations between these traits and alcohol use disorder (AUD) from the first to second year of college, when alcohol use increases rapidly, or has evaluated gender differences in these associations.

Methods

The longitudinal College Experiences Study (N = 209, 60% female, 90% white) was used to detangle antecedent vs. consequence between constraint, negative emotionality, and AUD symptoms using multiple methods (cross-lagged panel analysis, latent difference score approach).

Results

Providing evidence for a scar/complication model, greater AUD symptoms in the first year of college was predictive of rank-order and correlated decreases in constraint in the second year, but only for males. Surprisingly, negative emotionality was not associated with AUD symptoms for either gender. Qualitative analyses show that the vast majority of those that met an AUD diagnosis (90%+) did not consider their drinking to be problematic.

Conclusion

Given the vast majority of college students with AUD do not perceive their drinking to be problematic, results support the potential of using personality-based risk prevention/intervention programs to target at-risk individuals for problematic drinking, rather than targeting problematic drinking alone.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zV6DwS

Willingness as a mediator of the effects of personality on alcohol-related consequences between the first and second years of college: A longitudinal prospective study

Publication date: Available online 5 October 2018

Source: Addictive Behaviors

Author(s): Bradley M. Trager, Kimberly A. Mallett, Rob Turrisi, Nichole M. Sell, Brittney A. Hultgren

Abstract

The present study used a prospective longitudinal design to examine whether willingness to experience negative alcohol-related consequences mediated the effects of personality on consequences (e.g., blacking out, getting into a fight, and regretted sex). Students (N = 2024) were assessed at three time points: fall semester of the students' first year in college (baseline), 6-months post-baseline, and one-year post-baseline. Personality constructs were assessed at baseline (i.e., impulsivity, sensation seeking, self-regulation), willingness to experience negative alcohol-related consequences and negative alcohol-related consequences were examined at baseline and one-year post-baseline. A structural path model was used to examine if willingness mediated the effects of personality on consequences. Covariates assessing baseline drinking and consequences were also included in the model. Results demonstrated willingness to experience consequences significantly mediated the effects of impulsivity, sensation seeking, and self-regulation on consequences. Findings from this study support the idea that consequence-specific cognitions, such as willingness, can explain changes in consequences associated with personality. This suggests that intervention efforts aimed at reducing negative alcohol-related consequences could benefit from the inclusion of consequence-specific cognitions, personality (e.g., impulsivity, sensation seeking, and self-regulation), and drinking.

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Flu shot myths, such as that you should wait for cold weather to get the vaccine

Another myth is that people with egg allergies can't get the flu vaccine. (Source: ABC News: Health)

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Flu shot myths, such as that you should wait for cold weather to get the vaccine

Another myth is that people with egg allergies can't get the flu vaccine. (Source: ABC News: Health)

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Molecular Detection of New SHV-β-lactamase Variants in Clinical Escherichia coli and Klebsiella pneumoniae Isolates from Egypt

Publication date: Available online 5 October 2018Source: Comparative Immunology, Microbiology and Infectious DiseasesAuthor(s): Gamal A. Elmowalid, Adel Attia M. Ahmad, Muhammad N. Hassan, Norhan K. Abd El-Aziz, Ashraf MO Abd-Elwahab, Shymaa I. ElwanAbstractThe emergence of multidrug-resistant (MDR) pathogens was reported worldwide. Herein, SHV extended-spectrum β-lactamase (SHV-ESBL) variants detection was investigated in MDR E. coli and K. pneumoniae isolates recovered from human subjects (n = 144), one day-old chicks (n = 36) and broiler clinical samples (n = 90). All examined samples were positive for E. coli (n = 246/270; 91.11%) and Klebsiella species (n = 24/270; 8.89%). Antimicrobial susceptibility testing was performed on E. coli and K. pneumoniae. SHV-ESBL pr...

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The potential role of folate metabolism in interstitial cystitis

AbstractThe topic of interstitial cystitis (IC), also known as painful bladder syndrome (PBS), and folate/one carbon metabolism has previously been unaddressed in research. This narrative review highlights a potential connection for those with mast cell-related IC and histamine-mediated pain that is explored through four conceptual sections. The first section focuses on the nature of mast cell involvement and histamine-mediated pain in some interstitial cystitis patients. The second section reviews the literature on folate status in wider allergic conditions. The third section addresses the role of folate and methylation in general in histamine excretion. Finally, folate metabolism and vascular function are addressed because of the vascular abnormalities present in some IC bladders. (Sourc...

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Molecular Detection of New SHV-β-lactamase Variants in Clinical Escherichia coli and Klebsiella pneumoniae Isolates from Egypt

Publication date: Available online 5 October 2018Source: Comparative Immunology, Microbiology and Infectious DiseasesAuthor(s): Gamal A. Elmowalid, Adel Attia M. Ahmad, Muhammad N. Hassan, Norhan K. Abd El-Aziz, Ashraf MO Abd-Elwahab, Shymaa I. ElwanAbstractThe emergence of multidrug-resistant (MDR) pathogens was reported worldwide. Herein, SHV extended-spectrum β-lactamase (SHV-ESBL) variants detection was investigated in MDR E. coli and K. pneumoniae isolates recovered from human subjects (n = 144), one day-old chicks (n = 36) and broiler clinical samples (n = 90). All examined samples were positive for E. coli (n = 246/270; 91.11%) and Klebsiella species (n = 24/270; 8.89%). Antimicrobial susceptibility testing was performed on E. coli and K. pneumoniae. SHV-ESBL pr...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zVlcjW

The potential role of folate metabolism in interstitial cystitis

AbstractThe topic of interstitial cystitis (IC), also known as painful bladder syndrome (PBS), and folate/one carbon metabolism has previously been unaddressed in research. This narrative review highlights a potential connection for those with mast cell-related IC and histamine-mediated pain that is explored through four conceptual sections. The first section focuses on the nature of mast cell involvement and histamine-mediated pain in some interstitial cystitis patients. The second section reviews the literature on folate status in wider allergic conditions. The third section addresses the role of folate and methylation in general in histamine excretion. Finally, folate metabolism and vascular function are addressed because of the vascular abnormalities present in some IC bladders. (Sourc...

