Contrast-enhanced ultrasound in the evaluation of splenic injury healing time and grade

Abstract

Aims

To assess mean healing time of blunt spleen injuries managed nonoperatively using CEUS (contrast-enhanced ultrasound); to analyze whether spleen injury grade, subcapsular hematoma (SCH) presence, SCH grade and spleen infarct after spleen artery angioembolization could be related to healing time; and to evaluate CEUS sensitivity in diagnosing spleen injury and to assess CEUS performance in classifying spleen injury grade compared to CT.

Materials and methods

After CT evaluation in the Emergency Department, 101 hemodynamic stable blunt spleen trauma patients (73 males; 28 females; mean age 46.4 years, range 18–92) underwent serial CEUS follow-up examinations at pre-established intervals (1, 3, 8, 15, 30, 60, 90 and 180 days after trauma), until spleen injury became no more identifiable.

Results

Mean CEUS examinations performed before spleen injury healing were 4.5; mean spleen injury healing time was 22.6 days. Spleen injury healing time was significantly related to spleen injury grade, subcapsular hematoma (SCH) presence, SCH grade and spleen infarct. CEUS spleen injury diagnostic sensitivity was 96.9% and, according to the American Association for the Surgery of Trauma (AAST)–spleen injury scale (SIS), CEUS-CT concordance was 95.8%.

Conclusions

Spleen injury healing time in blunt abdominal trauma nonoperatively managed is significantly related to AAST-SIS grade, SCH presence and grade, and spleen infarct development, and CEUS can be used in order to evaluate spleen injury grade.

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Shirley ’ s Cookie Company In. Issues Allergy Alert on Undeclared Peanuts in " Chocolate Whoopie Pie "

Shirley ' s Cookie Company Inc. of Claysburg, PA, is recalling its 16 ounce packages of " Chocolate Whoopie Pie " because they may contain undeclared peanuts. People who have allergies to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products. (Source: Food and Drug Administration)

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To the editor: Response to Willame, et al., published in Vaccine 35 (2017) 5551-5558, entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review".

To the editor: Response to Willame, et al., published in Vaccine 35 (2017) 5551-5558, entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review". Vaccine. 2018 Oct 29;36(45):6587-6588 Authors: Lee AW, Saldutti LP, Wolfson LJ, Stek JE, Kuter BJ PMID: 30348361 [PubMed - in process] (Source: Vaccine)

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Reply to Lee et al.'s letter to the editor pertaining to our publication entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review".

Reply to Lee et al.'s letter to the editor pertaining to our publication entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review". Vaccine. 2018 Oct 29;36(45):6589-6590 Authors: Willame C, Lin L, Vetter V, Baril L, Praet N PMID: 30348362 [PubMed - in process] (Source: Vaccine)

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Shirley ’ s Cookie Company In. Issues Allergy Alert on Undeclared Peanuts in " Chocolate Whoopie Pie "

Shirley ' s Cookie Company Inc. of Claysburg, PA, is recalling its 16 ounce packages of " Chocolate Whoopie Pie " because they may contain undeclared peanuts. People who have allergies to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products. (Source: Food and Drug Administration)

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To the editor: Response to Willame, et al., published in Vaccine 35 (2017) 5551-5558, entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review".

To the editor: Response to Willame, et al., published in Vaccine 35 (2017) 5551-5558, entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review". Vaccine. 2018 Oct 29;36(45):6587-6588 Authors: Lee AW, Saldutti LP, Wolfson LJ, Stek JE, Kuter BJ PMID: 30348361 [PubMed - in process] (Source: Vaccine)

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Reply to Lee et al.'s letter to the editor pertaining to our publication entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review".

Reply to Lee et al.'s letter to the editor pertaining to our publication entitled "Pain caused by measles, mumps, and rubella vaccines: A systematic literature review". Vaccine. 2018 Oct 29;36(45):6589-6590 Authors: Willame C, Lin L, Vetter V, Baril L, Praet N PMID: 30348362 [PubMed - in process] (Source: Vaccine)

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The physician and hereditary angioedema friend or foe: 62-year diagnostic delay and iatrogenic procedures

Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease characterized by episodes of acute subcutaneous swelling, and/or recurrent severe abdominal pain. The dise...

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Nine year follow-up of a rare case of angioedema due to acquired C1-inhibitor deficiency with late onset and good response to attenuated androgen

Angioedema due to acquired deficiency of C1-inhibitor (C1-INH-AAE) is a rare disease sharing some clinical and laboratory similarities with hereditary angioedema, but with late onset and no positive family his...

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Practicalities of a reduced volume formulation of a C1-INH concentrate for the treatment of hereditary angioedema: real-life experience

Hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency is characterized by recurrent swelling attacks that can be life-threatening if left untreated. Prompt treatment is vital during acut...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z1NkjJ

The physician and hereditary angioedema friend or foe: 62-year diagnostic delay and iatrogenic procedures

Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease characterized by episodes of acute subcutaneous swelling, and/or recurrent severe abdominal pain. The dise...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z2nEUc

Nine year follow-up of a rare case of angioedema due to acquired C1-inhibitor deficiency with late onset and good response to attenuated androgen

Angioedema due to acquired deficiency of C1-inhibitor (C1-INH-AAE) is a rare disease sharing some clinical and laboratory similarities with hereditary angioedema, but with late onset and no positive family his...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Sin0ea

Practicalities of a reduced volume formulation of a C1-INH concentrate for the treatment of hereditary angioedema: real-life experience

Hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency is characterized by recurrent swelling attacks that can be life-threatening if left untreated. Prompt treatment is vital during acut...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z1NkjJ

Shirley ’ s Cookie Company In. Issues Allergy Alert on Undeclared Peanuts in " Chocolate Whoopie Pie "

Shirley ' s Cookie Company Inc. of Claysburg, PA, is recalling its 16 ounce packages of " Chocolate Whoopie Pie " because they may contain undeclared peanuts. People who have allergies to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products. (Source: Food and Drug Administration)

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Shirley ’ s Cookie Company In. Issues Allergy Alert on Undeclared Peanuts in " Chocolate Whoopie Pie "

Shirley ' s Cookie Company Inc. of Claysburg, PA, is recalling its 16 ounce packages of " Chocolate Whoopie Pie " because they may contain undeclared peanuts. People who have allergies to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products. (Source: Food and Drug Administration)

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When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

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When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

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The Common Key to Class-Switch Recombination and Somatic Hypermutation: Discovery of AID and Its Role in Antibody Gene Diversification.

Authors: Leeman-Neill RJ, Lim J, Basu U PMID: 30348657 [PubMed - in process] (Source: Journal of Immunology)

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Pillars Article: Class Switch Recombination and Hypermutation Require Activation-Induced Cytidine Deaminase (AID), a Potential RNA Editing Enzyme. Cell. 2000. 102: 553-563.

Authors: Muramatsu M, Kinoshita K, Fagarasan S, Yamada S, Shinkai Y, Honjo T PMID: 30348658 [PubMed - in process] (Source: Journal of Immunology)

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The End of the Binary Era: Revisiting the Spectrum of Tuberculosis.

Authors: Lin PL, Flynn JL Abstract Human Mycobacterium tuberculosis infection was thought to result in either active symptomatic tuberculosis (TB) or latent asymptomatic infection. It is now clear that this binary classification is insufficient to describe the myriad of infection outcomes. In active TB, symptomatic disease can be mild to severe, with a range of lung and thoracic lymph node involvement or extrapulmonary manifestations. Most humans control the infection and develop latent TB infection, with differential risks of reactivation to active TB. However, some frequently exposed persons appear to be resistant to infection, whereas others may initially become infected yet subsequently eliminate all bacilli. The immunologic factors influencing these varied outcomes are still n...

