Impact of big data on oral health outcomes

Abstract

Biomedical big data amasses from different sources such as electronic health records, health research, wearable devices and social media. Recent advances in data capturing, storage and analysis techniques have facilitated conversion of a wealth of knowledge in biomedical big data into evidence‐based actionable plans to enhance population health and wellbeing. The delay in reaping the benefits of biomedical big data in dentistry is mainly due to the slow adoption of electronic health record systems, unstructured clinical records, tattered communication between data silos and perceiving oral health as a separate entity from general health. Recent recognition of the complex interplay between oral and general health has acknowledged the power of oral health big data to glean new insights on disease prevention and management. This review paper summarizes recent advances, limitations and challenges in biomedical big data in health care with emphasis on oral health and discusses the potential future applications of oral health big data to improve the quality and efficiency of personalized health care.

This article is protected by copyright. All rights reserved.

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Impact of big data on oral health outcomes

Abstract

Biomedical big data amasses from different sources such as electronic health records, health research, wearable devices and social media. Recent advances in data capturing, storage and analysis techniques have facilitated conversion of a wealth of knowledge in biomedical big data into evidence‐based actionable plans to enhance population health and wellbeing. The delay in reaping the benefits of biomedical big data in dentistry is mainly due to the slow adoption of electronic health record systems, unstructured clinical records, tattered communication between data silos and perceiving oral health as a separate entity from general health. Recent recognition of the complex interplay between oral and general health has acknowledged the power of oral health big data to glean new insights on disease prevention and management. This review paper summarizes recent advances, limitations and challenges in biomedical big data in health care with emphasis on oral health and discusses the potential future applications of oral health big data to improve the quality and efficiency of personalized health care.

This article is protected by copyright. All rights reserved.

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Read, Understand, Learn, & amp; Excel (RULE): Development and Feasibility of a Reading Comprehension Measure for Postsecondary Learners

Conclusion RULE design and preliminary findings of concurrent validity and alternate form reliability provide "proof of concept" for an ecologically valid testing format that assesses comprehension skills appropriate for the postsecondary level. Suggestions for strengthening validity and reliability of the tool are provided, and clinical contributions of RULE are discussed.Supplemental Materialhttps://doi.org/10.23641/asha.6987371 (Source: American Journal of Speech-Language Pathology)

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Concatenation of the Moving Window Technique for Auditory-Perceptual Analysis of Voice Quality

Conclusions The concatenated moving window method showed improved sensitivity and specificity for detecting voice disorders using auditory-perceptual analysis, compared with the short moving window segment. It is a helpful tool for perceptual analytic protocols, allowing for voice evaluation using standardized and automated voice-segmenting procedures.Supplemental Materialhttps://doi.org/10.23641/asha.7100951 (Source: American Journal of Speech-Language Pathology)

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How Gender Stereotypes May Limit Female Faculty Advancement in Communication Sciences and Disorders

Conclusions Cultural stereotypes about men and women lead to implicit gender bias that may have real consequences for female faculty advancement in CSD. Such implicit bias can influence career selection and outcomes within the field in multiple ways. To ensure that CSD continues to attract top talent and maintain a robust pipeline of future faculty in doctoral training programs, the field must recognize the existence of implicit gender bias and implement evidence-based strategies to minimize its potentially damaging effects on the future of the profession. (Source: American Journal of Speech-Language Pathology)

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Masthead

(Source: American Journal of Speech-Language Pathology)

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Current Practice of Child Grammar Intervention: A Survey of Speech-Language Pathologists

Conclusions This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses. (Source: American Journal of Speech-Language Pathology)

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Phonological Development in a Bilingual Arabic –English-Speaking Child With Bilateral Cochlear Implants: A Longitudinal Case Study

Conclusion Bilingual children with CIs have the capability to learn both of their languages and perform similarly to, and even surpass in accuracy, monolingual children with CIs; however, it is also possible to exhibit a slower rate of acquisition of segmental accuracy as compared to their typically developing, hearing peers. Clinical implications of bilingual early intervention are discussed. (Source: American Journal of Speech-Language Pathology)

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Children's Consonant Acquisition in 27 Languages: A Cross-Linguistic Review

Conclusions Children across the world acquire consonants at a young age. Five-year-old children have acquired most consonants within their ambient language; however, individual variability should be considered.Supplemental Materialhttps://doi.org/10.23641/asha.6972857 (Source: American Journal of Speech-Language Pathology)

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An Integrative Analysis of Spontaneous Storytelling Discourse in Aphasia: Relationship With Listeners' Rating and Prediction of Severity and Fluency Status of Aphasia

Conclusions The linguistically based measures appeared to be the most clinically effective and powerful in reflecting PWA's performance of spoken discourse. (Source: American Journal of Speech-Language Pathology)

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Speech Impairment in Boys With Fetal Alcohol Spectrum Disorders

Conclusions Findings indicate that the speech impairment in boys with FASD results from a combination of deficits in multiple subsystems and should be approached as a disorder rather than a developmental delay. The results suggest that reduced speech motor planning/programming, auditory discrimination, and oral motor abilities should be considered in long-term, individually tailored treatment. (Source: American Journal of Speech-Language Pathology)

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

Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities

Conclusions Findings highlighted several barriers in LTCFs that worked to discourage persons with aphasia from living social and expressive lives. Specific obstacles included a misunderstanding of aphasia and its influence on communicative exchanges and performance-oriented environment that overlooked psychosocial needs. Speech-language pathologists have an important role for advocacy in LTCFs. Clinical implications for assessment and treatment in institutions are discussed. (Source: American Journal of Speech-Language Pathology)

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Effects of Submental Surface Electrical Stimulation on Swallowing Kinematics in Healthy Adults: An Error-Based Learning Paradigm

Conclusions These findings indicate that electrical stimulation of the agonists for hyoid movement might not alter swallowing outcomes tested in this study. However, submental SES could have clinical utility by minimizing swallowing impairments related to reduced hyoid swallowing range of motion in individuals with dysphagia. (Source: American Journal of Speech-Language Pathology)

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Modifying Food Textures: Practices and Beliefs of Staff Involved in Nutrition Care

Conclusions Survey respondents conveyed generally positive attitudes and opinions about the use of texture-modified foods, and respondents perceived them to be easy to execute and beneficial to the nutritional well-being of patients. Survey findings clearly highlight the contributions of frontline staff in the service delivery of modified food textures. Consideration must be given to continued reliance on informal, limited instruction about texture-modified foods and possible implications for safe nutrition care. Both professional and frontline staff convey a willingness to customize or alter food textures and the belief that patients should be able to choose the level of texture modification that they want to eat. (Source: American Journal of Speech-Language Pathology)

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

A Case Study Using a Multimodal Approach to Melodic Intonation Therapy

Conclusions Integration of melodic intonation therapy through the addition of musical elements may result in improved speech and expressive language skills when administered over a 9-month period in conjunction with a group socialization program. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Rf00vp

Changing Nonstuttering Preschool Children's Stuttering Attitudes

Conclusion This study provides empirical evidence that young children's stuttering attitudes can be improved using the Attitude Change and Tolerance program. In addition, it supports previous research that negative stuttering attitudes emerge as early as preschool. (Source: American Journal of Speech-Language Pathology)

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The Accuracy of Smartphone Sound Level Meter Applications With and Without Calibration

Conclusions These findings suggest that some SLMAs are accurate for measuring NBN and WN stimuli within the range of 50 –100 dB in sound-treated environments when calibrated. However, outcomes indicated that some SLMAs, even with calibration, overestimated low ambient noise levels and may not accurately verify quiet room environments< 50 dB for clinical services. These results should not be generalized for all smartphone types, and continued research on SLMAs using next-generation smartphone devices is warranted. (Source: American Journal of Speech-Language Pathology)

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3 Steps to Reduce Stress Over the Things You Can ’ t Change

Being an audiologist or speech-language pathologist can be incredibly rewarding. As clinicians, we get to help people communicate better, safely enjoy their food again, hear their parents or grandchildren, and generally thrive in their lives. Our work can also cause stress and feel overwhelming at times. And those stressful moments often come from factors out of our control, such as demands from paperwork, productivity and growing caseloads. Sometimes stress even comes from a patient or client not achieving desired outcomes or making progress at the rate we expected, causing us to wonder what we can do better. These stresses can be enough to make you feel drained, mentally exhausted and constantly worried about your work. When those stressful moments seem to override positive moments, burn...