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Flu shot myths, such as that you should wait for cold weather to get the vaccine

Another myth is that people with egg allergies can't get the flu vaccine. (Source: ABC News: Health)

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Flu shot myths, such as that you should wait for cold weather to get the vaccine

Another myth is that people with egg allergies can't get the flu vaccine. (Source: ABC News: Health)

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The internal nasal valve: a validated grading system and operative guide

Abstract

Purpose

Nasal obstruction is a highly subjective and commonly reported symptom. The internal nasal valve (INV) is the rate limiting step to nasal airflow. A static INV grading score was devised with regard to visibility of the middle turbinate.

Methods

A prospective study of all patients who underwent primary external functional septorhinoplasty in 2017 for nasal obstruction. All patients' INV score was assessed pre- and postoperatively in a blinded and independent fashion by surgeons of varying seniority.

Results

Twenty-eight patients were studied, with mean age 30.9 years and follow-up 18.8 weeks. Inter-rater and test–retest reliability of INV grading were excellent, with Cronbach's alpha 0.936 and 0.920, respectively. There was also statistically significant improvement in both subjective and objective postoperative outcome measures including nasal inspiratory peak flows.

Conclusions

We demonstrate a novel, easy to interpret, clinically valuable grading system of the static internal nasal valve that is reliable and reproducible.

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The internal nasal valve: a validated grading system and operative guide

Abstract

Purpose

Nasal obstruction is a highly subjective and commonly reported symptom. The internal nasal valve (INV) is the rate limiting step to nasal airflow. A static INV grading score was devised with regard to visibility of the middle turbinate.

Methods

A prospective study of all patients who underwent primary external functional septorhinoplasty in 2017 for nasal obstruction. All patients' INV score was assessed pre- and postoperatively in a blinded and independent fashion by surgeons of varying seniority.

Results

Twenty-eight patients were studied, with mean age 30.9 years and follow-up 18.8 weeks. Inter-rater and test–retest reliability of INV grading were excellent, with Cronbach's alpha 0.936 and 0.920, respectively. There was also statistically significant improvement in both subjective and objective postoperative outcome measures including nasal inspiratory peak flows.

Conclusions

We demonstrate a novel, easy to interpret, clinically valuable grading system of the static internal nasal valve that is reliable and reproducible.

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Retentive force of PEEK secondary crowns on zirconia primary crowns over time

Abstract

Objectives

The purpose of the present study was to evaluate the retentive forces of CAD/CAM-fabricated polyetheretherketone (PEEK) secondary crowns on zirconia primary crowns over an artificial aging period representing 10 years of clinical service and compare them to electroformed secondary crowns made from pure gold.

Material and methods

Implant-supported zirconia primary crowns (N = 20) were CAD/CAM milled and provided either with electroformed secondary crowns (group ZE; N = 10) or CAD/CAM-fabricated PEEK secondary crowns (group ZP; N = 10). All secondary crowns were attached to a casted tertiary structure to ensure adequate stability. A universal testing machine was used to determine the retentive force values at baseline and after 1, 3, 5, and 10 years of simulated aging in the presence of artificial saliva. Data were analyzed applying Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U test. Level of significance was set at p < 0.05.

Results

Retentive forces were not different for the groups ZE and ZP at baseline (median ZE 2.85 N; ZP 2.8 N; p ≤ 0.218). Because retentive force values changed significantly over simulation time for group ZE (Kruskal-Wallis; p ≤ 0.028), the values between the test groups ZE and ZP differed significantly (Mann-Whitney U) at 5 years (ZE 3.03 N; ZP 2.76 N; p ≤ 0.003) and 10 years (ZE 3.1 N; ZP 2.78 N; p ≤ 0.011).

Conclusions

PEEK secondary crowns exhibit stable retentive force values over 10 years of simulated aging showing no signs of deterioration while the retentive force values of electroformed secondary crowns increase over time.

Clinical relevance

PEEK might be a suitable alternative to proven metallic materials for the fabrication of secondary crowns.

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Effect of EDTA root conditioning on the outcome of coronally advanced flap with connective tissue graft: a systematic review and meta-analysis

Abstract

Objectives

CAF in combination with a connective tissue graft (CTG) is considered the technique of choice for treating gingival recessions (GRs). Among the many recognized factors that can affect the outcomes, the use of chemical agents has been proposed. The effect of EDTA, as a commonly used agent, remains controversial. Therefore, the aim of this review was to assess the efficacy of EDTA root conditioning when combined to CAF + CTG.

Material and methods

A literature search was conducted to identify randomized clinical trials (RCTs) that performed CAF + CTG with and without EDTA for root coverage procedures. The following outcomes were assessed: recession reduction (Rec Red), complete root coverage (CRC), keratinized tissue gain (KT gain), clinical attachment level changes (CAL gain), and changes in pocket depth (PD changes).