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Background factors of chemical intolerance and parent –child relationships

ConclusionsThe results suggest that inherent physical constitution and childhood housing environment are associated with a risk of acquiring chemical intolerance. Children of mothers with chemical intolerance have a possible risk of respiratory hypersensitivity or inflammation. Further investigation is recommended to determine the inherent physical constitution and background environmental factors associated with the risk of acquiring chemical intolerance. The impact of having mothers with chemical intolerance on the health of children also requires further study. (Source: Environmental Health and Preventive Medicine)

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ILC-poiesis: Ensuring tissue ILC differentiation at the right place and time.

This article is protected by copyright. All rights reserved. PMID: 30350853 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z0Rp7D

When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O5MgRc

The Common Key to Class-Switch Recombination and Somatic Hypermutation: Discovery of AID and Its Role in Antibody Gene Diversification.

Authors: Leeman-Neill RJ, Lim J, Basu U PMID: 30348657 [PubMed - in process] (Source: Journal of Immunology)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z51AbE

Pillars Article: Class Switch Recombination and Hypermutation Require Activation-Induced Cytidine Deaminase (AID), a Potential RNA Editing Enzyme. Cell. 2000. 102: 553-563.

Authors: Muramatsu M, Kinoshita K, Fagarasan S, Yamada S, Shinkai Y, Honjo T PMID: 30348658 [PubMed - in process] (Source: Journal of Immunology)

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

The End of the Binary Era: Revisiting the Spectrum of Tuberculosis.

Authors: Lin PL, Flynn JL Abstract Human Mycobacterium tuberculosis infection was thought to result in either active symptomatic tuberculosis (TB) or latent asymptomatic infection. It is now clear that this binary classification is insufficient to describe the myriad of infection outcomes. In active TB, symptomatic disease can be mild to severe, with a range of lung and thoracic lymph node involvement or extrapulmonary manifestations. Most humans control the infection and develop latent TB infection, with differential risks of reactivation to active TB. However, some frequently exposed persons appear to be resistant to infection, whereas others may initially become infected yet subsequently eliminate all bacilli. The immunologic factors influencing these varied outcomes are still n...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z0RqIJ

Background factors of chemical intolerance and parent –child relationships

ConclusionsThe results suggest that inherent physical constitution and childhood housing environment are associated with a risk of acquiring chemical intolerance. Children of mothers with chemical intolerance have a possible risk of respiratory hypersensitivity or inflammation. Further investigation is recommended to determine the inherent physical constitution and background environmental factors associated with the risk of acquiring chemical intolerance. The impact of having mothers with chemical intolerance on the health of children also requires further study. (Source: Environmental Health and Preventive Medicine)

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

ILC-poiesis: Ensuring tissue ILC differentiation at the right place and time.

This article is protected by copyright. All rights reserved. PMID: 30350853 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2z0Rp7D

When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O5MgRc

When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O5MgRc

When Sam Found Language

I will never forget the day that I met Sam. He came into my room cautiously and sat quietly. I greeted him and he smiled tentatively in return. Sam came to me like most of my other students—severely language deprived. He was 8 years old, with bilateral cochlear implants, unable to speak, sign, read or write. Although he was a typical child developmentally and cognitively, he used tantrums to communicate. I asked him how he was doing. He smiled again. I pointed to myself and signed my sign name. "Kim." Then I pointed to him and gestured for him to introduce himself. "Eh," he said. "How old are you?" I signed. He stared at me. I signed, "You. Age?" Another blank stare. I tried again: "Seven? Eight? Nine?" Sam squinted, confused. I wrote the numbers down, gesturing for h...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2O5MgRc

Incalculable harm to special needs education | Letters

Guardian readers respond to our report on the rise in families desperate for educational support for their childrenAn increasingly effective framework of support for some of the nation 's most vulnerable children and their families, young people with special educational needs and disabilities, that has shown steady progress since the groundbreaking 1978 Warnock report, has been destroyed by the policies of Michael Gove and George Osborne (Crisis looms for special needs education, 23 October).As a former local education authority (LEA) senior adviser and higher education lecturer for special educational needs (SEN), I can 't express how angry I feel over the destruction of these services. It is not "looming"; it is a crisis. Fifteen out of every 100 children have these needs, which ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OPW7QD

Incalculable harm to special needs education | Letters

Guardian readers respond to our report on the rise in families desperate for educational support for their childrenAn increasingly effective framework of support for some of the nation 's most vulnerable children and their families, young people with special educational needs and disabilities, that has shown steady progress since the groundbreaking 1978 Warnock report, has been destroyed by the policies of Michael Gove and George Osborne (Crisis looms for special needs education, 23 October).As a former local education authority (LEA) senior adviser and higher education lecturer for special educational needs (SEN), I can 't express how angry I feel over the destruction of these services. It is not "looming"; it is a crisis. Fifteen out of every 100 children have these needs, which ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OPW7QD

Incalculable harm to special needs education | Letters

Guardian readers respond to our report on the rise in families desperate for educational support for their childrenAn increasingly effective framework of support for some of the nation 's most vulnerable children and their families, young people with special educational needs and disabilities, that has shown steady progress since the groundbreaking 1978 Warnock report, has been destroyed by the policies of Michael Gove and George Osborne (Crisis looms for special needs education, 23 October).As a former local education authority (LEA) senior adviser and higher education lecturer for special educational needs (SEN), I can 't express how angry I feel over the destruction of these services. It is not "looming"; it is a crisis. Fifteen out of every 100 children have these needs, which ...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OPW7QD

Incalculable harm to special needs education | Letters

Guardian readers respond to our report on the rise in families desperate for educational support for their childrenAn increasingly effective framework of support for some of the nation 's most vulnerable children and their families, young people with special educational needs and disabilities, that has shown steady progress since the groundbreaking 1978 Warnock report, has been destroyed by the policies of Michael Gove and George Osborne (Crisis looms for special needs education, 23 October).As a former local education authority (LEA) senior adviser and higher education lecturer for special educational needs (SEN), I can 't express how angry I feel over the destruction of these services. It is not "looming"; it is a crisis. Fifteen out of every 100 children have these needs, which ...

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Which patients with acute stroke due to proximal occlusion should not be treated with endovascular thrombectomy?

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The physician and hereditary angioedema friend or foe: 62-year diagnostic delay and iatrogenic procedures

Abstract

Background

Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease characterized by episodes of acute subcutaneous swelling, and/or recurrent severe abdominal pain. The disease is potentially fatal if the upper-airway is involved. Iatrogenic harm can occur if HAE is not considered in the differential diagnosis, the specialists are not aware of the natural history, diagnosis and treatment of HAE, or as a result of unnecessary surgical and other iatrogenic interventions.

Case presentation

We present the case of a 72-year-old man who began suffering recurrent abdominal pain at the age of 8 years. The pain led to frequent emergency department visits, three emergency surgical interventions, and 5 endoscopies before C1-INH-HAE was diagnosed at the age of 70. Infrequent subcutaneous swellings were attributed to unknown allergic reactions that were not related to the primary diagnosis of abdominal pain. Family history was positive for recurrent abdominal pain and angioedema but was ignored until the propositus' grandson developed recurrent severe oro-facial edema attacks. The boy's mother searched the worldwide web and found educational materials on a patient association website. She suggested complement C4 and C1-INH testing that led to the appropriate diagnosis of C1-INH-HAE type 1 in her son and his grandfather.

Conclusion

This report emphasizes the importance of accurately evaluating personal and family history in patients with a long history of recurrent, acute, severe but medically unexplained abdominal pain and cutaneous swellings. Here, the diagnosis of HAE was overlooked for 62 years and the focus on abdominal complaints led to numerous surgical interventions without consideration of the full differential diagnosis. Screening family members from all generations for unrecognized angioedema, abdominal pain, and measurement of C1-INH and C4 are essential for accurate and timely diagnosis of HAE.