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Read, Understand, Learn, & amp; Excel (RULE): Development and Feasibility of a Reading Comprehension Measure for Postsecondary Learners

Conclusion RULE design and preliminary findings of concurrent validity and alternate form reliability provide "proof of concept" for an ecologically valid testing format that assesses comprehension skills appropriate for the postsecondary level. Suggestions for strengthening validity and reliability of the tool are provided, and clinical contributions of RULE are discussed.Supplemental Materialhttps://doi.org/10.23641/asha.6987371 (Source: American Journal of Speech-Language Pathology)

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

Concatenation of the Moving Window Technique for Auditory-Perceptual Analysis of Voice Quality

Conclusions The concatenated moving window method showed improved sensitivity and specificity for detecting voice disorders using auditory-perceptual analysis, compared with the short moving window segment. It is a helpful tool for perceptual analytic protocols, allowing for voice evaluation using standardized and automated voice-segmenting procedures.Supplemental Materialhttps://doi.org/10.23641/asha.7100951 (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2RiqX1e

How Gender Stereotypes May Limit Female Faculty Advancement in Communication Sciences and Disorders

Conclusions Cultural stereotypes about men and women lead to implicit gender bias that may have real consequences for female faculty advancement in CSD. Such implicit bias can influence career selection and outcomes within the field in multiple ways. To ensure that CSD continues to attract top talent and maintain a robust pipeline of future faculty in doctoral training programs, the field must recognize the existence of implicit gender bias and implement evidence-based strategies to minimize its potentially damaging effects on the future of the profession. (Source: American Journal of Speech-Language Pathology)

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Clinical Progression in Four Cases of Primary Progressive Apraxia of Speech

Conclusions This case series demonstrates that patients who initially present with PPAOS may develop aphasia and dysarthria, cognitive and behavioral changes, and other neurologic signs. Whether these changes can be predicted by the perceptual characteristics of the apraxia of speech is yet to be determined. The detailed longitudinal profiles provide valuable clinical insight into the progression of disease in people with PPAOS.Supplemental Materialhttps://doi.org/10.23641/asha.7051616 (Source: American Journal of Speech-Language Pathology)

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Continuous Vocal Fry Simulated in Laboratory Subjects: A Preliminary Report on Voice Production and Listener Ratings

Conclusions Thirty minutes of simulated, continuous vocal fry worsened some voice measures when compared with a habitual voice quality. Samples of continuous vocal fry were rated as significantly less employable, less natural, and requiring greater listener concentration as compared with samples of habitual voice quality. Future studies should include habitual users of vocal fry to investigate speech stimulability and adaptation with cueing to further understand pathogenesis of vocal fry. (Source: American Journal of Speech-Language Pathology)

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Writing Changes and Perceptions After Traumatic Brain Injury: “Oh, by the way, I can't write”

Conclusion Understanding the writing experiences and perceptions of people with TBI can guide professionals in designing assessments and interventions to facilitate educational, vocational, social, and personal success following injury. (Source: American Journal of Speech-Language Pathology)

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Current Practice of Child Grammar Intervention: A Survey of Speech-Language Pathologists

Conclusions This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses. (Source: American Journal of Speech-Language Pathology)

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

Phonological Development in a Bilingual Arabic –English-Speaking Child With Bilateral Cochlear Implants: A Longitudinal Case Study

Conclusion Bilingual children with CIs have the capability to learn both of their languages and perform similarly to, and even surpass in accuracy, monolingual children with CIs; however, it is also possible to exhibit a slower rate of acquisition of segmental accuracy as compared to their typically developing, hearing peers. Clinical implications of bilingual early intervention are discussed. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PYy6Ya

Children's Consonant Acquisition in 27 Languages: A Cross-Linguistic Review

Conclusions Children across the world acquire consonants at a young age. Five-year-old children have acquired most consonants within their ambient language; however, individual variability should be considered.Supplemental Materialhttps://doi.org/10.23641/asha.6972857 (Source: American Journal of Speech-Language Pathology)

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

An Integrative Analysis of Spontaneous Storytelling Discourse in Aphasia: Relationship With Listeners' Rating and Prediction of Severity and Fluency Status of Aphasia

Conclusions The linguistically based measures appeared to be the most clinically effective and powerful in reflecting PWA's performance of spoken discourse. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PYy3eW

Speech Impairment in Boys With Fetal Alcohol Spectrum Disorders

Conclusions Findings indicate that the speech impairment in boys with FASD results from a combination of deficits in multiple subsystems and should be approached as a disorder rather than a developmental delay. The results suggest that reduced speech motor planning/programming, auditory discrimination, and oral motor abilities should be considered in long-term, individually tailored treatment. (Source: American Journal of Speech-Language Pathology)

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

Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities

Conclusions Findings highlighted several barriers in LTCFs that worked to discourage persons with aphasia from living social and expressive lives. Specific obstacles included a misunderstanding of aphasia and its influence on communicative exchanges and performance-oriented environment that overlooked psychosocial needs. Speech-language pathologists have an important role for advocacy in LTCFs. Clinical implications for assessment and treatment in institutions are discussed. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PYy02K

Effects of Submental Surface Electrical Stimulation on Swallowing Kinematics in Healthy Adults: An Error-Based Learning Paradigm

Conclusions These findings indicate that electrical stimulation of the agonists for hyoid movement might not alter swallowing outcomes tested in this study. However, submental SES could have clinical utility by minimizing swallowing impairments related to reduced hyoid swallowing range of motion in individuals with dysphagia. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2RiqVq8

Modifying Food Textures: Practices and Beliefs of Staff Involved in Nutrition Care

Conclusions Survey respondents conveyed generally positive attitudes and opinions about the use of texture-modified foods, and respondents perceived them to be easy to execute and beneficial to the nutritional well-being of patients. Survey findings clearly highlight the contributions of frontline staff in the service delivery of modified food textures. Consideration must be given to continued reliance on informal, limited instruction about texture-modified foods and possible implications for safe nutrition care. Both professional and frontline staff convey a willingness to customize or alter food textures and the belief that patients should be able to choose the level of texture modification that they want to eat. (Source: American Journal of Speech-Language Pathology)

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

A Case Study Using a Multimodal Approach to Melodic Intonation Therapy

Conclusions Integration of melodic intonation therapy through the addition of musical elements may result in improved speech and expressive language skills when administered over a 9-month period in conjunction with a group socialization program. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Rf00vp

Changing Nonstuttering Preschool Children's Stuttering Attitudes

Conclusion This study provides empirical evidence that young children's stuttering attitudes can be improved using the Attitude Change and Tolerance program. In addition, it supports previous research that negative stuttering attitudes emerge as early as preschool. (Source: American Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PVy6Iv

The Accuracy of Smartphone Sound Level Meter Applications With and Without Calibration

Conclusions These findings suggest that some SLMAs are accurate for measuring NBN and WN stimuli within the range of 50 –100 dB in sound-treated environments when calibrated. However, outcomes indicated that some SLMAs, even with calibration, overestimated low ambient noise levels and may not accurately verify quiet room environments< 50 dB for clinical services. These results should not be generalized for all smartphone types, and continued research on SLMAs using next-generation smartphone devices is warranted. (Source: American Journal of Speech-Language Pathology)

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Sense of Effort and Fatigue Associated With Talking After Total Laryngectomy

Conclusions Effort and fatigue associated with talking are a common report for individuals using alaryngeal speech. The location of effort within the body and the type of fatigue experienced vary to some extent across alaryngeal speaking methods. (Source: American Journal of Speech-Language Pathology)

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Acquired Velopharyngeal Dysfunction: Survey, Literature Review, and Clinical Recommendations

Conclusions Clinical uncertainty among speech-language pathologists surveyed and the paucity of published clinical guidelines for assessing individuals with AVPD indicate the need for additional clinical research for this disorder, one that is heterogeneous and distinct from those with congenital velopharyngeal dysfunction. The proposed evidence-based clinical worksheet may assist in determining management for patients with AVPD and may serve as a starting place for validation of a clinical guideline. (Source: American Journal of Speech-Language Pathology)

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Molecular Classification of Thyroid Nodules with Indeterminate Cytology: Development and Validation of a Highly Sensitive and Specific New miRNA-Based Classifier Test Using Fine-Needle Aspiration Smear Slides

Thyroid, Ahead of Print.


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Molecular Classification of Thyroid Nodules with Indeterminate Cytology: Development and Validation of a Highly Sensitive and Specific New miRNA-Based Classifier Test Using Fine-Needle Aspiration Smear Slides

Thyroid, Ahead of Print.


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

Molecular Classification of Thyroid Nodules with Indeterminate Cytology: Development and Validation of a Highly Sensitive and Specific New miRNA-Based Classifier Test Using Fine-Needle Aspiration Smear Slides

Thyroid, Ahead of Print.


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Effects of equibiaxial mechanical stretch on extracellular matrix‐related gene expression in human calvarial osteoblasts

Mechanical stretch commonly promotes craniofacial suture remodeling during interceptive orthodontics. The mechanical responses of osteoblasts in craniofacial sutures play a role in suture remodeling. Moreover, the extracellular matrix (ECM) produced by osteoblasts is crucial for the transduction of mechanical signals that promote cell differentiation. Therefore, we aimed to investigate the effect of mechanical stretch on cell viability and ECM‐related gene‐expression changes in human osteoblasts. Human calvarial osteoblasts (HCObs) were subjected to 2% deformation. Caspase activity, MTT, and cell viability assays were used to estimate osteoblast apoptosis, proliferation, and viability, respectively. Real‐time RT‐PCR (RT²‐PCR) arrays were used to assess expression of cytoskeletal‐, apoptosis‐, osteogenesis‐, and ECM‐related genes. We found that mechanical stretch significantly increased osteoblast viability and cell proliferation, and decreased the activities of caspases 3 and 7. Moreover, the expression of 18 genes related to osteoblast differentiation, apoptosis, and ECM remodeling changed by more than two‐fold in a time‐dependent manner. Therefore, mechanical stretch promotes HCOb viability and alters expression of genes that are closely related to suture remodeling under mechanical stretch.

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A'Hypoallergenic' Dog? You May Be Barking Up the Wrong Tree

MONDAY, Nov. 26, 2018 -- Do so-called hypoallergenic dogs really protect you against asthma? Many dog-lovers believe it, but Swedish researchers found no evidence that " allergy-friendly " breeds -- such as poodles and miniature Schnauzers -- actually... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DJ5P0a

Molecular Classification of Thyroid Nodules with Indeterminate Cytology: Development and Validation of a Highly Sensitive and Specific New miRNA-Based Classifier Test Using Fine-Needle Aspiration Smear Slides

Thyroid, Ahead of Print.