Results

Fourteen RCTs (575 GRs) were included and analyzed. Six articles were included in the EDTA group, with 8 in the non-EDTA group. Meta-analyses revealed statistically significant differences for the outcomes of Rec Red (3.68 mm versus 3.07 mm), CAL gain (4.15 mm versus 3.07 mm), and PD changes (− 0.44 mm versus 0.27 mm) in favor of the EDTA group, while outcomes of CRC (odds ratio of 1.15) and KT gain (1.98 mm versus 1.62 mm) were not significantly different.

Conclusions

Limited evidence is available when evaluating the effectiveness of EDTA root conditioning with CAF + CTG. However, the adjunct application of EDTA with CAF + CTG appears to be beneficial.

Clinical relevance

The adjunct application of EDTA may provide benefits when performing root coverage procedure via CAF + CTG.

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Retentive force of PEEK secondary crowns on zirconia primary crowns over time

Abstract

Objectives

The purpose of the present study was to evaluate the retentive forces of CAD/CAM-fabricated polyetheretherketone (PEEK) secondary crowns on zirconia primary crowns over an artificial aging period representing 10 years of clinical service and compare them to electroformed secondary crowns made from pure gold.

Material and methods

Implant-supported zirconia primary crowns (N = 20) were CAD/CAM milled and provided either with electroformed secondary crowns (group ZE; N = 10) or CAD/CAM-fabricated PEEK secondary crowns (group ZP; N = 10). All secondary crowns were attached to a casted tertiary structure to ensure adequate stability. A universal testing machine was used to determine the retentive force values at baseline and after 1, 3, 5, and 10 years of simulated aging in the presence of artificial saliva. Data were analyzed applying Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U test. Level of significance was set at p < 0.05.

Results

Retentive forces were not different for the groups ZE and ZP at baseline (median ZE 2.85 N; ZP 2.8 N; p ≤ 0.218). Because retentive force values changed significantly over simulation time for group ZE (Kruskal-Wallis; p ≤ 0.028), the values between the test groups ZE and ZP differed significantly (Mann-Whitney U) at 5 years (ZE 3.03 N; ZP 2.76 N; p ≤ 0.003) and 10 years (ZE 3.1 N; ZP 2.78 N; p ≤ 0.011).

Conclusions

PEEK secondary crowns exhibit stable retentive force values over 10 years of simulated aging showing no signs of deterioration while the retentive force values of electroformed secondary crowns increase over time.

Clinical relevance

PEEK might be a suitable alternative to proven metallic materials for the fabrication of secondary crowns.

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Effect of EDTA root conditioning on the outcome of coronally advanced flap with connective tissue graft: a systematic review and meta-analysis

Abstract

Objectives

CAF in combination with a connective tissue graft (CTG) is considered the technique of choice for treating gingival recessions (GRs). Among the many recognized factors that can affect the outcomes, the use of chemical agents has been proposed. The effect of EDTA, as a commonly used agent, remains controversial. Therefore, the aim of this review was to assess the efficacy of EDTA root conditioning when combined to CAF + CTG.

Material and methods

A literature search was conducted to identify randomized clinical trials (RCTs) that performed CAF + CTG with and without EDTA for root coverage procedures. The following outcomes were assessed: recession reduction (Rec Red), complete root coverage (CRC), keratinized tissue gain (KT gain), clinical attachment level changes (CAL gain), and changes in pocket depth (PD changes).

Results

Fourteen RCTs (575 GRs) were included and analyzed. Six articles were included in the EDTA group, with 8 in the non-EDTA group. Meta-analyses revealed statistically significant differences for the outcomes of Rec Red (3.68 mm versus 3.07 mm), CAL gain (4.15 mm versus 3.07 mm), and PD changes (− 0.44 mm versus 0.27 mm) in favor of the EDTA group, while outcomes of CRC (odds ratio of 1.15) and KT gain (1.98 mm versus 1.62 mm) were not significantly different.

Conclusions

Limited evidence is available when evaluating the effectiveness of EDTA root conditioning with CAF + CTG. However, the adjunct application of EDTA with CAF + CTG appears to be beneficial.

Clinical relevance

The adjunct application of EDTA may provide benefits when performing root coverage procedure via CAF + CTG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E1QpWB

Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966 –2010

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966 –2010

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OCzkXD

International neural monitoring study group guideline 2018 part I: Staging bilateral thyroid surgery with monitoring loss of signal

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future?

Publication date: Available online 5 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Rudolf Valenta, Alexander Karaulov, Verena Niederberger, Yury Zhernov, Olga Elisyutina, Raffaela Campana, Margarete Focke-Tejkl, Mirela Curin, Leyla Namazova-Baranova, Jiu-Yao Wang, Ruby Paw.ar, Musa KhaitovToday, in vivo allergy diagnosis and allergen-specific immunotherapy (AIT) are still based on allergen extracts obtained from natural allergen sources. Several studies analyzing the composition of natural allergen extracts have shown severe problems regarding their quality such as the presence of undefined nonallergenic materials, contaminants as well as high variabilities regarding contents and biological activity of individual allergens. Despite the increasin...

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Vitamin D level affects IVF outcome partially mediated via Th/Tc cell ratio

American Journal of Reproductive Immunology, EarlyView. (Source: American Journal of Reproductive Immunology)

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Irritant Contact Dermatitis

AbstractContact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus. Pruritus is classically reported by patients with AD and ACD. ICD lesions are typically well-demarcated unlike AD and ACD. ICD is diagnosed by exclusion. Patients undergo testing to rule out type I and type IV hypersensitivity. Negative results suggest a diagnosis of ICD. Man...

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Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future?