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Practicalities of a reduced volume formulation of a C1-INH concentrate for the treatment of hereditary angioedema: real-life experience

Abstract

Background

Hereditary angioedema (HAE) due to C1 esterase inhibitor (C1-INH) deficiency is characterized by recurrent swelling attacks that can be life-threatening if left untreated. Prompt treatment is vital during acute attacks; plasma-derived C1-INH (Berinert^®) is one treatment currently licensed for the intravenous treatment of acute HAE attacks in adults, adolescents and children. A new, volume-reduced formulation, of C1-INH is currently available which aims to reduce the time to treatment, and provide greater convenience to patients and healthcare professionals. Here we compare the clinical experience of the reduced volume 1500 IU vial with multiple 500 IU vials.

Methods

HAE patients treated with C1-INH at the Royal London Hospital were selected to take part in this assessment. Included patients were aged 10–65 with moderate to severe HAE requiring high doses of C1-INH. The practicalities of the reduced 1500 IU vial compared with multiple 500 IU vials were assessed, including preparation and administration time, training to self-administer time and several quality of life aspects.

Results

Twenty-three patients participated in this study. Twenty-one patients were previously treated with C1-INH (Berinert^®) 500 IU for 1–14 years prior to switching to the 1500 IU vial format, two patients were naïve to C1-INH (Berinert^®). Preparation and administration of C1-INH (Berinert^®) 1500 IU was faster than an equivalent dose with multiple 500 IU vials (11 and 17 min, respectively) and also required less time to train to self-administer (45 and 55 min, respectively). Overall, patients rated the 1500 IU vial format higher in all assessed aspects than the 500 IU format, including preparation, administration, training, travel and storage. Nonetheless, reconstitution of the 1500 IU vial was noted more difficult, requiring gentle mixing to fully dissolve prior to intravenous injection. Patients remained stable on C1-INH (Berinert^®) 1500 IU; two patients switched back to multiple 500 IU vials due to headaches and preference for a larger volume.

Conclusions

The volume-reduced C1-INH concentrate (Berinert^®) 1500 IU is a practical and convenient alternative to multiple 500 IU vials for the treatment of HAE, which provides patients with more control and independence over their disease owing to a simpler to administer treatment.

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Nine year follow-up of a rare case of angioedema due to acquired C1-inhibitor deficiency with late onset and good response to attenuated androgen

Abstract

Background

Angioedema due to acquired deficiency of C1-inhibitor (C1-INH-AAE) is a rare disease sharing some clinical and laboratory similarities with hereditary angioedema, but with late onset and no positive family history. The underlining cause may be malignant or due to autoimmune diseases, but some cases remain idiopathic.

Case presentation

We report a case of a 75 year old woman suffering from recurrent episodes of angioedema since the age of 66, considered first induced by treatment with angiotensin-converting-enzyme inhibitors (ACEI). She continued to have angioedema attacks during 6 years after discontinuation of ACEI, until evaluation in our clinic in 2014, when C1 inhibitor esterase (C1-INH) deficiency was confirmed. The extended medical evaluation for inflammatory, allergic, autoimmune and neoplasic diseases was negative. C1-INH and complement fraction C4 plasma levels were significantly decreased at all measurements, but no diagnostic criteria for diseases known to induce C1-INH deficiency could be found. We first initiated daily prophylactic treatment with tranexamic acid, with no amelioration after 3 months. During the last and most severe attack, with the first facial and laryngeal edema, we have switched to attenuated androgen danazol. The evolution was very good, with prompt remission of angioedema and significant increase of C1-INH and C4 plasma levels after 2 weeks of daily danazol use. She completed 3 years of continuous treatment with low daily maintenance dose of danazol (ongoing), with no angioedema attack. We closely monitored C1-INH and C4 plasma levels, possible danazol side effects and any signs suggesting late onset of C1-INH deficiency causal disease.

Conclusion

We reported a particular case of rare angioedema due to acquired deficiency of C1-inhibitor, which has no clear cause after long follow-up, but good response to attenuated androgen. We concluded that the awareness of angioedema due to C1-INH deficiency should be increased within medical community and therapeutic options should be more clearly indicated and available for all diagnosed cases.

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Risk of asthma onset after natural and surgical menopause: Results from the French E3N Cohort

The most compelling argument for a role of sex hormones in asthma is that asthma is more frequent in boys in childhood and that there is a gender switch around puberty [1,2]. Features of the women's reproductive life, such as menstrual cycles, age of menarche, pregnancy, parity or use of oral contraception have been found also to be associated with asthma [3,4]. Studies have shown that the incidence of asthma, in particular non-allergic asthma, was higher in women as compared to men over all the reproductive years [2,5]. (Source: Maturitas)

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Risk of asthma onset after natural and surgical menopause: Results from the French E3N Cohort

The most compelling argument for a role of sex hormones in asthma is that asthma is more frequent in boys in childhood and that there is a gender switch around puberty [1,2]. Features of the women's reproductive life, such as menstrual cycles, age of menarche, pregnancy, parity or use of oral contraception have been found also to be associated with asthma [3,4]. Studies have shown that the incidence of asthma, in particular non-allergic asthma, was higher in women as compared to men over all the reproductive years [2,5]. (Source: Maturitas)

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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [RPK Pharmaceuticals, Inc.]

Updated Date: Oct 24, 2018 EST (Source: DailyMed Drug Label Updates)

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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [RPK Pharmaceuticals, Inc.]

Updated Date: Oct 24, 2018 EST (Source: DailyMed Drug Label Updates)

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MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence

Abstract

mHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly affect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients largely use over-the-counter medications dispensed in pharmacies. Shared decision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), the Phase 3 ARIA initiative, is based on the freely available MASK app (the Allergy Diary, Android and iOS platforms). MASK is available in 16 languages and deployed in 23 countries. The present paper provides an overview of the methods used in MASK and the key results obtained to date. These include a novel phenotypic characterization of the patients, confirmation of the impact of allergic rhinitis on work productivity and treatment patterns in real life. Most patients appear to self-medicate, are often non-adherent and do not follow guidelines. Moreover, the Allergy Diary is able to distinguish between AR medications. The potential usefulness of MASK will be further explored by POLLAR (Impact of Air Pollution on Asthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary.

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“Evaluating primary endpoints in peanut immunotherapy clinical trials”

Food immunotherapy has been the focus of several allergy research initiatives over the last decade. Though many questions remain unanswered, the evidence suggests that this treatment may be available in the near future outside clinical trials. Additionally, pharmaceutical companies, in light of promising early stage results, have shown interest in developing commercially available products, thus increasing the likelihood that new immunotherapy treatments will be introduced, especially for peanut allergy. (Source: Journal of Allergy and Clinical Immunology)

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Regulatory T cell therapy for autoimmune and autoinflammatory diseases: the next frontier

FOXP3-expressing regulatory T cells (Tregs) are essential for self-tolerance with an emerging role in tissue repair and regeneration. Their ability to traffic to tissue and perform complex therapeutic tasks in response to the tissue microenvironment make them an attractive candidate for drug development. Early experiences of Treg cell therapy in graft-versus-host disease, type 1 diabetes, and organ transplant have shown that it is feasible, safe, and potentially efficacious in some settings. Many ongoing trials in a wide variety of diseases will further enhance our knowledge about the optimal approaches for Treg manufacturing and dosing. (Source: Journal of Allergy and Clinical Immunology)

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Integrative approach identifies corticosteroid response variant in diverse populations with asthma

This is the first study to use a non-white study population for the discovery of pharmacogenomic predictors of asthma controller response. Variant rs3827907 genotype appeared to influenced ICS response especially in the setting of eosinophilic inflammation. (Source: Journal of Allergy and Clinical Immunology)

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Earlens closes $87m offering

Earlens said today it closed an $87 million round of financing to help support continued development and a next-gen rollout of its hearing aid technology. The round was led by newly invested KCK Ltd., and joined by Exor Seets and previously invested Lightstone Ventures, CRG Partners, Windham Life Sciences Partners, Arch Healthcare, Relativity Health Fund, New Enterprise Associates, Aisling Capital, Vertex Global Healthcare, MS Pace LP, Cochlear, Mellon Foundation, Baltisches Haus Limited, GDN Holdings, Sightline Healthcare Opportunity, and Far East Ventures, the Menlo Park, Calif.-based company said. "Our team of medical experts, engineers and technologists have spent nearly a decade developing and refining this small, highly effective device.  We feel confident it can benefit many ...