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

Effects of equibiaxial mechanical stretch on extracellular matrix‐related gene expression in human calvarial osteoblasts

Mechanical stretch commonly promotes craniofacial suture remodeling during interceptive orthodontics. The mechanical responses of osteoblasts in craniofacial sutures play a role in suture remodeling. Moreover, the extracellular matrix (ECM) produced by osteoblasts is crucial for the transduction of mechanical signals that promote cell differentiation. Therefore, we aimed to investigate the effect of mechanical stretch on cell viability and ECM‐related gene‐expression changes in human osteoblasts. Human calvarial osteoblasts (HCObs) were subjected to 2% deformation. Caspase activity, MTT, and cell viability assays were used to estimate osteoblast apoptosis, proliferation, and viability, respectively. Real‐time RT‐PCR (RT²‐PCR) arrays were used to assess expression of cytoskeletal‐, apoptosis‐, osteogenesis‐, and ECM‐related genes. We found that mechanical stretch significantly increased osteoblast viability and cell proliferation, and decreased the activities of caspases 3 and 7. Moreover, the expression of 18 genes related to osteoblast differentiation, apoptosis, and ECM remodeling changed by more than two‐fold in a time‐dependent manner. Therefore, mechanical stretch promotes HCOb viability and alters expression of genes that are closely related to suture remodeling under mechanical stretch.

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

A'Hypoallergenic' Dog? You May Be Barking Up the Wrong Tree

MONDAY, Nov. 26, 2018 -- Do so-called hypoallergenic dogs really protect you against asthma? Many dog-lovers believe it, but Swedish researchers found no evidence that " allergy-friendly " breeds -- such as poodles and miniature Schnauzers -- actually... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DJ5P0a

A'Hypoallergenic' Dog? You May Be Barking Up the Wrong Tree

MONDAY, Nov. 26, 2018 -- Do so-called hypoallergenic dogs really protect you against asthma? Many dog-lovers believe it, but Swedish researchers found no evidence that " allergy-friendly " breeds -- such as poodles and miniature Schnauzers -- actually... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DJ5P0a

A'Hypoallergenic' Dog? You May Be Barking Up the Wrong Tree

MONDAY, Nov. 26, 2018 -- Do so-called hypoallergenic dogs really protect you against asthma? Many dog-lovers believe it, but Swedish researchers found no evidence that " allergy-friendly " breeds -- such as poodles and miniature Schnauzers -- actually... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DJ5P0a

Molecular Classification of Thyroid Nodules with Indeterminate Cytology: Development and Validation of a Highly Sensitive and Specific New miRNA-Based Classifier Test Using Fine-Needle Aspiration Smear Slides

Thyroid, Ahead of Print.


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

Are antithrombotic agents necessary for head and neck microvascular surgery?

The aim of this prospective study was to determine the effect of antithrombotic agents in preventing thrombosis after head and neck reconstructive surgery. A randomized clinical trial of referred patients undergoing free flap surgery between February 2015 and July 2017 was conducted. Four hundred and fifty-four patients were randomly assigned to group A (n=153), administered aspirin and low molecular weight dextran; group B (n=150), administered low molecular weight heparin; and group C (n=151), not administered any antithrombotic agent. (Source: International Journal of Oral and Maxillofacial Surgery)

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Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study

In this study, the type of radiotherapy treatment, i.e. three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT), was the predictor variable. The primary outcome variable was crestal bone loss, recorded at implant placement and after 3, 6, 12, and 24 months. (Source: International Journal of Oral and Maxillofacial Surgery)

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

Are antithrombotic agents necessary for head and neck microvascular surgery?

The aim of this prospective study was to determine the effect of antithrombotic agents in preventing thrombosis after head and neck reconstructive surgery. A randomized clinical trial of referred patients undergoing free flap surgery between February 2015 and July 2017 was conducted. Four hundred and fifty-four patients were randomly assigned to group A (n=153), administered aspirin and low molecular weight dextran; group B (n=150), administered low molecular weight heparin; and group C (n=151), not administered any antithrombotic agent. (Source: International Journal of Oral and Maxillofacial Surgery)

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

Crestal bone loss around dental implants placed in head and neck cancer patients treated with different radiotherapy techniques: a prospective cohort study

In this study, the type of radiotherapy treatment, i.e. three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT), was the predictor variable. The primary outcome variable was crestal bone loss, recorded at implant placement and after 3, 6, 12, and 24 months. (Source: International Journal of Oral and Maxillofacial Surgery)

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

Radiation dose and image quality with new protocol in lower extremity computed tomography angiography

Abstract

Purpose

To compare radiation dose and image quality of lower extremity computed tomography angiography (CTA) between cranio-caudal acquisition with single-source CT (SSCT) and flash caudo-cranial acquisition with dual-source CT (DSCT).

Materials and methods

In this prospective study, 60 patients were randomly assigned to Group A (control) or Group B (experimental) to undergo lower extremity CTA for peripheral obliterative arterial disease. Group A received protocol 1 (P1) with SSCT cranio-caudal acquisition. Group B received protocol (P2) with DSCT flash caudo-cranial acquisition. Intravascular attenuation (IVA), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image noise were compared. Two radiologists assessed the image quality. Computed tomography volume dose index (CTDI_vol) and dose-length product (DLP) were also compared.

Results

IVA with P2 was higher than with P1 (586.8 ± 140.3 vs. 496.1 ± 129.3 HU, p = 0.011), as was SNR (33.0 ± 11.3 vs. 27.4 ± 12.3; p = 0.042), CNR (30.1 ± 13.3 vs. 24.2 ± 10.3; p = 0.029) and image quality score of small arteries below the knee (3.8 ± 0.2 vs. 3.1 ± 0.2; p = 0.001). Radiation dose was significantly lower in P2 than in P1 with CTDI_vol reduction of 40.9% (1.3 ± 0.1 vs. 2.2 ± 0.3 mGy; p = 0.006) and DLP reduction of 42.8% (148.7 ± 21.9 vs 260.2 ± 59.1 mGy * cm; p = 0.018).

Conclusion

Lower extremity CTA with DSCT flash caudo-cranial acquisition allows lower radiation dose with higher IVA, SNR, CNR and better image quality for small arteries below the knee than SSCT cranio-caudal acquisition.

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Radiation dose and image quality with new protocol in lower extremity computed tomography angiography

Abstract

Purpose

To compare radiation dose and image quality of lower extremity computed tomography angiography (CTA) between cranio-caudal acquisition with single-source CT (SSCT) and flash caudo-cranial acquisition with dual-source CT (DSCT).

Materials and methods

In this prospective study, 60 patients were randomly assigned to Group A (control) or Group B (experimental) to undergo lower extremity CTA for peripheral obliterative arterial disease. Group A received protocol 1 (P1) with SSCT cranio-caudal acquisition. Group B received protocol (P2) with DSCT flash caudo-cranial acquisition. Intravascular attenuation (IVA), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image noise were compared. Two radiologists assessed the image quality. Computed tomography volume dose index (CTDI_vol) and dose-length product (DLP) were also compared.

Results

IVA with P2 was higher than with P1 (586.8 ± 140.3 vs. 496.1 ± 129.3 HU, p = 0.011), as was SNR (33.0 ± 11.3 vs. 27.4 ± 12.3; p = 0.042), CNR (30.1 ± 13.3 vs. 24.2 ± 10.3; p = 0.029) and image quality score of small arteries below the knee (3.8 ± 0.2 vs. 3.1 ± 0.2; p = 0.001). Radiation dose was significantly lower in P2 than in P1 with CTDI_vol reduction of 40.9% (1.3 ± 0.1 vs. 2.2 ± 0.3 mGy; p = 0.006) and DLP reduction of 42.8% (148.7 ± 21.9 vs 260.2 ± 59.1 mGy * cm; p = 0.018).

Conclusion

Lower extremity CTA with DSCT flash caudo-cranial acquisition allows lower radiation dose with higher IVA, SNR, CNR and better image quality for small arteries below the knee than SSCT cranio-caudal acquisition.

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Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

ConclusionsPEW OIT is an effective treatment for children with persistent egg allergy. A 30% weekly plus 5% daily increment pattern could be more effective and safer than one with only 30% weekly increments. (Source: Pediatric Allergy and Immunology)

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Relative reactivity to egg white and yolk or change upon heating as markers for baked egg tolerance

ConclusionsEgg ‐allergic children were often both sensitized to EY and EW and heterogeneous patterns of relative responses were evidenced. Irrespective of age and level of sensitization, a low EW/EY ratio or SPT getting null with hard‐boiling were found in children allowed to eat baked egg.This article is protected by copyright. All rights reserved. (Source: Pediatric Allergy and Immunology)

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Egg oral immunotherapy in children (SEICAP I): Daily or weekly desensitization pattern

ConclusionsPEW OIT is an effective treatment for children with persistent egg allergy. A 30% weekly plus 5% daily increment pattern could be more effective and safer than one with only 30% weekly increments. (Source: Pediatric Allergy and Immunology)

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List of Reviewers 2018

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Use of a modified BAPRAS Delphi process for research priority setting in Plastic Surgery in the UK

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) aims to raise understanding of the profession, and to promote innovation, education, and research. The latter is the remit of its Research Committee.