Publication date: Available online 5 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Rudolf Valenta, Alexander Karaulov, Verena Niederberger, Yury Zhernov, Olga Elisyutina, Raffaela Campana, Margarete Focke-Tejkl, Mirela Curin, Leyla Namazova-Baranova, Jiu-Yao Wang, Ruby Paw.ar, Musa KhaitovToday, in vivo allergy diagnosis and allergen-specific immunotherapy (AIT) are still based on allergen extracts obtained from natural allergen sources. Several studies analyzing the composition of natural allergen extracts have shown severe problems regarding their quality such as the presence of undefined nonallergenic materials, contaminants as well as high variabilities regarding contents and biological activity of individual allergens. Despite the increasin...

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Vitamin D level affects IVF outcome partially mediated via Th/Tc cell ratio

American Journal of Reproductive Immunology, EarlyView. (Source: American Journal of Reproductive Immunology)

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Irritant Contact Dermatitis

AbstractContact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus. Pruritus is classically reported by patients with AD and ACD. ICD lesions are typically well-demarcated unlike AD and ACD. ICD is diagnosed by exclusion. Patients undergo testing to rule out type I and type IV hypersensitivity. Negative results suggest a diagnosis of ICD. Man...

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Role and Mechanism of the Nod-Like Receptor Family Pyrin Domain-Containing 3 Inflammasome in Oral Disease

Publication date: Available online 6 October 2018

Source: Archives of Oral Biology

Author(s): Kejia Lv, Guohua Wang, Chenlu Shen, Xia Zhang, Hua Yao

Abstract

Objective

To summarize evidence and data from experimental studies regarding the role and mechanism of the Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome in the pathogenesis of several representative oral diseases.

Materials and methods

A literature search of PubMed and EBSCO was performed. The literature was searched using a combination of keywords, e.g., NLRP3 inflammasome, inflammation, microorganisms, oral inflammatory diseases, and oral immunological diseases.

Results

The initiation and activation of the NLRP3 inflammasome are associated with the pathogenesis and progression of several representative oral diseases, including periodontitis, oral lichen planus, dental pulp disease, and oral cavity squamous cell carcinoma.

Conclusions

The NLRP3 inflammasome plays a crucial role in the progression of inflammatory and adaptive immune responses. The possible role of the NLRP3 inflammasome in several oral diseases, including not only periodontitis and pulpitis but also mucosal diseases and oral cavity squamous cell carcinoma, may involve the aberrant regulation of inflammatory and immune responses. Understanding the cellular and molecular biology of the NLRP3 inflammasome is necessary because the NLRP3 inflammasome may be a potential therapeutic target for the treatment and prevention of oral inflammatory and immunological diseases.

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Five decades of orofacial cleft management and research in Brazil

Publication date: Available online 6 October 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J.L.G.C. Monteiro, J.A.A. de Arruda, D.F. Bueno, B.C.d.E. Vasconcelos

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Role and Mechanism of the Nod-Like Receptor Family Pyrin Domain-Containing 3 Inflammasome in Oral Disease

Publication date: Available online 6 October 2018

Source: Archives of Oral Biology

Author(s): Kejia Lv, Guohua Wang, Chenlu Shen, Xia Zhang, Hua Yao

Abstract

Objective

To summarize evidence and data from experimental studies regarding the role and mechanism of the Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome in the pathogenesis of several representative oral diseases.

Materials and methods

A literature search of PubMed and EBSCO was performed. The literature was searched using a combination of keywords, e.g., NLRP3 inflammasome, inflammation, microorganisms, oral inflammatory diseases, and oral immunological diseases.

Results

The initiation and activation of the NLRP3 inflammasome are associated with the pathogenesis and progression of several representative oral diseases, including periodontitis, oral lichen planus, dental pulp disease, and oral cavity squamous cell carcinoma.

Conclusions

The NLRP3 inflammasome plays a crucial role in the progression of inflammatory and adaptive immune responses. The possible role of the NLRP3 inflammasome in several oral diseases, including not only periodontitis and pulpitis but also mucosal diseases and oral cavity squamous cell carcinoma, may involve the aberrant regulation of inflammatory and immune responses. Understanding the cellular and molecular biology of the NLRP3 inflammasome is necessary because the NLRP3 inflammasome may be a potential therapeutic target for the treatment and prevention of oral inflammatory and immunological diseases.

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Five decades of orofacial cleft management and research in Brazil

Publication date: Available online 6 October 2018

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J.L.G.C. Monteiro, J.A.A. de Arruda, D.F. Bueno, B.C.d.E. Vasconcelos

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Interferon-induced epithelial response to rhinovirus-16 in asthma relates to inflammation and FEV1

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Abilash Ravi, Jan Koster, Annemiek Dijkhuis, Suzanne M. Bal, Yanaika S. Sabogal Piñeros, Peter I. Bonta, Christof J. Majoor, Peter J. Sterk, René Lutter

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Cholestenoic Acid is a Prognostic Biomarker in Acute Respiratory Distress Syndrome

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jennifer H. Madenspacher, Renee D. Stapleton, Benjamin T. Suratt, Anne E. Dixon, Fred B. Lih, Julie M. Lowe, Kara J. Mould, William J. Janssen, Eric D. Morrell, Mark M. Wurfel, Stavros Garantziotis, Kenneth B. Tomer, Michael B. Fessler

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Increased surface expression of NOTCH on memory T cells in peripheral blood from asthma patients

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irma Tindemans, Heleen Vroman, Melanie Lukkes, Menno van Nimwegen, Marjolein J.W. de Bruijn, Bobby W.S. Li, Alex Kleinjan, Geertje M. de Boer, Gerdien A. Tramper, Mirjam Kool, Gert-Jan Braunstahl, Rudi W. Hendriks