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“Evaluating primary endpoints in peanut immunotherapy clinical trials”

Food immunotherapy has been the focus of several allergy research initiatives over the last decade. Though many questions remain unanswered, the evidence suggests that this treatment may be available in the near future outside clinical trials. Additionally, pharmaceutical companies, in light of promising early stage results, have shown interest in developing commercially available products, thus increasing the likelihood that new immunotherapy treatments will be introduced, especially for peanut allergy. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CE4iYT

Regulatory T cell therapy for autoimmune and autoinflammatory diseases: the next frontier

FOXP3-expressing regulatory T cells (Tregs) are essential for self-tolerance with an emerging role in tissue repair and regeneration. Their ability to traffic to tissue and perform complex therapeutic tasks in response to the tissue microenvironment make them an attractive candidate for drug development. Early experiences of Treg cell therapy in graft-versus-host disease, type 1 diabetes, and organ transplant have shown that it is feasible, safe, and potentially efficacious in some settings. Many ongoing trials in a wide variety of diseases will further enhance our knowledge about the optimal approaches for Treg manufacturing and dosing. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CDFD6D

Integrative approach identifies corticosteroid response variant in diverse populations with asthma

This is the first study to use a non-white study population for the discovery of pharmacogenomic predictors of asthma controller response. Variant rs3827907 genotype appeared to influenced ICS response especially in the setting of eosinophilic inflammation. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q9T72N

Earlens closes $87m offering

Earlens said today it closed an $87 million round of financing to help support continued development and a next-gen rollout of its hearing aid technology. The round was led by newly invested KCK Ltd., and joined by Exor Seets and previously invested Lightstone Ventures, CRG Partners, Windham Life Sciences Partners, Arch Healthcare, Relativity Health Fund, New Enterprise Associates, Aisling Capital, Vertex Global Healthcare, MS Pace LP, Cochlear, Mellon Foundation, Baltisches Haus Limited, GDN Holdings, Sightline Healthcare Opportunity, and Far East Ventures, the Menlo Park, Calif.-based company said. "Our team of medical experts, engineers and technologists have spent nearly a decade developing and refining this small, highly effective device.  We feel confident it can benefit many ...

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Effect of Incudostapedial Reconstruction Using Conchal Cartilage Interposition Graft on Hearing Outcome

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1661398

Introduction Chronic otitis media is a widely prevalent condition in developing countries and is a cause of correctable hearing loss. The most frequent ossicular chain defect found during surgery for chronic otitis media has been a discontinuity of the incudostapedial joint. This study observes the effect of incudostapedial reconstruction using conchal cartilage on the hearing of the patient. Objectives To evaluate improvement in hearing by incudostapedial reconstruction using conchal cartilage interposition graft in tympanoplasty and to identify the independent factors associated with erosion of the long process of incus among patients with chronic suppurative otitis media tubotympanic type. Methods This study was conducted in the department of ear, nose and throat (ENT) amongst 22 patients with tubotympanic-type chronic suppurative otitis media who were found to have erosion of the long process during tympanoplasty. These patients underwent incudostapedial reconstruction using conchal cartilage. Their hearing was again reassessed at 12 weeks postsurgery, and the changes were observed. Results A statistically significant improvement in air conduction by 15.14 dB was found after undergoing incudostapedial reconstruction using conchal cartilage (p < 0.001). There was no statistically significant change in bone conduction (p value > 0.05). A total of 59.1% of patients in the study had an improvement in hearing ranging from 11 to 20 dB. It was also found that 50% of the patients had a postoperative hearing of 10 to 20 dB. Conclusion Conchal cartilage interposition graft effectively improved hearing when used for the reconstruction of the incudostapedial joint during tympanoplasty in patients of chronic suppurative otitis media.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1667005

Introduction Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition. Objective To describe the clinical characteristics and management of patients with indolent mucormycosis. Methods In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolent mucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis. Results We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptoms were nonspecific: facial pain/headache, mucoid discharge and cacosmia were the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatment in one immunosuppressed patient. All immunocompetent patients had single paranasal sinus disease and received only surgical treatment. All patients are alive and free of disease. Conclusion Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Postoperative Management of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps: Impact of High-Dose Corticosteroid Nasal Spray

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668515

Introduction Eosinophilic chronic rhinosinusitis (ECRS) is characterized by an eosinophilic inflammation driven by Th2-type cytokines. Glucocorticosteroids are the most common first-line treatment for ECRS with nasal polyps. Objective We have evaluated the long-term treatment with double-dose intranasal corticosteroids in refractory ECRS nasal polyps resistant to the conventional dose and assessed the risk of adverse systemic effects Methods Sixteen subjects were enrolled in this study. All subjects had ECRS after endoscopic sinus surgery that resulted in recurrent mild and moderate nasal polyps and were undergoing a postoperative follow-up application of mometasone furoate at a dose of 2 sprays (100 μg) in each nostril once a day (200 μg). All the patients were prescribed mometasone furoate, administered at a dose of 2 sprays (100 μg) in each nostril twice a day (400 μg) for 6 months. Results The average scores of the symptoms during the regular dose of intranasal steroid treatment were 5.2 ± 2.2, but 6 months after the high-dose application, they had significantly decreased to 2.5 ± 1.4 (p < 0.05). The polyp size showed an average score of 1.38 during the regular dose which was significantly reduced to 0.43 (p < 0.01) by the double dose. Glycated hemoglobin (HbA1c) showed normal ranges in all the patients tested. The cortisol plasma concentration was also normal. Conclusion Doubling the dose of the nasal topical spray mometasone furoate might be recommended for the treatment of recurrent nasal polyps in the postoperative follow-up of intractable ECRS.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Mucocele: Clinical Characteristics and Outcomes in 46 Operated Patients

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668126

Introduction Paranasal sinus mucocele is a benign, expansive lesion associated with paranasal sinus obstruction. It affects mostly adults, and is most common in the frontal and ethmoidal sinuses. Objective To evaluate outcomes in patients undergoing surgical treatment for paranasal sinus mucocele. Methods Retrospective review of medical records of patients treated for paranasal sinus mucocele at the ENT department of a tertiary care hospital between 2005 and 2016. Results Forty-six patients underwent surgical treatment of paranasal sinus mucocele. The mean age was 50.1 years, and 56.5% were male. The most prevalent symptom was pain, and the frontal sinus was most commonly affected. The vast majority of patients (89.1%) underwent endoscopic sinus marsupialization; 10.9% required combined open and endoscopic access. Seven recurrences occurred. Conclusion Sinus mucocele is an expansive disease that primarily affects the frontal sinus of adult patients. In most cases, endoscopic surgery is an effective treatment modality.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668127

Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voice and recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 from each county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Surgical Treatment of Chronic Parotitis