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Ergonomic hazards in otolaryngology

ConclusionsOur data suggest that pain and disability induced by poor ergonomics are widespread among the otolaryngology community and confirm that surgeons rarely receive ergonomic training in the surgical context. Additionally, intraoperative observational findings identified that the majority of observed surgeons display poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazard. These data provide guidance for future interventional studies.Level of EvidenceNALaryngoscope, 2018 (Source: The Laryngoscope)

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The effects of cryotherapy on vocal fold healing in a rabbit model

ConclusionsCryotherapy can inhibit the inflammatory reaction and simulate a fetal healing environment in extracellular matrix synthesis to regenerate vocal fold tissue with less fibrosis. Histological results showed that cryotherapy achieves a mature healing result with less scar, which tends to return to normal. In summary, the findings of this study suggest that administration of cryotherapy at the time of injury has the potential to minimize vocal fold scarring.Level of EvidenceNALaryngoscope, 2018 (Source: The Laryngoscope)

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Physician impact on the patient and family experience in a pediatric otolaryngology practice

ConclusionPatient satisfaction surveys are utilized as a quality metric of the patient and family experience. These scores serve as one of several measures that affect reimbursement. The results demonstrate that most of the factors correlated with "likelihood of recommending practice" are provider‐based. In conclusion, the physician–patient interaction strongly influences the potential for a practice to earn top box scores on the PG item "likelihood of recommending practice" and thereby achieve the highest patient satisfaction.Level of EvidenceNA.Laryngoscope, 2018 (Source: The Laryngoscope)

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Do steroids improve recovery in vestibular neuritis?

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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Second primary lung malignancy following head and neck squamous cell carcinoma

ConclusionsPatients who undergo curative treatment of HNSCC are at high risk for developing SPLMs. Subsite ‐specific differences may help elucidate the degree of risk attributable to smoking, genetic susceptibility, human papillomavirus infection, or metastasis masquerading as an SPLM.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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Levator claviculae muscle: Anatomic variation found during neck dissection

We report here, for the first time, a case discovering this muscle variation intraoperatively during a modified radical neck dissection. The muscle was identified on the left side, originating from the transverse processes of the upper cervical vertebrae (C2 ‐C3), attached to the upper aspect of the middle part of the clavicle. This muscle was innervated by the supraclavicular nerve, coming from the third and fourth rami of the cervical spinal nerves. Blood supply to the muscle could not be identified clearly during the surgical procedure. Surgeons an d radiologists should be aware of the presence of this rare variant muscle so as not to misinterpret the anatomy.Laryngoscope, 2018 (Source: The Laryngoscope)

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Acute inflammatory response to contrast agent aspiration and its mechanisms in the rat lung

ConclusionsBa caused significantly more acute lung inflammation in a rodent model than did ioinic and nonionic iodinated CAs. Nonionic contrast did not cause any discernible inflammatory response in the lungs, suggesting that it may be the safest contrast for videofluoroscopic swallow studies.Level of EvidenceNA (Source: The Laryngoscope)

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Olfactory function in mild cognitive impairment and Alzheimer's disease: A meta ‐analysis

ConclusionsMeta ‐analysis results revealed that olfactory identification was more profoundly impaired in patients with AD than in those with MCI. These findings suggest that a simple test of odor identification is valuable in differentiating individuals at a risk of AD.Level of EvidenceNALaryngoscope, 2018 (Source: The Laryngoscope)

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The Impact of a Stepwise Approach to Primary Tumor Detection in Squamous Cell Carcinoma of the Neck With Unknown Primary

ConclusionsA stepwise approach to primary tumor identification identifies a primary tumor in a majority of patients.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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Validation of a septoplasty deformity grading system for the evaluation of nasal obstruction

ConclusionsOur SDG system addresses the challenge of providing objective anatomic information on the severity of nasal septal deformities, and may be valuable when used in conjunction with subjective data gathered from the NOSE questionnaire.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

ConclusionThis study reveals that metagenomic shotgun sequencing of biofilms formed on pediatric TTs is feasible with an apparent difference in microbiome for patients with granulation tissue. Further studies are necessary to elucidate the pathogenesis of microbial ecology and its role in airway disease in patients with TTs.Level of Evidence2c.Laryngoscope, 2018 (Source: The Laryngoscope)

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Solving periprosthetic leakage with a novel prosthetic device

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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List of Reviewers 2018

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Use of a modified BAPRAS Delphi process for research priority setting in Plastic Surgery in the UK

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) aims to raise understanding of the profession, and to promote innovation, education, and research. The latter is the remit of its Research Committee.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2FSgR5U

Ergonomic hazards in otolaryngology

ConclusionsOur data suggest that pain and disability induced by poor ergonomics are widespread among the otolaryngology community and confirm that surgeons rarely receive ergonomic training in the surgical context. Additionally, intraoperative observational findings identified that the majority of observed surgeons display poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazard. These data provide guidance for future interventional studies.Level of EvidenceNALaryngoscope, 2018 (Source: The Laryngoscope)

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The effects of cryotherapy on vocal fold healing in a rabbit model

ConclusionsCryotherapy can inhibit the inflammatory reaction and simulate a fetal healing environment in extracellular matrix synthesis to regenerate vocal fold tissue with less fibrosis. Histological results showed that cryotherapy achieves a mature healing result with less scar, which tends to return to normal. In summary, the findings of this study suggest that administration of cryotherapy at the time of injury has the potential to minimize vocal fold scarring.Level of EvidenceNALaryngoscope, 2018 (Source: The Laryngoscope)

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Medialization laryngoplasty/arytenoid adduction: U.S. outcomes, discharge status, and utilization trends

ConclusionTo our knowledge, this is the first search evaluating national claims data for ML with or without AA. Overall rate of ML is low, and same ‐day discharge has become more common over a 10‐year period, with an associated higher 30‐day hospital admission risk. Correct patient selection criteria for disposition status cannot be fully determined based on current data, but a high Elixhauser comorbidity index clearly carries increased r isk for hospitalization after initial discharge.Level of Evidence4.Laryngoscope, 2018 (Source: The Laryngoscope)

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Do steroids improve recovery in vestibular neuritis?

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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

Second primary lung malignancy following head and neck squamous cell carcinoma

ConclusionsPatients who undergo curative treatment of HNSCC are at high risk for developing SPLMs. Subsite ‐specific differences may help elucidate the degree of risk attributable to smoking, genetic susceptibility, human papillomavirus infection, or metastasis masquerading as an SPLM.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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

Acute inflammatory response to contrast agent aspiration and its mechanisms in the rat lung

ConclusionsBa caused significantly more acute lung inflammation in a rodent model than did ioinic and nonionic iodinated CAs. Nonionic contrast did not cause any discernible inflammatory response in the lungs, suggesting that it may be the safest contrast for videofluoroscopic swallow studies.Level of EvidenceNA (Source: The Laryngoscope)

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Should the Contralateral Tonsil Be Removed in Cases of HPV ‐Positive Squamous Cell Carcinoma of the Tonsil?

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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Analysis of patient factors associated with 30 ‐day mortality after tracheostomy

ConclusionHigher CCI and specifically severe liver disease, congestive heart failure, and peripheral vascular disease were associated with increased 30 ‐day mortality posttracheostomy. No association was found between BMI or SES and 30‐day survival. This study identified three comorbidities that independently affect mortality in tracheostomy patients, which should be discussed with patients and families before tracheostomy.Level of Evidence3.Laryngoscope, 2018 (Source: The Laryngoscope)

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The Impact of a Stepwise Approach to Primary Tumor Detection in Squamous Cell Carcinoma of the Neck With Unknown Primary

ConclusionsA stepwise approach to primary tumor identification identifies a primary tumor in a majority of patients.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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

Validation of a septoplasty deformity grading system for the evaluation of nasal obstruction

ConclusionsOur SDG system addresses the challenge of providing objective anatomic information on the severity of nasal septal deformities, and may be valuable when used in conjunction with subjective data gathered from the NOSE questionnaire.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E0CI9M

Feasibility of shotgun metagenomics to assess microbial ecology of pediatric tracheostomy tubes

ConclusionThis study reveals that metagenomic shotgun sequencing of biofilms formed on pediatric TTs is feasible with an apparent difference in microbiome for patients with granulation tissue. Further studies are necessary to elucidate the pathogenesis of microbial ecology and its role in airway disease in patients with TTs.Level of Evidence2c.Laryngoscope, 2018 (Source: The Laryngoscope)

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Solving periprosthetic leakage with a novel prosthetic device

The Laryngoscope, EarlyView. (Source: The Laryngoscope)

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

The shifting relationship between weight and pediatric obstructive sleep apnea: A historical review

ConclusionsWe may need new and different treatments for obesity ‐associated OSA as adenotonsillectomy—which is effective at reversing failure to thrive in OSA—is not as effective at treating OSA in children with obesity. One option is drug‐induced sleep endoscopy, which could personalize and improve surgical treatment of OSA. There is some evidence that therapies used for OSA in adults (e.g., weight loss and positive airway pressure) are also helpful for overweight/obese children with OSA.Laryngoscope, 2018 (Source: The Laryngoscope)

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Presentation and eustachian tube function test results in children evaluated at a specialty clinic

ConclusionsETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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Isolated Paresis of Laryngeal Adduction: What Are the Laryngoscopic and Stroboscopic Findings?

ConclusionsFindings on VLS as described suggest isolated paresis of laryngeal adduction and should warrant indication of LEMG for definite diagnosis. Voice improvement may be related to clinical and LEMG findings.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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The shifting relationship between weight and pediatric obstructive sleep apnea: A historical review

ConclusionsWe may need new and different treatments for obesity ‐associated OSA as adenotonsillectomy—which is effective at reversing failure to thrive in OSA—is not as effective at treating OSA in children with obesity. One option is drug‐induced sleep endoscopy, which could personalize and improve surgical treatment of OSA. There is some evidence that therapies used for OSA in adults (e.g., weight loss and positive airway pressure) are also helpful for overweight/obese children with OSA.Laryngoscope, 2018 (Source: The Laryngoscope)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P4BM5c

Presentation and eustachian tube function test results in children evaluated at a specialty clinic

ConclusionsETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing.Level of Evidence4Laryngoscope, 2018 (Source: The Laryngoscope)

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Highlights and recent developments in airway diseases in EAACI journals (2017)

Abstract

The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2017 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidies, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and metaanalyses have been the highlights of the last year.