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Human TBK1 is required for early autophagy induction upon HSV1 infection

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Liyana Ahmad, Bayarchimeg Mashbat, Corwin Leung, Charlotte Brookes, Samar Hamad, Sina Krokowski, Avinash R. Shenoy, Lazaro Lorenzo, Michael Levin, Peter O'Hare, Shen-Ying Zhang, Jean-Laurent Casanova, Serge Mostowy, Vanessa Sancho-Shimizu

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Interferon-induced epithelial response to rhinovirus-16 in asthma relates to inflammation and FEV1

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Abilash Ravi, Jan Koster, Annemiek Dijkhuis, Suzanne M. Bal, Yanaika S. Sabogal Piñeros, Peter I. Bonta, Christof J. Majoor, Peter J. Sterk, René Lutter

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Cholestenoic Acid is a Prognostic Biomarker in Acute Respiratory Distress Syndrome

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jennifer H. Madenspacher, Renee D. Stapleton, Benjamin T. Suratt, Anne E. Dixon, Fred B. Lih, Julie M. Lowe, Kara J. Mould, William J. Janssen, Eric D. Morrell, Mark M. Wurfel, Stavros Garantziotis, Kenneth B. Tomer, Michael B. Fessler

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Increased surface expression of NOTCH on memory T cells in peripheral blood from asthma patients

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irma Tindemans, Heleen Vroman, Melanie Lukkes, Menno van Nimwegen, Marjolein J.W. de Bruijn, Bobby W.S. Li, Alex Kleinjan, Geertje M. de Boer, Gerdien A. Tramper, Mirjam Kool, Gert-Jan Braunstahl, Rudi W. Hendriks

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Human TBK1 is required for early autophagy induction upon HSV1 infection

Publication date: Available online 5 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Liyana Ahmad, Bayarchimeg Mashbat, Corwin Leung, Charlotte Brookes, Samar Hamad, Sina Krokowski, Avinash R. Shenoy, Lazaro Lorenzo, Michael Levin, Peter O'Hare, Shen-Ying Zhang, Jean-Laurent Casanova, Serge Mostowy, Vanessa Sancho-Shimizu

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Delivering Otolaryngologic Care Safely and Successfully

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Sujana S. Chandrasekhar

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Publicly Available Databases in Otolaryngology Quality Improvement

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Alexander L. Schneider, Jennifer M. Lavin

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Multidisciplinary Tracheostomy Care: How Collaboratives Drive Quality Improvement

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Joshua R. Bedwell, Vinciya Pandian, David W. Roberson, Brendan A. McGrath, Tanis S. Cameron, Michael J. Brenner

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Rethinking Morbidity and Mortality Conference

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Brian Nussenbaum, Richard A. Chole

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Medical Management of Acute Facial Paralysis

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Teresa M. O

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Management of Flaccid Facial Paralysis of Less Than Two Years’ Duration

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Andrew William Joseph, Jennifer C. Kim

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Delivering Otolaryngologic Care Safely and Successfully

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Sujana S. Chandrasekhar

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Publicly Available Databases in Otolaryngology Quality Improvement

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Alexander L. Schneider, Jennifer M. Lavin

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Multidisciplinary Tracheostomy Care: How Collaboratives Drive Quality Improvement

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Joshua R. Bedwell, Vinciya Pandian, David W. Roberson, Brendan A. McGrath, Tanis S. Cameron, Michael J. Brenner

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Rethinking Morbidity and Mortality Conference

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Brian Nussenbaum, Richard A. Chole

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Medical Management of Acute Facial Paralysis

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Teresa M. O

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Management of Flaccid Facial Paralysis of Less Than Two Years’ Duration

Publication date: Available online 5 October 2018

Source: Otolaryngologic Clinics of North America

Author(s): Andrew William Joseph, Jennifer C. Kim

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Carcinogenic epithelial-mesenchymal transition initiated by oral cancer exosomes is inhibited by anti-EGFR antibody cetuximab

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Toshifumi Fujiwara, Takanori Eguchi, Chiharu Sogawa, Kisho Ono, Jun Murakami, Soichiro Ibaragi, Jun-ichi Asaumi, Stuart K. Calderwood, Kuniaki Okamoto, Ken-ichi Kozaki

Abstract

Overexpression and increased signaling from the epidermal growth factor receptor (EGFR) often changes oral squamous cell carcinoma (OSCC) and thus EGFR is frequently targeted molecularly by the therapeutic antibody cetuximab. We assessed the roles of OSCC-derived extracellular vesicles (EVs), including exosomes in the trafficking of cetuximab and in epithelial-mesenchymal transition (EMT) of epithelial cells. OSCC cells abundantly expressed EGFR, which was secreted from cells with OSCC-EVs upon EGF stimulations. The OSCC-EGFR-EVs were then able to enter into and transform epithelial cells leading to increased mesenchymal traits with increased vimentin and spindle-like shapes. EGF priming of OSCC cells further increased this EMT-initiating effect of the OSCC-EVs. The internalization and pro-EMT effects of the OSCC-EVs were largely blocked by cetuximab. Thus, OSCC-derived EVs transform normal epithelial cells into a mesenchymal phenotype and anti-EGFR therapeutic antibody cetuximab inhibits such a carcinogenic effect of the OSCC-EVs.