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1667006

Introduction chronic parotitis (CP) is a hindering, recurring inflammatory ailment that eventually leads to the destruction of the parotid gland. When conservative measures and sialendoscopy fail, parotidectomy can be indicated. Objective to evaluate the efficacy and safety of parotidectomy as a treatment for CP unresponsive to conservative therapy, and to compare superficial and near-total parotidectomy (SP and NTP). Methods retrospective consecutive case series of patients who underwent parotidectomy for CP between January 1999 and May 2012. The primary outcome variables were recurrence, patient contentment, transient and permanent facial nerve palsy and Frey syndrome. The categorical variables were analyzed using the two-sided Fisher exact test. Alongside, an elaborate review of the current literature was conducted. Results a total of 46 parotidectomies were performed on 37 patients with CP. Near-total parotidectomy was performed in 41 and SP in 5 cases. Eighty-four percent of patients was available for the telephone questionnaire (31 patients, 40 parotidectomies) with a mean follow-up period of 6,2 years. Treatment was successful in 40/46 parotidectomies (87%) and 95% of the patients were content with the result. The incidence of permanent and transient facial nerve palsy was 0 (0%) and 12 (26.1%), respectively. Frey syndrome manifested in 20 (43.5%) patients. Neither this study nor careful review of the current literature resulted in evident difference between SP and NTP regarding the primary outcome variables. Conclusion parotidectomy is a safe and effective treatment for CP in case conservative therapy fails. There is no evidence of a distinct difference between SP and NTP regarding efficiency, facial nerve palsy or Frey syndrome.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Variations in Cochlear Size of Cochlear Implant Candidates

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1661360

Introduction The cochlear anatomy varies in each individual, and that has an impact on decisions regarding the insertion of electrodes. The measurement of the cochlear size is the routine examination required to choose the proper cochlear implant (CI) electrodes. Objective To acquire normative data on the size of the cochlea (length, width, height, scala timpani [ST] height, cochlear duct length [CDL]) of CI candidates in Medan, Indonesia. Methods This descriptive study was conducted based on high-resolution computed tomography (HRCT) temporal bone data and on HRCT temporal data manipulated to reconstruct three-dimensional (3D) multiplanar images with OsiriX MD DICOM Viewer version 9.5.1 (Pixmeo SARL, Bernex, Geneva, Switzerland) viewer of 18 patients (36 ears) who were CI candidates in Medan, Indonesia, in order to determine cochlear length (A), cochlear width, cochlear height, ST height and CDL, calculated through a simple mathematical function. Results The average cochlear length (A) was 8.75 mm (standard deviation [SD] = 0.31 mm); the average cochlear width was 6.53 mm (SD = 0.35 mm); the average cochlear height was 3.26 mm (SD = 0.24 mm) and the average ST height at the basal cochlea was 1.00 mm (SD = 0.1 mm); and 0.71 mm (SD = 0.1 mm) at the half turn of cochlea. The average total CDL was 32.45 mm (SD = 1.31 mm; range: 30.01–34.83 mm). Conclusion The cochlear size varies in each individual; therefore, the temporal bone measurement of CI candidates using HRCT is essential: for the selection of suitable implant electrodes; to minimize cochlear damages at the insertion of the electrode arrays; and to maximize the hearing improvements.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1667005

Introduction Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition. Objective To describe the clinical characteristics and management of patients with indolent mucormycosis. Methods In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolent mucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis. Results We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptoms were nonspecific: facial pain/headache, mucoid discharge and cacosmia were the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatment in one immunosuppressed patient. All immunocompetent patients had single paranasal sinus disease and received only surgical treatment. All patients are alive and free of disease. Conclusion Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Postoperative Management of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps: Impact of High-Dose Corticosteroid Nasal Spray

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668515

Introduction Eosinophilic chronic rhinosinusitis (ECRS) is characterized by an eosinophilic inflammation driven by Th2-type cytokines. Glucocorticosteroids are the most common first-line treatment for ECRS with nasal polyps. Objective We have evaluated the long-term treatment with double-dose intranasal corticosteroids in refractory ECRS nasal polyps resistant to the conventional dose and assessed the risk of adverse systemic effects Methods Sixteen subjects were enrolled in this study. All subjects had ECRS after endoscopic sinus surgery that resulted in recurrent mild and moderate nasal polyps and were undergoing a postoperative follow-up application of mometasone furoate at a dose of 2 sprays (100 μg) in each nostril once a day (200 μg). All the patients were prescribed mometasone furoate, administered at a dose of 2 sprays (100 μg) in each nostril twice a day (400 μg) for 6 months. Results The average scores of the symptoms during the regular dose of intranasal steroid treatment were 5.2 ± 2.2, but 6 months after the high-dose application, they had significantly decreased to 2.5 ± 1.4 (p < 0.05). The polyp size showed an average score of 1.38 during the regular dose which was significantly reduced to 0.43 (p < 0.01) by the double dose. Glycated hemoglobin (HbA1c) showed normal ranges in all the patients tested. The cortisol plasma concentration was also normal. Conclusion Doubling the dose of the nasal topical spray mometasone furoate might be recommended for the treatment of recurrent nasal polyps in the postoperative follow-up of intractable ECRS.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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

Mucocele: Clinical Characteristics and Outcomes in 46 Operated Patients

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668126

Introduction Paranasal sinus mucocele is a benign, expansive lesion associated with paranasal sinus obstruction. It affects mostly adults, and is most common in the frontal and ethmoidal sinuses. Objective To evaluate outcomes in patients undergoing surgical treatment for paranasal sinus mucocele. Methods Retrospective review of medical records of patients treated for paranasal sinus mucocele at the ENT department of a tertiary care hospital between 2005 and 2016. Results Forty-six patients underwent surgical treatment of paranasal sinus mucocele. The mean age was 50.1 years, and 56.5% were male. The most prevalent symptom was pain, and the frontal sinus was most commonly affected. The vast majority of patients (89.1%) underwent endoscopic sinus marsupialization; 10.9% required combined open and endoscopic access. Seven recurrences occurred. Conclusion Sinus mucocele is an expansive disease that primarily affects the frontal sinus of adult patients. In most cases, endoscopic surgery is an effective treatment modality.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2D2gofh

Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1668127

Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voice and recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 from each county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PYR9xy

Surgical Treatment of Chronic Parotitis

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1667006

Introduction chronic parotitis (CP) is a hindering, recurring inflammatory ailment that eventually leads to the destruction of the parotid gland. When conservative measures and sialendoscopy fail, parotidectomy can be indicated. Objective to evaluate the efficacy and safety of parotidectomy as a treatment for CP unresponsive to conservative therapy, and to compare superficial and near-total parotidectomy (SP and NTP). Methods retrospective consecutive case series of patients who underwent parotidectomy for CP between January 1999 and May 2012. The primary outcome variables were recurrence, patient contentment, transient and permanent facial nerve palsy and Frey syndrome. The categorical variables were analyzed using the two-sided Fisher exact test. Alongside, an elaborate review of the current literature was conducted. Results a total of 46 parotidectomies were performed on 37 patients with CP. Near-total parotidectomy was performed in 41 and SP in 5 cases. Eighty-four percent of patients was available for the telephone questionnaire (31 patients, 40 parotidectomies) with a mean follow-up period of 6,2 years. Treatment was successful in 40/46 parotidectomies (87%) and 95% of the patients were content with the result. The incidence of permanent and transient facial nerve palsy was 0 (0%) and 12 (26.1%), respectively. Frey syndrome manifested in 20 (43.5%) patients. Neither this study nor careful review of the current literature resulted in evident difference between SP and NTP regarding the primary outcome variables. Conclusion parotidectomy is a safe and effective treatment for CP in case conservative therapy fails. There is no evidence of a distinct difference between SP and NTP regarding efficiency, facial nerve palsy or Frey syndrome.
[...]

Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Variations in Cochlear Size of Cochlear Implant Candidates

Int Arch Otorhinolaryngol
DOI: 10.1055/s-0038-1661360

Introduction The cochlear anatomy varies in each individual, and that has an impact on decisions regarding the insertion of electrodes. The measurement of the cochlear size is the routine examination required to choose the proper cochlear implant (CI) electrodes. Objective To acquire normative data on the size of the cochlea (length, width, height, scala timpani [ST] height, cochlear duct length [CDL]) of CI candidates in Medan, Indonesia. Methods This descriptive study was conducted based on high-resolution computed tomography (HRCT) temporal bone data and on HRCT temporal data manipulated to reconstruct three-dimensional (3D) multiplanar images with OsiriX MD DICOM Viewer version 9.5.1 (Pixmeo SARL, Bernex, Geneva, Switzerland) viewer of 18 patients (36 ears) who were CI candidates in Medan, Indonesia, in order to determine cochlear length (A), cochlear width, cochlear height, ST height and CDL, calculated through a simple mathematical function. Results The average cochlear length (A) was 8.75 mm (standard deviation [SD] = 0.31 mm); the average cochlear width was 6.53 mm (SD = 0.35 mm); the average cochlear height was 3.26 mm (SD = 0.24 mm) and the average ST height at the basal cochlea was 1.00 mm (SD = 0.1 mm); and 0.71 mm (SD = 0.1 mm) at the half turn of cochlea. The average total CDL was 32.45 mm (SD = 1.31 mm; range: 30.01–34.83 mm). Conclusion The cochlear size varies in each individual; therefore, the temporal bone measurement of CI candidates using HRCT is essential: for the selection of suitable implant electrodes; to minimize cochlear damages at the insertion of the electrode arrays; and to maximize the hearing improvements.
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Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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Earlens closes $87m offering

Earlens said today it closed an $87 million round of financing to help support continued development and a next-gen rollout of its hearing aid technology. The round was led by newly invested KCK Ltd., and joined by Exor Seets and previously invested Lightstone Ventures, CRG Partners, Windham Life Sciences Partners, Arch Healthcare, Relativity Health Fund, New Enterprise Associates, Aisling Capital, Vertex Global Healthcare, MS Pace LP, Cochlear, Mellon Foundation, Baltisches Haus Limited, GDN Holdings, Sightline Healthcare Opportunity, and Far East Ventures, the Menlo Park, Calif.-based company said. "Our team of medical experts, engineers and technologists have spent nearly a decade developing and refining this small, highly effective device.  We feel confident it can benefit many ...

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Inhibitory functions of PD-L1 and PD-L2 in the regulation of anti-tumor immunity in murine tumor microenvironment

AbstractAlthough a role of PD-L1 in the suppression of anti-tumor immunity and its value as a predictive biomarker has been suggested by various preclinical and clinical studies, the  precise mechanisms how PD-L1 and PD-L2, another ligand of PD-1, regulate anti-tumor immunity in the tumor microenvironment are yet to be fully explored. Here, we address this issue using PD-L1-deficient tumor cells, PD-L1-knockout (KO) mice, anti-PD-L1 monoclonal antibody (mAb), and anti-PD-L2 mAb . Firstly, PD-L1-deficient or competent tumor cells were inoculated into wild-type or PD-L1-KO mice. Results of tumor growth and mouse survival indicated that both tumor- and host-derived PD-L1 are functional to suppress anti-tumor immunity, while the former contributes predominantly than the latter . Experiments u...

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T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function

T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function, Published online: 24 October 2018; doi:10.1038/s41385-018-0092-6T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function (Source: Mucosal Immunology)

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Regulatory T cell therapy for autoimmune and autoinflammatory diseases: the next frontier

FOXP3-expressing regulatory T cells (Tregs) are essential for self-tolerance with an emerging role in tissue repair and regeneration. Their ability to traffic to tissue and perform complex therapeutic tasks in response to the tissue microenvironment make them an attractive candidate for drug development. Early experiences of Treg cell therapy in graft-versus-host disease, type 1 diabetes, and organ transplant have shown that it is feasible, safe, and potentially efficacious in some settings. Many ongoing trials in a wide variety of diseases will further enhance our knowledge about the optimal approaches for Treg manufacturing and dosing. (Source: Journal of Allergy and Clinical Immunology)

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Integrative approach identifies corticosteroid response variant in diverse populations with asthma

This is the first study to use a non-white study population for the discovery of pharmacogenomic predictors of asthma controller response. Variant rs3827907 genotype appeared to influenced ICS response especially in the setting of eosinophilic inflammation. (Source: Journal of Allergy and Clinical Immunology)

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“Evaluating primary endpoints in peanut immunotherapy clinical trials”

Food immunotherapy has been the focus of several allergy research initiatives over the last decade. Though many questions remain unanswered, the evidence suggests that this treatment may be available in the near future outside clinical trials. Additionally, pharmaceutical companies, in light of promising early stage results, have shown interest in developing commercially available products, thus increasing the likelihood that new immunotherapy treatments will be introduced, especially for peanut allergy. (Source: Journal of Allergy and Clinical Immunology)

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Earlens closes $87m offering

Earlens said today it closed an $87 million round of financing to help support continued development and a next-gen rollout of its hearing aid technology. The round was led by newly invested KCK Ltd., and joined by Exor Seets and previously invested Lightstone Ventures, CRG Partners, Windham Life Sciences Partners, Arch Healthcare, Relativity Health Fund, New Enterprise Associates, Aisling Capital, Vertex Global Healthcare, MS Pace LP, Cochlear, Mellon Foundation, Baltisches Haus Limited, GDN Holdings, Sightline Healthcare Opportunity, and Far East Ventures, the Menlo Park, Calif.-based company said. "Our team of medical experts, engineers and technologists have spent nearly a decade developing and refining this small, highly effective device.  We feel confident it can benefit many ...

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Inhibitory functions of PD-L1 and PD-L2 in the regulation of anti-tumor immunity in murine tumor microenvironment

AbstractAlthough a role of PD-L1 in the suppression of anti-tumor immunity and its value as a predictive biomarker has been suggested by various preclinical and clinical studies, the  precise mechanisms how PD-L1 and PD-L2, another ligand of PD-1, regulate anti-tumor immunity in the tumor microenvironment are yet to be fully explored. Here, we address this issue using PD-L1-deficient tumor cells, PD-L1-knockout (KO) mice, anti-PD-L1 monoclonal antibody (mAb), and anti-PD-L2 mAb . Firstly, PD-L1-deficient or competent tumor cells were inoculated into wild-type or PD-L1-KO mice. Results of tumor growth and mouse survival indicated that both tumor- and host-derived PD-L1 are functional to suppress anti-tumor immunity, while the former contributes predominantly than the latter . Experiments u...