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Highlights and recent developments in airway diseases in EAACI journals (2017)

Abstract

The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2017 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidies, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and metaanalyses have been the highlights of the last year.

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Isolated Paresis of Laryngeal Adduction: What Are the Laryngoscopic and Stroboscopic Findings?

Objectives/Hypothesis

This study aimed to describe the videolaryngostroboscopic (VLS) findings in a cohort of patients with isolated paresis of laryngeal adduction and identify predictive variables that may be related to voice recovery.

Study Design

Chart review and VLS analysis of dysphonic patients diagnosed with isolated paresis of laryngeal adduction by laryngeal electromyography (LEMG).

Methods

Demographic, clinical, VLS, and LEMG findings were analyzed according to the outcome of dysphonia.

Results

There were 17 patients, 12 males (70.6%), mean age of 46.6 years, with median dysphonia duration of 4 months (range, 1–60 months) included in the study. In all patients, gross movement of both vocal folds were normal. Laryngoscopy showed limited adduction of the ipsilateral ventricular fold, contralateral interarytenoid region deviation, and vocal fold atrophy in 100%, 94.1%, and 76.5% of patients, respectively. VLS findings included: impairment of glottic closure (94.1%), phase asymmetry (94.1%), and reduced mucosal wave on the affected side (76.5%). Predictors of good voice outcome were sudden onset (P = .012), duration of dysphonia on presentation shorter than 5 months (P = .005), and absence of polyphasic potentials on LEMG (P = .041).

Conclusions

Findings on VLS as described suggest isolated paresis of laryngeal adduction and should warrant indication of LEMG for definite diagnosis. Voice improvement may be related to clinical and LEMG findings.

Level of Evidence

4 Laryngoscope, 2018

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Presentation and eustachian tube function test results in children evaluated at a specialty clinic

Objectives/Hypothesis

Interest in eustachian tube (ET) dysfunction (ETD) has increased with the recent Food and Drug Administration approval of a new device for balloon dilation of the ET (BDET) in adults. However, children have been receiving BDET treatment with ET‐specific or sinus balloons around the world and off‐label in the United States for years. It is important, therefore, to understand the manifestations of and methods to verify ETD in children.

Study Design

Retrospective cross‐sectional study.

Methods

This is a retrospective study of clinical presentations and results of ET function (ETF) tests in children referred to the ETD clinic. An otorhinolaryngology exam, nasopharyngeal videoendoscopy of the ET orifices during swallow and maneuvers, and ETF tests, including inflation deflation, forced response test, and pressure chamber tests, were performed as applicable.

Results

Data for 30 children aged 6.2 to 17.3 years (mean = 12.9 ± 2.8 years) were analyzed. Of 60 ears, 19 (31.7%) had an intact tympanic membrane (TM), 16 (26.7%) had a patent and two had a blocked ventilation tube, and 23 (38.3%) had a TM perforation. Endoscopy of the nasopharynx revealed a large amount of secretions in 19/45 (42.2%); ET orifices and mucosal inflammation in 22/45 (48.8%); a large amount of adenoid tissue in the fossa of Rosenmuller was noted in 21/45 (46.7%). ETF tests revealed abnormal active function in 43/54 ears (79.6%) and abnormal passive function in 40/54 ears (74.1%).

Conclusions

ETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing.

Level of Evidence

4 Laryngoscope, 2018

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The shifting relationship between weight and pediatric obstructive sleep apnea: A historical review

Objectives

For more than a century, pediatric obstructive sleep apnea (OSA) was associated with failure to thrive. However, that association has faded over the last few decades. A 21st century child with OSA is much more likely to be overweight than underweight. This raises the question: Has pediatric OSA changed over time, or has the rise of childhood obesity in the United States created a new, separate disease? This literature review explores the historical shift in the relationship between weight and OSA, and the associated changes in treatment.

Results

We demonstrate a clear transition in the prevalence of failure to thrive and obesity in the OSA literature in the mid‐2000s. What is less clear is whether these two clinical phenotypes should be considered two distinct diseases, or whether subtle differences in one set of pathophysiologic pathways—adenotonsillar hypertrophy, altered inflammation, and increased energy expenditure—can lead to divergent metabolic outcomes. More research is needed to fully elucidate the pathophysiology of OSA in children with obesity.

Conclusions

We may need new and different treatments for obesity‐associated OSA as adenotonsillectomy—which is effective at reversing failure to thrive in OSA—is not as effective at treating OSA in children with obesity. One option is drug‐induced sleep endoscopy, which could personalize and improve surgical treatment of OSA. There is some evidence that therapies used for OSA in adults (e.g., weight loss and positive airway pressure) are also helpful for overweight/obese children with OSA. Laryngoscope, 2018

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First Case of Allergy to Secondhand Marijuana Reported First Case of Allergy to Secondhand Marijuana Reported

Allergy to marijuana can occur in adults who use it, but researchers are flagging the first report of a young child with a positive allergy test who was exposed only to secondhand smoke.Medscape Medical News (Source: Medscape Allergy Headlines)

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

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Ergonomic hazards in otolaryngology

Objectives/Hypothesis

To evaluate the presence of postural‐related strain and musculoskeletal discomfort, along with the level of ergonomics training and the availability of ergonomic equipment among otolaryngology surgeons.

Study Design

Intraoperative observations and survey study.

Methods

Using the Rapid Entire Body Assessment score system to identify ergonomic hazards, we conducted intraoperative observations assessing operating room personnel during different otolaryngological subspecialty procedures. Based on these findings, otolaryngology surgeons at a single academic institution in the United States were sent a survey that evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education.

Results

A response rate of 69% was obtained from 70 surgeons, with 72.9% of responding surgeons suffering from some level of back pain, with cervical spine pain being the most common. Interestingly, residents were equally affected when compared to more senior surgeons both in subjective survey reports and from observational risk analysis. Furthermore, 43.8% of surgeons reported suffering from the highest level of pain when standing, whereas only 12.5% experienced pain when sitting. Importantly, 10% stated that pain impacted their work. Only 24% of surgeons had any prior ergonomic training or education.

Conclusions

Our data suggest that pain and disability induced by poor ergonomics are widespread among the otolaryngology community and confirm that surgeons rarely receive ergonomic training in the surgical context. Additionally, intraoperative observational findings identified that the majority of observed surgeons display poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazard. These data provide guidance for future interventional studies.

Level of Evidence

NA Laryngoscope, 2018

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Isolated Paresis of Laryngeal Adduction: What Are the Laryngoscopic and Stroboscopic Findings?

Objectives/Hypothesis

This study aimed to describe the videolaryngostroboscopic (VLS) findings in a cohort of patients with isolated paresis of laryngeal adduction and identify predictive variables that may be related to voice recovery.

Study Design

Chart review and VLS analysis of dysphonic patients diagnosed with isolated paresis of laryngeal adduction by laryngeal electromyography (LEMG).

Methods

Demographic, clinical, VLS, and LEMG findings were analyzed according to the outcome of dysphonia.

Results

There were 17 patients, 12 males (70.6%), mean age of 46.6 years, with median dysphonia duration of 4 months (range, 1–60 months) included in the study. In all patients, gross movement of both vocal folds were normal. Laryngoscopy showed limited adduction of the ipsilateral ventricular fold, contralateral interarytenoid region deviation, and vocal fold atrophy in 100%, 94.1%, and 76.5% of patients, respectively. VLS findings included: impairment of glottic closure (94.1%), phase asymmetry (94.1%), and reduced mucosal wave on the affected side (76.5%). Predictors of good voice outcome were sudden onset (P = .012), duration of dysphonia on presentation shorter than 5 months (P = .005), and absence of polyphasic potentials on LEMG (P = .041).

Conclusions

Findings on VLS as described suggest isolated paresis of laryngeal adduction and should warrant indication of LEMG for definite diagnosis. Voice improvement may be related to clinical and LEMG findings.

Level of Evidence

4 Laryngoscope, 2018

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Presentation and eustachian tube function test results in children evaluated at a specialty clinic

Objectives/Hypothesis

Interest in eustachian tube (ET) dysfunction (ETD) has increased with the recent Food and Drug Administration approval of a new device for balloon dilation of the ET (BDET) in adults. However, children have been receiving BDET treatment with ET‐specific or sinus balloons around the world and off‐label in the United States for years. It is important, therefore, to understand the manifestations of and methods to verify ETD in children.

Study Design

Retrospective cross‐sectional study.

Methods

This is a retrospective study of clinical presentations and results of ET function (ETF) tests in children referred to the ETD clinic. An otorhinolaryngology exam, nasopharyngeal videoendoscopy of the ET orifices during swallow and maneuvers, and ETF tests, including inflation deflation, forced response test, and pressure chamber tests, were performed as applicable.

Results

Data for 30 children aged 6.2 to 17.3 years (mean = 12.9 ± 2.8 years) were analyzed. Of 60 ears, 19 (31.7%) had an intact tympanic membrane (TM), 16 (26.7%) had a patent and two had a blocked ventilation tube, and 23 (38.3%) had a TM perforation. Endoscopy of the nasopharynx revealed a large amount of secretions in 19/45 (42.2%); ET orifices and mucosal inflammation in 22/45 (48.8%); a large amount of adenoid tissue in the fossa of Rosenmuller was noted in 21/45 (46.7%). ETF tests revealed abnormal active function in 43/54 ears (79.6%) and abnormal passive function in 40/54 ears (74.1%).

Conclusions

ETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing.