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Small cell neuroendocrine carcinoma of the alveolar process of maxilla

Publication date: Available online 5 October 2018

Source: Oral Oncology

Author(s): Muhammad Shahid Iqbal, Sarah Matthews, Anne Chambers, Charles Kelly, Omar Ahmed, James Adams

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Carcinogenic epithelial-mesenchymal transition initiated by oral cancer exosomes is inhibited by anti-EGFR antibody cetuximab

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Toshifumi Fujiwara, Takanori Eguchi, Chiharu Sogawa, Kisho Ono, Jun Murakami, Soichiro Ibaragi, Jun-ichi Asaumi, Stuart K. Calderwood, Kuniaki Okamoto, Ken-ichi Kozaki

Abstract

Overexpression and increased signaling from the epidermal growth factor receptor (EGFR) often changes oral squamous cell carcinoma (OSCC) and thus EGFR is frequently targeted molecularly by the therapeutic antibody cetuximab. We assessed the roles of OSCC-derived extracellular vesicles (EVs), including exosomes in the trafficking of cetuximab and in epithelial-mesenchymal transition (EMT) of epithelial cells. OSCC cells abundantly expressed EGFR, which was secreted from cells with OSCC-EVs upon EGF stimulations. The OSCC-EGFR-EVs were then able to enter into and transform epithelial cells leading to increased mesenchymal traits with increased vimentin and spindle-like shapes. EGF priming of OSCC cells further increased this EMT-initiating effect of the OSCC-EVs. The internalization and pro-EMT effects of the OSCC-EVs were largely blocked by cetuximab. Thus, OSCC-derived EVs transform normal epithelial cells into a mesenchymal phenotype and anti-EGFR therapeutic antibody cetuximab inhibits such a carcinogenic effect of the OSCC-EVs.

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Small cell neuroendocrine carcinoma of the alveolar process of maxilla

Publication date: Available online 5 October 2018

Source: Oral Oncology

Author(s): Muhammad Shahid Iqbal, Sarah Matthews, Anne Chambers, Charles Kelly, Omar Ahmed, James Adams

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Association between air pollution in the 2015 winter in South Korea and population size, car emissions, industrial activity, and fossil-fuel power plants: an ecological study

Compared to 10 years ago, the ambient particulate matter 10 (PM10) and carbon monoxide (CO) levels in South Korea have decreased. However, compared to many other OECD countries, these levels are still too high. C...

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Association between air pollution in the 2015 winter in South Korea and population size, car emissions, industrial activity, and fossil-fuel power plants: an ecological study

Compared to 10 years ago, the ambient particulate matter 10 (PM10) and carbon monoxide (CO) levels in South Korea have decreased. However, compared to many other OECD countries, these levels are still too high. C...

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Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future?

Publication date: Available online 5 October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Rudolf Valenta, Alexander Karaulov, Verena Niederberger, Yury Zhernov, Olga Elisyutina, Raffaela Campana, Margarete Focke-Tejkl, Mirela Curin, Leyla Namazova-Baranova, Jiu-Yao Wang, Ruby Pawankar, Musa Khaitov

Today, in vivo allergy diagnosis and allergen-specific immunotherapy (AIT) are still based on allergen extracts obtained from natural allergen sources. Several studies analyzing the composition of natural allergen extracts have shown severe problems regarding their quality such as the presence of undefined nonallergenic materials, contaminants as well as high variabilities regarding contents and biological activity of individual allergens. Despite the increasing availability of sophisticated analytical technologies, these problems cannot be overcome because they are inherent to allergen sources and methods of extract production. For in vitro allergy diagnosis problems related to natural allergen extracts have been largely overcome by the implementation of recombinant allergen molecules that are defined regarding purity and biological activity. However, no such advances have been made for allergen preparations to be used in vivo for diagnosis and therapy. No clinical studies have been performed for allergen extracts available for in vivo allergy diagnosis that document safety, sensitivity, and specificity of the products. Only for very few therapeutic allergen extracts state-of-the-art clinical studies have been performed that provide evidence for safety and efficacy. In this article, we discuss problems related to the inconsistent quality of products based on natural allergen extracts and share our observations that most of the products available for in vivo diagnosis and AIT do not meet the international standards for medicinal products. We argue that a replacement of natural allergen extracts by defined recombinantly produced allergen molecules and/or mixtures thereof may be the only way to guarantee the supply of clinicians with state-of-the-art medicinal products for in vivo diagnosis and treatment of allergic patients in the future.

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Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future?

Publication date: Available online 5 October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Rudolf Valenta, Alexander Karaulov, Verena Niederberger, Yury Zhernov, Olga Elisyutina, Raffaela Campana, Margarete Focke-Tejkl, Mirela Curin, Leyla Namazova-Baranova, Jiu-Yao Wang, Ruby Pawankar, Musa Khaitov

Today, in vivo allergy diagnosis and allergen-specific immunotherapy (AIT) are still based on allergen extracts obtained from natural allergen sources. Several studies analyzing the composition of natural allergen extracts have shown severe problems regarding their quality such as the presence of undefined nonallergenic materials, contaminants as well as high variabilities regarding contents and biological activity of individual allergens. Despite the increasing availability of sophisticated analytical technologies, these problems cannot be overcome because they are inherent to allergen sources and methods of extract production. For in vitro allergy diagnosis problems related to natural allergen extracts have been largely overcome by the implementation of recombinant allergen molecules that are defined regarding purity and biological activity. However, no such advances have been made for allergen preparations to be used in vivo for diagnosis and therapy. No clinical studies have been performed for allergen extracts available for in vivo allergy diagnosis that document safety, sensitivity, and specificity of the products. Only for very few therapeutic allergen extracts state-of-the-art clinical studies have been performed that provide evidence for safety and efficacy. In this article, we discuss problems related to the inconsistent quality of products based on natural allergen extracts and share our observations that most of the products available for in vivo diagnosis and AIT do not meet the international standards for medicinal products. We argue that a replacement of natural allergen extracts by defined recombinantly produced allergen molecules and/or mixtures thereof may be the only way to guarantee the supply of clinicians with state-of-the-art medicinal products for in vivo diagnosis and treatment of allergic patients in the future.