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T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function

T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function, Published online: 24 October 2018; doi:10.1038/s41385-018-0092-6T-bet controls intestinal mucosa immune responses via repression of type 2 innate lymphoid cell function (Source: Mucosal Immunology)

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Regulatory T cell therapy for autoimmune and autoinflammatory diseases: the next frontier

FOXP3-expressing regulatory T cells (Tregs) are essential for self-tolerance with an emerging role in tissue repair and regeneration. Their ability to traffic to tissue and perform complex therapeutic tasks in response to the tissue microenvironment make them an attractive candidate for drug development. Early experiences of Treg cell therapy in graft-versus-host disease, type 1 diabetes, and organ transplant have shown that it is feasible, safe, and potentially efficacious in some settings. Many ongoing trials in a wide variety of diseases will further enhance our knowledge about the optimal approaches for Treg manufacturing and dosing. (Source: Journal of Allergy and Clinical Immunology)

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Integrative approach identifies corticosteroid response variant in diverse populations with asthma

This is the first study to use a non-white study population for the discovery of pharmacogenomic predictors of asthma controller response. Variant rs3827907 genotype appeared to influenced ICS response especially in the setting of eosinophilic inflammation. (Source: Journal of Allergy and Clinical Immunology)

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“Evaluating primary endpoints in peanut immunotherapy clinical trials”

Food immunotherapy has been the focus of several allergy research initiatives over the last decade. Though many questions remain unanswered, the evidence suggests that this treatment may be available in the near future outside clinical trials. Additionally, pharmaceutical companies, in light of promising early stage results, have shown interest in developing commercially available products, thus increasing the likelihood that new immunotherapy treatments will be introduced, especially for peanut allergy. (Source: Journal of Allergy and Clinical Immunology)

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Comparison of complications with semi-solid versus liquid diet via nasogastric feeding tube after orthognathic surgery

The aim of this retrospective study was to compare the effectiveness of nasogastric tube (NGT) feeding of a semi-solid diet versus a liquid diet after orthognathic surgery.

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Comparison of complications with semi-solid versus liquid diet via nasogastric feeding tube after orthognathic surgery

The aim of this retrospective study was to compare the effectiveness of nasogastric tube (NGT) feeding of a semi-solid diet versus a liquid diet after orthognathic surgery.

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Comparison of complications with semi-solid versus liquid diet via nasogastric feeding tube after orthognathic surgery

The aim of this retrospective study was to compare the effectiveness of nasogastric tube (NGT) feeding of a semi-solid diet versus a liquid diet after orthognathic surgery.

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Comparison of complications with semi-solid versus liquid diet via nasogastric feeding tube after orthognathic surgery

The aim of this retrospective study was to compare the effectiveness of nasogastric tube (NGT) feeding of a semi-solid diet versus a liquid diet after orthognathic surgery.

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Regulatory T cell therapy for autoimmune and autoinflammatory diseases: the next frontier

FOXP3-expressing regulatory T cells (Tregs) are essential for self-tolerance with an emerging role in tissue repair and regeneration. Their ability to traffic to tissue and perform complex therapeutic tasks in response to the tissue microenvironment make them an attractive candidate for drug development. Early experiences of Treg cell therapy in graft-versus-host disease, type 1 diabetes, and organ transplant have shown that it is feasible, safe, and potentially efficacious in some settings. Many ongoing trials in a wide variety of diseases will further enhance our knowledge about the optimal approaches for Treg manufacturing and dosing.

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Does lactate clearance prognosticates outcomes in ECMO therapy: a retrospective observational study

Abstract

Background

ECMO support is a final treatment modality for patients in the refractory cardiogenic arrest and postcardiotomy cardiogenic shock with an utmost importance. Eventhough it is linked to high mortality, its usage gains popularity worldwide. We assessed the fluctuation of lactate levels and the clearance of lactate during the ECMO therapy and its prognostic role on mortality.

Methods

Data were gathered on all patients receiving ECMO therapy longer than 48 h between January 2015 and December 2017 retrospectively. Blood lactate had been recorded before ECMO implantation and at specific time points during ECMO support as a routine procedure. In this study, the Lactate clearance at specific time points (Lactate clearance-1) and the duration that lactate cleared more than 10% of the initial lactate level (Lactate clearance-2) was measured. Statistical analysis included Mann Whitney U-test and ROC-curves to predict 30-day mortality.

Results

Fourty-eight patients underwent ECMO therapy for refractory cardiogenic shock resulting in 70.8% mortality. The lactate levels before and after ECMO therapy as well as the dynamic changes were significantly correlated with mortality variable. With AUC calculation, LC-2 has a strong discrimination (AUC = 0.97) on 30-day survivors and nonsurvivors. LAE-LBE (AUC = 0.785), L48-LBE (AUC = 0.706) showed moderate predictive power on 30-day mortality.

Conclusions

Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based on our results, an early insertion of ECMO before lactate gets high was suggested. Serial changes on lactate levels and calculation of its clearance may be superior to single lactate on both effective circulatory support and as prognostic prediction. LC-2 showed a strong discrimination on 30-day mortality.

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Laryngeal mask airway Unique™ position in paediatric patients undergoing magnetic resonance imaging (MRI): prospective observational study

Abstract

Background

Laryngeal mask UNIQUE® (LMAU) is supraglottic airway device with good clinical performance and low failure rate. Little is known about the ideal position of the LMAU on the magnetic resonance imaging (MRI) and whether radiological malposition can be associated with clinical performance (audible leak) in children. The primary aim of the study was to evaluate incidence of the radiologic malposition of the LMAU according to size. The secondary outcome was the clinical performance and associated complications (1st attempt success rate, audible leak) in LMAUs in correct position vs. radiologically misplaced LMAUs.

Methods

In prospective observational study, all paediatric patients undergoing MRI of the brain under general anaesthesia with the LMAU were included (1.9.2016–16.5.2017). The radiologically correct position: LMAU in hypopharynx, proximal cuff opposite to the C1 or C2 and distance A (proximal cuff end and aditus laryngis) ≤ distance B (distal cuff end and aditus laryngis). Malposition A: LMAU outside the hypopharynx. Malposition B: proximal cuff outside C1-C2. Malposition C: distance A ≥ distance B. We measured distances on the MRI image. Malposition incidence between LMAU sizes and first attempt success rate in trainees and consultant groups was compared using Fisher exact test, difference in incidence of malpositions using McNemar test and difference in leakage according to radiological position using two-sample binomial test.

Results

Overall 202 paediatric patients were included. The incidence of radiologically defined malposition was 26.2% (n = 53). Laryngeal mask was successfully inserted on the 1st attempt in 91.1% (n = 184) cases. Audible leak was detected in 3.5% (n = 7) patients. The radiologically defined malposition was present in 42.9% (n = 3) cases with audible leak. The rate of associated complications was 1.5% (n = 3): laryngospasm, desaturation, cough. In 4.0% (n = 8) the LMAU was soiled from blood.

Higher incidence of radiological malposition was in LMAU 1.0, 1.5 and LMAU 3, 4 compared to LMAU 2 or LMAU 2.5 (p < 0.001).

Conclusion

Malposition was not associated with impaired clinical performance (audible leak, complications) of the LMAU or the need for alternative airway management.

Trial registration

Clinicaltrials.gov  (NCT02940652) Registered 18 October 18 2016.

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Laryngeal mask airway Unique™ position in paediatric patients undergoing magnetic resonance imaging (MRI): prospective observational study

Abstract

Background

Laryngeal mask UNIQUE® (LMAU) is supraglottic airway device with good clinical performance and low failure rate. Little is known about the ideal position of the LMAU on the magnetic resonance imaging (MRI) and whether radiological malposition can be associated with clinical performance (audible leak) in children. The primary aim of the study was to evaluate incidence of the radiologic malposition of the LMAU according to size. The secondary outcome was the clinical performance and associated complications (1st attempt success rate, audible leak) in LMAUs in correct position vs. radiologically misplaced LMAUs.

Methods

In prospective observational study, all paediatric patients undergoing MRI of the brain under general anaesthesia with the LMAU were included (1.9.2016–16.5.2017). The radiologically correct position: LMAU in hypopharynx, proximal cuff opposite to the C1 or C2 and distance A (proximal cuff end and aditus laryngis) ≤ distance B (distal cuff end and aditus laryngis). Malposition A: LMAU outside the hypopharynx. Malposition B: proximal cuff outside C1-C2. Malposition C: distance A ≥ distance B. We measured distances on the MRI image. Malposition incidence between LMAU sizes and first attempt success rate in trainees and consultant groups was compared using Fisher exact test, difference in incidence of malpositions using McNemar test and difference in leakage according to radiological position using two-sample binomial test.