Level of Evidence

4 Laryngoscope, 2018

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The shifting relationship between weight and pediatric obstructive sleep apnea: A historical review

Objectives

For more than a century, pediatric obstructive sleep apnea (OSA) was associated with failure to thrive. However, that association has faded over the last few decades. A 21st century child with OSA is much more likely to be overweight than underweight. This raises the question: Has pediatric OSA changed over time, or has the rise of childhood obesity in the United States created a new, separate disease? This literature review explores the historical shift in the relationship between weight and OSA, and the associated changes in treatment.

Results

We demonstrate a clear transition in the prevalence of failure to thrive and obesity in the OSA literature in the mid‐2000s. What is less clear is whether these two clinical phenotypes should be considered two distinct diseases, or whether subtle differences in one set of pathophysiologic pathways—adenotonsillar hypertrophy, altered inflammation, and increased energy expenditure—can lead to divergent metabolic outcomes. More research is needed to fully elucidate the pathophysiology of OSA in children with obesity.

Conclusions

We may need new and different treatments for obesity‐associated OSA as adenotonsillectomy—which is effective at reversing failure to thrive in OSA—is not as effective at treating OSA in children with obesity. One option is drug‐induced sleep endoscopy, which could personalize and improve surgical treatment of OSA. There is some evidence that therapies used for OSA in adults (e.g., weight loss and positive airway pressure) are also helpful for overweight/obese children with OSA. Laryngoscope, 2018

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First Case of Allergy to Secondhand Marijuana Reported First Case of Allergy to Secondhand Marijuana Reported

Allergy to marijuana can occur in adults who use it, but researchers are flagging the first report of a young child with a positive allergy test who was exposed only to secondhand smoke.Medscape Medical News (Source: Medscape Allergy Headlines)

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Airborne allergic contact dermatitis caused by wood tars

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Airborne allergic contact dermatitis caused by wood tars

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2FH4k5p

First Case of Allergy to Secondhand Marijuana Reported First Case of Allergy to Secondhand Marijuana Reported

Allergy to marijuana can occur in adults who use it, but researchers are flagging the first report of a young child with a positive allergy test who was exposed only to secondhand smoke.Medscape Medical News (Source: Medscape Allergy Headlines)

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/2P1YxXu

Deep convolutional neural network-based speech enhancement to improve speech intelligibility and quality for hearing-impaired listeners

AbstractIn this paper, we propose a deep learning-based speech enhancement (DLSE) method to improve speech intelligibility for the hearing-impaired listeners. The algorithm decomposes the noisy speech signal into frames (as features) and feeds them to the deep convolutional neural networks (DCNNs) to produce an estimation of which frequency channels contain more perceptually important information (higher signal-to-noise ratio, SNR). This estimate is used to attenuate noise-dominated and retain speech-dominated cochlear implant (CI) channels for electrical stimulation, as in traditionaln-of-m CI coding strategies. The proposed algorithm was evaluated by measuring the speech-in-noise performance of 12 CI users using two types of background noises such as fan and music sounds. The architectur...

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Wireless binaural hearing aid technology for telephone use and listening in wind noise

. (Source: International Journal of Audiology)

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The relationships among verbal ability, executive function, and theory of mind in young children with cochlear implants

Volume 57, Issue 12, December 2018, Page 875-882 . (Source: International Journal of Audiology)

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International journal of audiology reviewer contact information

. (Source: International Journal of Audiology)

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.

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A preliminary study on time-compressed speech recognition in noise among teenage students who use personal listening devices

. (Source: International Journal of Audiology)

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Marilyn K. Glassberg, MD - Examining the IPF Patient ’s Journey to Diagnosis, Appropriate Therapy, and Overall Individualized Care

Examining the IPF Patient's Journey to Diagnosis, Appropriate Therapy, and Overall Individualized Care (Source: PeerView CME/CE Audio Podcast - Immunology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OYQcE1

First Case of Allergy to Secondhand Marijuana Reported First Case of Allergy to Secondhand Marijuana Reported

Allergy to marijuana can occur in adults who use it, but researchers are flagging the first report of a young child with a positive allergy test who was exposed only to secondhand smoke.Medscape Medical News (Source: Medscape Allergy Headlines)

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/2P1YxXu

Deep convolutional neural network-based speech enhancement to improve speech intelligibility and quality for hearing-impaired listeners

AbstractIn this paper, we propose a deep learning-based speech enhancement (DLSE) method to improve speech intelligibility for the hearing-impaired listeners. The algorithm decomposes the noisy speech signal into frames (as features) and feeds them to the deep convolutional neural networks (DCNNs) to produce an estimation of which frequency channels contain more perceptually important information (higher signal-to-noise ratio, SNR). This estimate is used to attenuate noise-dominated and retain speech-dominated cochlear implant (CI) channels for electrical stimulation, as in traditionaln-of-m CI coding strategies. The proposed algorithm was evaluated by measuring the speech-in-noise performance of 12 CI users using two types of background noises such as fan and music sounds. The architectur...

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

Wireless binaural hearing aid technology for telephone use and listening in wind noise

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P5C77B

The relationships among verbal ability, executive function, and theory of mind in young children with cochlear implants

Volume 57, Issue 12, December 2018, Page 875-882 . (Source: International Journal of Audiology)

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

International journal of audiology reviewer contact information

. (Source: International Journal of Audiology)

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/2P4CNKG

A preliminary study on time-compressed speech recognition in noise among teenage students who use personal listening devices

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ztZ13T

Marilyn K. Glassberg, MD - Examining the IPF Patient ’s Journey to Diagnosis, Appropriate Therapy, and Overall Individualized Care

Examining the IPF Patient's Journey to Diagnosis, Appropriate Therapy, and Overall Individualized Care (Source: PeerView CME/CE Audio Podcast - Immunology)

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

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CCR10+ ILC2s with ILC1‐like properties exhibit a protective function in severe allergic asthma

Abstract

Background

We previously showed that patients with severe allergic asthma have high numbers of circulating ILC2s expressing CCR10.

Method

Herein, CCR10⁺ ILC2s were further analyzed in the blood of healthy individuals or patients with allergic and non−allergic asthma. Characteristics of human CCR10⁺ and CCR10⁻ ILC2s were assessed by flow cytometry as well as single‐cell multiplex RT‐qPCR. The role of CCR10⁺ ILC2s in asthma pathophysiology was studied in allergen‐treated mice.

Results

When compared to healthy controls, CCR10⁺ ILC2s are enriched in the blood of both allergic and non‐allergic severe asthmatic patients, and these cells are recruited to the lungs. Plasma concentrations of the CCR10 ligand CCL27 are significantly increased in severe asthmatics when compared to non‐asthmatic patients. CCR10⁺ ILC2s secrete little T_H2 cytokines, but exhibit ILC1‐like properties, including a capacity to produce IFN‐γ. Also, single cell analysis reveals that the CCR10⁺ ILC2 subset is enriched in cells expressing Amphiregulin. CCR10⁺ ILC2s depletion, as well as blocking of IFN‐γ activity, exacerbates airway hyperreactivity in allergen‐challenged mice, providing evidence for a protective role of these cells in allergic inflammation.

Conclusions

Frequencies of circulating CCR10⁺ ILC2s and CCL27 plasma concentrations represent candidate markers of asthma severity. The characterization of CCR10⁺ ILC2s in human samples and in mouse asthma models suggests that these cells downregulate allergic inflammation through IFN‐γ production.

This article is protected by copyright. All rights reserved.

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RNA is taking its Toll – Impact of RNA‐specific Toll‐like receptors on health and disease

Abstract

RNA‐sensing Toll‐like receptors (TLRs) are often described as anti‐viral receptors of the innate immune system. However, the past decade has shown that the function and importance of these receptors is far more complex. These receptors were found to be relevant for the detection of various bacterial, archaeal, and eukaryotic microorganisms and facilitate the discrimination between dead and living microbes. The cytokine and interferon response profile that is triggered has the potential to improve the efficacy of next‐generation vaccines and may prevent the development of asthma and allergy. Nevertheless, the ability to recognize foreign RNA comes with a cost as also damaged host cells can release nucleic acids that might induce an inappropriate immune response. Thus, it is not surprising that RNA‐sensing TLRs play a key role in various autoimmune diseases. However, promising new inhibitors and antagonists are on the horizon to improve their treatment.

This article is protected by copyright. All rights reserved.

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All items of the Food Allergy Quality of Life Questionnaires are relevant for peanut‐allergic patients

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P4CjnQ

CCR10+ ILC2s with ILC1‐like properties exhibit a protective function in severe allergic asthma

Abstract

Background

We previously showed that patients with severe allergic asthma have high numbers of circulating ILC2s expressing CCR10.

Method

Herein, CCR10⁺ ILC2s were further analyzed in the blood of healthy individuals or patients with allergic and non−allergic asthma. Characteristics of human CCR10⁺ and CCR10⁻ ILC2s were assessed by flow cytometry as well as single‐cell multiplex RT‐qPCR. The role of CCR10⁺ ILC2s in asthma pathophysiology was studied in allergen‐treated mice.

Results

When compared to healthy controls, CCR10⁺ ILC2s are enriched in the blood of both allergic and non‐allergic severe asthmatic patients, and these cells are recruited to the lungs. Plasma concentrations of the CCR10 ligand CCL27 are significantly increased in severe asthmatics when compared to non‐asthmatic patients. CCR10⁺ ILC2s secrete little T_H2 cytokines, but exhibit ILC1‐like properties, including a capacity to produce IFN‐γ. Also, single cell analysis reveals that the CCR10⁺ ILC2 subset is enriched in cells expressing Amphiregulin. CCR10⁺ ILC2s depletion, as well as blocking of IFN‐γ activity, exacerbates airway hyperreactivity in allergen‐challenged mice, providing evidence for a protective role of these cells in allergic inflammation.