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Comorbid Conditions are a Risk for Osteonecrosis of the Jaw Unrelated to Antiresorptive Therapy

Publication date: Available online 5 October 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Kenneth E. Fleisher, Malvin N. Janal, Nicole Albstein, James Young, Vanessa Bikhazi, Shlomit Schwalb, Mark S. Wolf, Robert S. Glickman

Abstract

Background: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJ_uat), confounding risk assessment. This study aimed to determine if ONJ_uat is associated with one or more particular comorbidities.

Study Design: Retrospective case-control study for patients with ONJ_uat and delayed healing (DH). Each case was matched for age, gender and location of the ONJ_uat or DH lesion to a control who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking.

Results: 92 patients were identified, 67 (73%) met the criteria for the ONJ_uat and 25 (27%) met the criteria for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least one) was more prevalent in ONJ_uat than Controls (p= .04), and there were more comorbidities in ONJ_uat and DH patients than Controls [M(SD)= 1.94 (1.2) and 2.0 (1.3) vs 1.26 (.89); both p< .001].

Conclusions: Osteonecrosis of the jaw and delayed healing are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJ_uat and DH.

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Comorbid Conditions are a Risk for Osteonecrosis of the Jaw Unrelated to Antiresorptive Therapy

Publication date: Available online 5 October 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Kenneth E. Fleisher, Malvin N. Janal, Nicole Albstein, James Young, Vanessa Bikhazi, Shlomit Schwalb, Mark S. Wolf, Robert S. Glickman

Abstract

Background: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJ_uat), confounding risk assessment. This study aimed to determine if ONJ_uat is associated with one or more particular comorbidities.

Study Design: Retrospective case-control study for patients with ONJ_uat and delayed healing (DH). Each case was matched for age, gender and location of the ONJ_uat or DH lesion to a control who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking.

Results: 92 patients were identified, 67 (73%) met the criteria for the ONJ_uat and 25 (27%) met the criteria for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least one) was more prevalent in ONJ_uat than Controls (p= .04), and there were more comorbidities in ONJ_uat and DH patients than Controls [M(SD)= 1.94 (1.2) and 2.0 (1.3) vs 1.26 (.89); both p< .001].

Conclusions: Osteonecrosis of the jaw and delayed healing are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJ_uat and DH.

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A Monte Carlo Simulation Study of Optimization for Collimator in a Pixelated SPECT Camera

Publication date: Available online 5 October 2018

Source: Journal of Medical Imaging and Radiation Sciences

Author(s): Zeinab Telikani, Alireza Sadremomtaz

Abstract

Objective

To investigate the influence of collimator hole shape, size, and material on the performance of the high-resolution SPECT camera to find the optimal collimator design using the GEANT4 application for the tomographic emission Monte Carlo platform.

Methods and Materials

The geometry of the dual head camera equipped with a pixelated CsI(Na) crystal, lead hexagonal-hole collimator, and two flat-panel H8500 position-sensitive photomultipliers were accurately described in the GEANT4 application for the tomographic emission. The basic features of the scanner were calculated by using 2 mCi ^99mTc sources.

Results

The simulated average spatial resolutions of lead hexagonal-, square-, and round-hole collimators were 2.68, 2.96, and 3.06 mm at 2.5 cm from the collimator surface, respectively. The sensitivity of the lead hexagonal-hole collimator was 10.86% and 18.84%, greater than that of the square and round holes, respectively, on the collimator surface. The measured averages of spatial resolution using gold were 16.14%, 11.39%, and 5.1% better than those of lead, tantalum, and tungsten hexagonal-hole collimators, respectively, at 2.5 cm from the collimator. The sensitivities of the tungsten, gold, tantalum, depleted uranium, and lead hexagonal-hole collimators were 0.74, 0.48, 1.127, 0.32, and 1.38 cps/μCi on the collimator surface, respectively.

Conclusions

The hexagonal-hole collimator was preferred over the square- and round-hole collimators because of the optimum sensitivity and spatial resolution offered by its regular arrangement of apertures. Also, the lower-absorption and stopping-power materials such as lead revealed relatively better characteristics at specific sensitivity, whereas higher-absorption materials such as gold showed the best spatial resolution. The collimator with finer hole size had the superior spatial resolution and less sensitivity than larger holes.

Résumé

Objectif

Cette étude a pour but d'évaluer, à l'aide de la plateforme Monte-Carlo GATE, l'influence qu'ont la forme et la grosseur des trous et le matériau d'un collimateur sur le rendement de la caméra à haute résolution de TEMP (HiReSPECT), et ce, en vue de déterminer le meilleur concept de collimateur.

Méthodologie et matériel

La géométrie de la caméra à deux têtes, qui est munie d'un collimateur en plomb à trous hexagonaux avec cristaux pixélisés de CsI (Na), ainsi que de deux photomultiplicateurs à panneaux plats H8500 à détection de position, a été décrite de façon exacte dans la plateforme GATE. Les caractéristiques de base du tomodensitomètre ont été calculées à l'aide de sources de 2 mCi ^99mTc.