Results

Overall 202 paediatric patients were included. The incidence of radiologically defined malposition was 26.2% (n = 53). Laryngeal mask was successfully inserted on the 1st attempt in 91.1% (n = 184) cases. Audible leak was detected in 3.5% (n = 7) patients. The radiologically defined malposition was present in 42.9% (n = 3) cases with audible leak. The rate of associated complications was 1.5% (n = 3): laryngospasm, desaturation, cough. In 4.0% (n = 8) the LMAU was soiled from blood.

Higher incidence of radiological malposition was in LMAU 1.0, 1.5 and LMAU 3, 4 compared to LMAU 2 or LMAU 2.5 (p < 0.001).

Conclusion

Malposition was not associated with impaired clinical performance (audible leak, complications) of the LMAU or the need for alternative airway management.

Trial registration

Clinicaltrials.gov  (NCT02940652) Registered 18 October 18 2016.

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The Oxford Handbook of Endangered Languages, Kenneth L. Rehg, Lyle Campbell (Eds.). Oxford University Press (2018), 946 pp.

Publication date: Available online 23 October 2018Source: LinguaAuthor(s): Andrew Cowell (Source: Lingua)

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In what sense is integrational theory lay-oriented? Notes on Harrisian core concepts and explanatory terminology

Publication date: Available online 24 October 2018Source: Language SciencesAuthor(s): Adrian Pablé (Source: Language Sciences)

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Onset pitch perturbations and the cross-linguistic implementation of voicing: Evidence from tonal and non-tonal languages

Publication date: November 2018Source: Journal of Phonetics, Volume 71Author(s): James P. KirbyAbstractThis paper investigates the relationship between Voice Onset Time (VOT) and onset f0 perturbations in three languages with a three-way laryngeal contrast between prevoiced, short-lag, and long-lag stops. To assess the relative contributions of aspiration and tonality to the realization of onset f0, a non-tonal language (Khmer) is compared to two tonal languages (Central Thai and Northern Vietnamese) using a common set of methods and materials. While the VOT distributions of the three languages are extremely similar, they differ in terms of their onset f0 behavior. Aspirated stops in general condition higher f0 on the following vowel, but this effect is mediated by tonal and sentential con...

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Exploring the shape of signal-detection distributions in individual recognition ROC data

Publication date: February 2019Source: Journal of Memory and Language, Volume 104Author(s): Simone Malejka, Arndt BröderAbstractThe question of whether recognition performance should be analyzed assuming continuous memory strength or discrete memory states has been bothering researchers for decades. Continuous-strength models (signal-detection theory) assume that memory strength varies according to Gaussian distributions, leading to graded memory-strength values. In contrast, discrete-state models (threshold theory) are formally equivalent to continuous-strength models with rectangular distributions, giving rise to detection and guessing states. Despite these different core properties, the models fits to empirical data are often highly positively correlated, and the form of empirical rece...

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From Deficit Remediation to Capacity Building: Learning to Enable Rather Than Disable Students With Dyslexia

Conclusion We find that further research is needed to explore strengths associated with dyslexia and argue that a shift in mindset from the deficit view toward the neurodiversity view is required to build the capacity of students with dyslexia to thrive in learning and life. (Source: Language, Speech, and Hearing Services in Schools)

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The State of Dyslexia: Recent Legislation and Guidelines for Serving School-Age Children and Adolescents With Dyslexia

Conclusion The information discussed in this article may serve as a useful model for states that are in the process of developing or revising their own policies or guidelines for meeting the needs of students with dyslexia. (Source: Language, Speech, and Hearing Services in Schools)

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Service Provision for Children Who Are Hard of Hearing at Preschool and Elementary School Ages

Conclusions As preschool-age CHH transition into school, the majority continue to qualify for services. Congruent with national trends, school-age CHH in the Outcomes of Children with Hearing Loss study were most often in general education settings. Without specialized preprofessional or postgraduate training, SLPs and teachers of CDHH did not report comfort with all the skills critical to developing listening and spoken language. This finding supports the need for increased implementation of interprofessional practice among SLPs and teachers of CDHH, as well as audiologists, to best meet the needs unique to this population. (Source: Language, Speech, and Hearing Services in Schools)

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Elementary Grade Intervention Approaches to Treat Specific Learning Disabilities, Including Dyslexia

Conclusion We conclude by describing a set of links to websites and technical assistance resources that may be helpful for speech-language pathologists, teachers, and other interventionists to stay current with this research base and to lead professional learning communities. (Source: Language, Speech, and Hearing Services in Schools)

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Five Ways Speech-Language Pathologists Can Positively Impact Children With Dyslexia

Purpose The purpose of this epilogue is to offer five ways speech-language pathologists can positively impact children with dyslexia, drawing from and expanding on the articles presented in this clinical forum on dyslexia. (Source: Language, Speech, and Hearing Services in Schools)

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Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits

Conclusion Speech-language pathologists have a unique opportunity to assist in the identification of young children who are at risk for dyslexia. (Source: Language, Speech, and Hearing Services in Schools)

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Reading Disabilities in Adolescents and Adults

Conclusions Further study of reading in older individuals may lead to important theoretical and clinical applications. Speech-language pathologists should keep in mind the various components of reading (such as decoding and comprehension), how these factors relate to oral language, and how they may be addressed in therapy. (Source: Language, Speech, and Hearing Services in Schools)

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Language Sample Practices With Children Who Are Deaf and Hard of Hearing

Conclusions Language samples offer a unique way to examine a child's language development that norm-referenced assessments are not sensitive enough to detect, particularly for children who are DHH. This offers insights into current practice and implications for the development of a more clearly defined language sample protocol to guide practices in the use of language samples with children who are DHH and use listening and spoken language. (Source: Language, Speech, and Hearing Services in Schools)

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The Oxford Handbook of Endangered Languages, Kenneth L. Rehg, Lyle Campbell (Eds.). Oxford University Press (2018), 946 pp.

Publication date: Available online 23 October 2018Source: LinguaAuthor(s): Andrew Cowell (Source: Lingua)

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Acoustic correlates of the voicing contrast in Lebanese Arabic singleton and geminate stops

This study explores which acoustic correlates best distinguish the voicing contrast in Lebanese Arabic, a language with a two-way voicing contrast that occurs with both singleton and geminate stops. The required timing, phonation and articulatory strength settings for each contrast act synergistically in the voiceless set, but it is unclear how the contrasting requirements for voiced geminates are implemented. Twenty adult speakers were recorded producing target words with medial singleton and geminate stops preceded by long and short vowels. Several temporal and non-temporal measures (duration, VOT, percent voicing, f0, F1, intensity, H1∗–H2∗) were taken in the surrounding vowels and in the closure and release phases. Results show that closure duration is the most important cue for ...

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Onset pitch perturbations and the cross-linguistic implementation of voicing: Evidence from tonal and non-tonal languages

Publication date: November 2018Source: Journal of Phonetics, Volume 71Author(s): James P. KirbyAbstractThis paper investigates the relationship between Voice Onset Time (VOT) and onset f0 perturbations in three languages with a three-way laryngeal contrast between prevoiced, short-lag, and long-lag stops. To assess the relative contributions of aspiration and tonality to the realization of onset f0, a non-tonal language (Khmer) is compared to two tonal languages (Central Thai and Northern Vietnamese) using a common set of methods and materials. While the VOT distributions of the three languages are extremely similar, they differ in terms of their onset f0 behavior. Aspirated stops in general condition higher f0 on the following vowel, but this effect is mediated by tonal and sentential con...

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