Conclusions

Frequencies of circulating CCR10⁺ ILC2s and CCL27 plasma concentrations represent candidate markers of asthma severity. The characterization of CCR10⁺ ILC2s in human samples and in mouse asthma models suggests that these cells downregulate allergic inflammation through IFN‐γ production.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P4TeXd

RNA is taking its Toll – Impact of RNA‐specific Toll‐like receptors on health and disease

Abstract

RNA‐sensing Toll‐like receptors (TLRs) are often described as anti‐viral receptors of the innate immune system. However, the past decade has shown that the function and importance of these receptors is far more complex. These receptors were found to be relevant for the detection of various bacterial, archaeal, and eukaryotic microorganisms and facilitate the discrimination between dead and living microbes. The cytokine and interferon response profile that is triggered has the potential to improve the efficacy of next‐generation vaccines and may prevent the development of asthma and allergy. Nevertheless, the ability to recognize foreign RNA comes with a cost as also damaged host cells can release nucleic acids that might induce an inappropriate immune response. Thus, it is not surprising that RNA‐sensing TLRs play a key role in various autoimmune diseases. However, promising new inhibitors and antagonists are on the horizon to improve their treatment.

This article is protected by copyright. All rights reserved.

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

All items of the Food Allergy Quality of Life Questionnaires are relevant for peanut‐allergic patients

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P4CjnQ

The Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for alveolar clefts. However, early SABG at the age of 4-7 years before the eruption of lateral incisors versus late SABG at the age of 8-12 years before the eruption of maxillary permanent canines is still debated.The purpose of this study is to perform a systematic review of the literature to evaluate the outcomes of early SABG in terms of residual bone volume or degree of bone resorption, maxillary canine movement or impaction rate, complications, aesthetic outcomes, and compare outcomes of early versus late SABG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zr6HDW

Do vertical soft-tissue and actual bony landmarks correlate in Le Fort I orthognathic surgery?

Vertical changes in LeFort I orthognathic surgery are critical to the overall aesthetic result. 3D planning enables vertical measurements from the rendered CT scan, but intraoperative points are ascribed partially from soft tissues landmarks. This study compares intraoperative soft tissue vertical measurements with pre- and postoperative CT-based values, and attempts to validate intraoperative soft tissue landmarks for vertical positioning.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P3ePiY

Medicare in Oral and Maxillofacial Surgery Part 2: Academic Surgeons and Cancer Surgeons are Reimbursed Less

To evaluate predictors of reimbursement of oral and maxillofacial surgery services in the Medicare population.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zpgg63

Remarkable short-term regression of a posterior mediastinum metastasis from primary intraosseous carcinoma treated with nivolumab: a case report

Primary intraosseous carcinoma (PIOC, NOS) is a rare odontogenic malignancy that is thought to arise from the odontogenic epithelium. In addition, some cases arise in odontogenic cysts or other benign precursors. There are no established treatment protocols for PIOC because of its rarity. In particular, no standard therapy has been established for patients with recurrent or metastatic PIOC. Here we report a case in which the use of nivolumab showed a significant treatment response in metastatic PIOC.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1Rqyg

Piezosurgery vs. Conventional Osteotomy in Impacted Lower Third Molar Extraction: Evaluation of Perioperative Anxiety, Pain and Paresthesia

Piezoelectric surgery is a safe and effective osteotomy technique that can decrease the perioperative complications and morbidity in oral-maxillofacial surgery. In this study, we compare piezosurgery and conventional rotary technique in the removal of impacted lower third molars. Our primary end points were perioperative anxiety, pain and postoperative discomfort while avoiding the drilling sound of the conventional instrument.

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

Delayed Pharyngeal Migration of a Mandibular Fixation Screw 30 Years After Orthognathic Surgery

Orthognathic surgery is a commonly performed operation used for correction of dentofacial abnormalities [1]. The operation involves osteotomies and realignment of the maxilla and/or mandible. Common procedures during orthognathic surgery include a LeFort 1 osteotomy, bilateral sagittal split osteotomies (BSSO), and not infrequently a genioplasty.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P29B6X

Are facial asymmetry and condylar displacement associated with ramus height and treatment outcomes in unilateral condylar fracture when managed by closed method?

This study measures the mandibular ramal height in patients with unilateral condylar fracture managed by closed method using elastic intermaxillary fixation (IMF). It's co-relation with facial asymmetry and condylar displacement were assessed. This will determine whether the treatment outcome is in favour of closed or open method.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zr6Bfy

Intraoperative ultrasound control of zygomatic arch fractures: Does additional imaging improves reduction quality?

Intraoperative navigation to assess anatomic reduction is the general trend in maxillofacial trauma surgery. Aim of this study was to evaluate closed reduction outcome of isolated zygomatic arch fractures using ultrasound compared to palpation control.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P29xEf

Segmental Maxillary Osteotomy to Close Wide Alveolar Clefts

Introduction: Wide alveolar clefts are challenging to treat and are often associated with a higher chance of failure requiring repeated bone grafts. Even if successful, an excessively large cleft leads to a wide edentulous space, and patients are faced with prolonged orthodontic treatment. We present a series of large alveolar clefts closed with the aid of segmental maxillary osteotomies. Cases of alveolar clefts treated by segmental maxillary osteotomy were reviewed from 2014-2016. Preoperative and postoperative CTs were analyzed to assess alveolar gap and bone fill.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zmp7pl

The role of salivary duct morphology in the etiology of chronic obstructive parotitis: statistical analysis of sialographic features and computational fluid dynamics analysis of salivary flow

The causes of some cases of chronic obstructive parotitis (COP) without obstructive factors are still unclear. We hypothesized that some morphological features of salivary ducts might contribute to development of COP. This study aims to investigate the role of salivary duct morphology in the etiology of COP.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P0ZHm8

In Reply to Letter to the Editor

We thank Dr. Tomsic for her appreciation of our article (1). She reiterates the claim that academic productivity is not held in high regard in many of the oral and maxillofacial surgery training programs. Furthermore, Dr. Tomsic points out that the lack of clear academic guidelines from the Commission on Dental Accreditation (CODA) does not aid the specialty in its pursuit of academic advancement. We agree with her claims and are quite optimistic that times will change with regard to this stagnating phenomenon.

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

The Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for alveolar clefts. However, early SABG at the age of 4-7 years before the eruption of lateral incisors versus late SABG at the age of 8-12 years before the eruption of maxillary permanent canines is still debated.The purpose of this study is to perform a systematic review of the literature to evaluate the outcomes of early SABG in terms of residual bone volume or degree of bone resorption, maxillary canine movement or impaction rate, complications, aesthetic outcomes, and compare outcomes of early versus late SABG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zr6HDW

Do vertical soft-tissue and actual bony landmarks correlate in Le Fort I orthognathic surgery?

Vertical changes in LeFort I orthognathic surgery are critical to the overall aesthetic result. 3D planning enables vertical measurements from the rendered CT scan, but intraoperative points are ascribed partially from soft tissues landmarks. This study compares intraoperative soft tissue vertical measurements with pre- and postoperative CT-based values, and attempts to validate intraoperative soft tissue landmarks for vertical positioning.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P3ePiY

Medicare in Oral and Maxillofacial Surgery Part 2: Academic Surgeons and Cancer Surgeons are Reimbursed Less

To evaluate predictors of reimbursement of oral and maxillofacial surgery services in the Medicare population.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zpgg63

Remarkable short-term regression of a posterior mediastinum metastasis from primary intraosseous carcinoma treated with nivolumab: a case report

Primary intraosseous carcinoma (PIOC, NOS) is a rare odontogenic malignancy that is thought to arise from the odontogenic epithelium. In addition, some cases arise in odontogenic cysts or other benign precursors. There are no established treatment protocols for PIOC because of its rarity. In particular, no standard therapy has been established for patients with recurrent or metastatic PIOC. Here we report a case in which the use of nivolumab showed a significant treatment response in metastatic PIOC.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1Rqyg

Piezosurgery vs. Conventional Osteotomy in Impacted Lower Third Molar Extraction: Evaluation of Perioperative Anxiety, Pain and Paresthesia

Piezoelectric surgery is a safe and effective osteotomy technique that can decrease the perioperative complications and morbidity in oral-maxillofacial surgery. In this study, we compare piezosurgery and conventional rotary technique in the removal of impacted lower third molars. Our primary end points were perioperative anxiety, pain and postoperative discomfort while avoiding the drilling sound of the conventional instrument.

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

Delayed Pharyngeal Migration of a Mandibular Fixation Screw 30 Years After Orthognathic Surgery

Orthognathic surgery is a commonly performed operation used for correction of dentofacial abnormalities [1]. The operation involves osteotomies and realignment of the maxilla and/or mandible. Common procedures during orthognathic surgery include a LeFort 1 osteotomy, bilateral sagittal split osteotomies (BSSO), and not infrequently a genioplasty.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P29B6X

Are facial asymmetry and condylar displacement associated with ramus height and treatment outcomes in unilateral condylar fracture when managed by closed method?

This study measures the mandibular ramal height in patients with unilateral condylar fracture managed by closed method using elastic intermaxillary fixation (IMF). It's co-relation with facial asymmetry and condylar displacement were assessed. This will determine whether the treatment outcome is in favour of closed or open method.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zr6Bfy

Intraoperative ultrasound control of zygomatic arch fractures: Does additional imaging improves reduction quality?