Résultats

La résolution spatiale moyenne simulée des collimateurs en plomb et à trous hexagonaux, carrés et ronds était respectivement de 2,68 mm, 2,96 mm et 3,06 mm, à 2,5 cm de la surface du collimateur. La sensibilité du collimateur en plomb à trous hexagonaux était de 10,86% et de 18,84%, plus grande que celles des collimateurs à trous de forme carrée et de forme ronde à la surface du collimateur, respectivement. Les résolutions spatiales moyennes obtenues en utilisant de l'or étaient de 16,14%, de 11,39% et de 5,1%, meilleures que celles obtenues respectivement à 2,5 cm du collimateur en utilisant des collimateurs à trous hexagonaux et faits à partir de plomb, de tantale et de tungstène. La sensibilité des collimateurs à trous hexagonaux et faits à partir de tungstène, d'or, de tantale, d'uranium appauvri et de plomb était respectivement de 0,74, 0,48, 1,127, 0,32 et 1,38 cps/μCi à la surface du collimateur.

Conclusions

Nous préférons le collimateur à trous hexagonaux aux collimateurs percés de trous carrés ou ronds puisqu'il est plus sensible que les autres et qu'il permet d'obtenir une résolution spatiale optimale grâce à la disposition régulière de ses ouvertures. De plus, de façon relative, les matériaux à faible capacité d'absorption et de pénétration tels que le plomb affichaient de meilleures caractéristiques à certaines sensibilités, alors que les matériaux à forte capacité d'absorption tels que l'or permettaient d'obtenir la meilleure résolution spatiale. Le collimateur avec des trous de dimension inférieure permettait d'obtenir une résolution spatiale supérieure aux autres et était moins sensible que les collimateurs percés de plus gros trous.

Graphical abstract

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A Pilot Project to Investigate Radiation Therapist Referrals to an Ad Hoc Supportive Care Oncology Clinic

Publication date: Available online 5 October 2018

Source: Journal of Medical Imaging and Radiation Sciences

Author(s): Angela Turner, Dilshad Nathoo

Abstract

Purpose/Aim

Approximately 400 patients are treated daily within the radiation therapy (XRT) department at the cancer centre where this project took place. As part of their clinical interactions during the treatment delivery process, radiation therapists (MRTs) may refer patients to a third party "RN Assessment Office" for non technical issues. These referrals can result in extended wait times for patients as well as disruptions to the scheduling of MRTs and other health care professionals. This review aimed to identify issues that resulted in third party referrals by MRTs. Data collected may enable insight into the issues that prompt third party referrals and help support MRTs in managing patient issues that are within their scope of practice.

Method/Process

A database of XRT patient referrals to the location "RN Assessment Office" in the electronic records (EMRs) was generated for this review. A 4-week period within the previous year was considered suitable by the investigators to produce a representative sample of referrals. Predetermined referral categories were compiled based on the experiences of the investigators. Data were extracted from two sources: (1) the progress note tab within each patient EMR and (2) the comments section of the registered nurses (RNs) Assessment workload location in the EMR systems.

Results/Benefits/Challenges

Data demonstrated that 17% of the progress notes in the EMR contained MRT documentation before referral. The majority of referrals (29%) were related to patient skin reactions and wound/dressing care.

Conclusions/Impact/Outcomes

Absence of documentation by MRTs in the EMR impaired the data collection. Anecdotal evidence suggests routine MRT patient assessment during the XRT process. Recommendations related to systematic assessments and documentation procedures may increase MRT documentation. Streamlining the referral processes may improve efficiencies and eliminate redundancies in the workflow of MRTs.

Résumé

But

Le service de radiothérapie du Odette Cancer Centre traite approximativement 400 patients par jour. Dans le cadre de leurs échanges avec les patients qu'ils traitent, les radiothérapeutes (TRM) acheminent parfois ces derniers à un tiers, « le bureau d'évaluation par le personnel infirmier autorisé (IA) », pour des questions d'ordre non techniques. Ce réacheminement peut occasionner de longues périodes d'attente pour les patients et peut même embrouiller les horaires des TRM et ceux d'autres membres du personnel soignant (PS). La présente étude vise à relever les problèmes qui poussent les TRM à acheminer leurs patients à un tiers. Les données recueillies pourraient faire ressortir certaines lacunes du milieu ou du processus qui empêchent les TRM de gérer eux-mêmes les problèmes de leurs patients qui ne sortent pas du cadre de leur pratique.

Méthodologie

Pour les besoins de cette étude, une base de données sur le réacheminement des patients au bureau d'évaluation des IA a été créée au moyen du dossier médical électronique (DME) dans MosaiqTM. Les chercheurs ont jugé qu'une période de quatre semaines de l'année précédente suffirait pour produire un échantillon représentatif des réacheminements. Ils ont compilé des catégories de réacheminement préétablies en se fondant sur leurs expériences. Les données proviennent de deux sources: i) l'onglet des notes sur les progrès dans le DME de chaque patient; ii) la section des commentaires de la partie sur la charge de travail en évaluation des IA, dans les systèmes du DME.

Résultats

Selon les données, 17% des notes sur les progrès dans le DME contenaient des documents que les TRM avaient créés avant de réacheminer un patient. La majorité des réacheminements (29%) était liée à des réactions cutanées chez le patient, au traitement de plaies ou à l'application de pansements.

Conclusions

L'absence de documents créés par des TRM dans le DME a entravé la collecte de données. Les données empiriques portent à croire que les patients sont couramment évalués par les TRM au cours du processus de radiothérapie. Des recommandations liées aux évaluations systématiques et au processus de documentation pourraient favoriser la documentation par les TRM. De plus, la simplification du processus de réacheminement pourrait améliorer le rendement et permettre aux TRM d'exercer pleinement leur profession.

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