Intraoperative navigation to assess anatomic reduction is the general trend in maxillofacial trauma surgery. Aim of this study was to evaluate closed reduction outcome of isolated zygomatic arch fractures using ultrasound compared to palpation control.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P29xEf

Segmental Maxillary Osteotomy to Close Wide Alveolar Clefts

Introduction: Wide alveolar clefts are challenging to treat and are often associated with a higher chance of failure requiring repeated bone grafts. Even if successful, an excessively large cleft leads to a wide edentulous space, and patients are faced with prolonged orthodontic treatment. We present a series of large alveolar clefts closed with the aid of segmental maxillary osteotomies. Cases of alveolar clefts treated by segmental maxillary osteotomy were reviewed from 2014-2016. Preoperative and postoperative CTs were analyzed to assess alveolar gap and bone fill.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zmp7pl

The role of salivary duct morphology in the etiology of chronic obstructive parotitis: statistical analysis of sialographic features and computational fluid dynamics analysis of salivary flow

The causes of some cases of chronic obstructive parotitis (COP) without obstructive factors are still unclear. We hypothesized that some morphological features of salivary ducts might contribute to development of COP. This study aims to investigate the role of salivary duct morphology in the etiology of COP.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P0ZHm8

In Reply to Letter to the Editor

We thank Dr. Tomsic for her appreciation of our article (1). She reiterates the claim that academic productivity is not held in high regard in many of the oral and maxillofacial surgery training programs. Furthermore, Dr. Tomsic points out that the lack of clear academic guidelines from the Commission on Dental Accreditation (CODA) does not aid the specialty in its pursuit of academic advancement. We agree with her claims and are quite optimistic that times will change with regard to this stagnating phenomenon.

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

Medical News Today: What is FPIES and how does it affect babies?

Food protein-induced enterocolitis syndrome (FPIES) is a type of allergy that affects babies and young children. Symptoms occur after eating certain trigger foods and include recurring severe diarrhea and vomiting. Learn more here. (Source: Health News from Medical News Today)

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/2zsfaGV

Medical News Today: What is FPIES and how does it affect babies?

Food protein-induced enterocolitis syndrome (FPIES) is a type of allergy that affects babies and young children. Symptoms occur after eating certain trigger foods and include recurring severe diarrhea and vomiting. Learn more here. (Source: Health News from Medical News Today)

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/2zsfaGV

The Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for alveolar clefts. However, early SABG at the age of 4-7 years before the eruption of lateral incisors versus late SABG at the age of 8-12 years before the eruption of maxillary permanent canines is still debated.The purpose of this study is to perform a systematic review of the literature to evaluate the outcomes of early SABG in terms of residual bone volume or degree of bone resorption, maxillary canine movement or impaction rate, complications, aesthetic outcomes, and compare outcomes of early versus late SABG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zr6HDW

Do vertical soft-tissue and actual bony landmarks correlate in Le Fort I orthognathic surgery?

Vertical changes in LeFort I orthognathic surgery are critical to the overall aesthetic result. 3D planning enables vertical measurements from the rendered CT scan, but intraoperative points are ascribed partially from soft tissues landmarks. This study compares intraoperative soft tissue vertical measurements with pre- and postoperative CT-based values, and attempts to validate intraoperative soft tissue landmarks for vertical positioning.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P3ePiY

Medicare in Oral and Maxillofacial Surgery Part 2: Academic Surgeons and Cancer Surgeons are Reimbursed Less

To evaluate predictors of reimbursement of oral and maxillofacial surgery services in the Medicare population.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zpgg63

Remarkable short-term regression of a posterior mediastinum metastasis from primary intraosseous carcinoma treated with nivolumab: a case report

Primary intraosseous carcinoma (PIOC, NOS) is a rare odontogenic malignancy that is thought to arise from the odontogenic epithelium. In addition, some cases arise in odontogenic cysts or other benign precursors. There are no established treatment protocols for PIOC because of its rarity. In particular, no standard therapy has been established for patients with recurrent or metastatic PIOC. Here we report a case in which the use of nivolumab showed a significant treatment response in metastatic PIOC.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1Rqyg

Piezosurgery vs. Conventional Osteotomy in Impacted Lower Third Molar Extraction: Evaluation of Perioperative Anxiety, Pain and Paresthesia

Piezoelectric surgery is a safe and effective osteotomy technique that can decrease the perioperative complications and morbidity in oral-maxillofacial surgery. In this study, we compare piezosurgery and conventional rotary technique in the removal of impacted lower third molars. Our primary end points were perioperative anxiety, pain and postoperative discomfort while avoiding the drilling sound of the conventional instrument.

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

Delayed Pharyngeal Migration of a Mandibular Fixation Screw 30 Years After Orthognathic Surgery

Orthognathic surgery is a commonly performed operation used for correction of dentofacial abnormalities [1]. The operation involves osteotomies and realignment of the maxilla and/or mandible. Common procedures during orthognathic surgery include a LeFort 1 osteotomy, bilateral sagittal split osteotomies (BSSO), and not infrequently a genioplasty.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P29B6X

Are facial asymmetry and condylar displacement associated with ramus height and treatment outcomes in unilateral condylar fracture when managed by closed method?

This study measures the mandibular ramal height in patients with unilateral condylar fracture managed by closed method using elastic intermaxillary fixation (IMF). It's co-relation with facial asymmetry and condylar displacement were assessed. This will determine whether the treatment outcome is in favour of closed or open method.

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Intraoperative ultrasound control of zygomatic arch fractures: Does additional imaging improves reduction quality?

Intraoperative navigation to assess anatomic reduction is the general trend in maxillofacial trauma surgery. Aim of this study was to evaluate closed reduction outcome of isolated zygomatic arch fractures using ultrasound compared to palpation control.

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Segmental Maxillary Osteotomy to Close Wide Alveolar Clefts

Introduction: Wide alveolar clefts are challenging to treat and are often associated with a higher chance of failure requiring repeated bone grafts. Even if successful, an excessively large cleft leads to a wide edentulous space, and patients are faced with prolonged orthodontic treatment. We present a series of large alveolar clefts closed with the aid of segmental maxillary osteotomies. Cases of alveolar clefts treated by segmental maxillary osteotomy were reviewed from 2014-2016. Preoperative and postoperative CTs were analyzed to assess alveolar gap and bone fill.

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The role of salivary duct morphology in the etiology of chronic obstructive parotitis: statistical analysis of sialographic features and computational fluid dynamics analysis of salivary flow

The causes of some cases of chronic obstructive parotitis (COP) without obstructive factors are still unclear. We hypothesized that some morphological features of salivary ducts might contribute to development of COP. This study aims to investigate the role of salivary duct morphology in the etiology of COP.

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In Reply to Letter to the Editor

We thank Dr. Tomsic for her appreciation of our article (1). She reiterates the claim that academic productivity is not held in high regard in many of the oral and maxillofacial surgery training programs. Furthermore, Dr. Tomsic points out that the lack of clear academic guidelines from the Commission on Dental Accreditation (CODA) does not aid the specialty in its pursuit of academic advancement. We agree with her claims and are quite optimistic that times will change with regard to this stagnating phenomenon.

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Pigmented villonodular synovitis occurring in the temporomandibular joint

Pigmented villonodular synovitis occurring in the region of the temporomandibular joint is a rare disease, requiring a review of the treatment method, follow-up period.

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The Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for alveolar clefts. However, early SABG at the age of 4-7 years before the eruption of lateral incisors versus late SABG at the age of 8-12 years before the eruption of maxillary permanent canines is still debated.The purpose of this study is to perform a systematic review of the literature to evaluate the outcomes of early SABG in terms of residual bone volume or degree of bone resorption, maxillary canine movement or impaction rate, complications, aesthetic outcomes, and compare outcomes of early versus late SABG.

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Do vertical soft-tissue and actual bony landmarks correlate in Le Fort I orthognathic surgery?

Vertical changes in LeFort I orthognathic surgery are critical to the overall aesthetic result. 3D planning enables vertical measurements from the rendered CT scan, but intraoperative points are ascribed partially from soft tissues landmarks. This study compares intraoperative soft tissue vertical measurements with pre- and postoperative CT-based values, and attempts to validate intraoperative soft tissue landmarks for vertical positioning.

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Medicare in Oral and Maxillofacial Surgery Part 2: Academic Surgeons and Cancer Surgeons are Reimbursed Less

To evaluate predictors of reimbursement of oral and maxillofacial surgery services in the Medicare population.

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Remarkable short-term regression of a posterior mediastinum metastasis from primary intraosseous carcinoma treated with nivolumab: a case report

Primary intraosseous carcinoma (PIOC, NOS) is a rare odontogenic malignancy that is thought to arise from the odontogenic epithelium. In addition, some cases arise in odontogenic cysts or other benign precursors. There are no established treatment protocols for PIOC because of its rarity. In particular, no standard therapy has been established for patients with recurrent or metastatic PIOC. Here we report a case in which the use of nivolumab showed a significant treatment response in metastatic PIOC.

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Piezosurgery vs. Conventional Osteotomy in Impacted Lower Third Molar Extraction: Evaluation of Perioperative Anxiety, Pain and Paresthesia

Piezoelectric surgery is a safe and effective osteotomy technique that can decrease the perioperative complications and morbidity in oral-maxillofacial surgery. In this study, we compare piezosurgery and conventional rotary technique in the removal of impacted lower third molars. Our primary end points were perioperative anxiety, pain and postoperative discomfort while avoiding the drilling sound of the conventional instrument.

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Delayed Pharyngeal Migration of a Mandibular Fixation Screw 30 Years After Orthognathic Surgery

Orthognathic surgery is a commonly performed operation used for correction of dentofacial abnormalities [1]. The operation involves osteotomies and realignment of the maxilla and/or mandible. Common procedures during orthognathic surgery include a LeFort 1 osteotomy, bilateral sagittal split osteotomies (BSSO), and not infrequently a genioplasty.

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