Styloid-stylohyoid syndrome: a rare cause of cranio-facial pain—a retrospective case series of 12 patients

Abstract

Purpose

Elongated styloid process results in severe cranio-facial/cervico-facial pain. The purpose of this study is to determine the efficacy of treatment outcomes using transcervical approach in the management of styloid-stylohyoid syndrome/styloid syndrome.

Study design

This is a retrospective cohort study. Subjects were enrolled from out-patient clinics reporting between the periods Jan 2016–Jan 2018.

Methods & methods

Twelve patients diagnosed with styloid syndrome based on history, thorough clinical workup, and assessment were included in the study. The primary outcomes—improvement in pain and regression of chief complaints following surgery were assessed. Elongated styloid was resected using transcervical approach under general anesthesia.

Results

The intra-operative lengths of the styloid process varied from 40 to 43 mm. No post-operative complications were encountered and the symptoms regressed completely after surgery in all the patients at follow-up of 6 months.

Conclusions

Transcervical styloidectomy is an effective treatment for exposure and resection of the styloid process with minimal complications in patients with stylo-stylohyoid syndrome.

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Technique and Results of Permanent Medial Tarsorrhaphy for Complex Eyelid Malposition

Purpose: To evaluate the results of permanent medial tarsorrhaphy and to describe the surgical technique. Methods: Medial tarsorrhaphy was performed on 30 eyelids with symptomatic exposure keratopathy secondary to eyelid malposition. Observational, retrospective review of preoperative and postoperative examination findings was performed. Results: Average age of the cohort was 66 years (31–91). Medial tarsorrhaphy was performed to correct eyelid retraction (100%), exposure keratopathy (80%), lagophthalmos (57%), and ectropion (17%) in patients with cranial nerve VII palsy (47%), Graves eye disease (13%), eczema (7%), floppy eyelid syndrome (7%), after Mohs reconstruction (7%), orbital myositis (3%), and neurofibromatosis (3%). Seventy-three percent (73%) of patients had an average of 3 surgeries (N = 22, standard deviation = 1.12, range = 2–7) before undergoing medial tarsorrhaphy. Medial tarsorrhaphy was performed in combination with another procedure in 53% of cases. Palpebral fissure decreased postoperatively an average of 1.1 mm (N = 20; p = 0.005), inferior scleral show decreased 0.72 mm (N = 22; p = 0.03), lagophthalmos decreased 0.4 mm (N = 15; p = 0.27), and superficial punctate keratopathy improved by 61% (N = 27; p = 0.009). Ectropion completely resolved in 4 of 10 patients (40%). Seven patients (23%) required additional surgery following tarsorrhaphy an average of 8 months later (range = 2–16). In 1 patient (3%), a tarsorrhaphy opened prematurely, and 1 patient (3%) requested partial opening of the tarsorrhaphy. Average duration of follow up was 13 months (N = 30, standard deviation = 14.97, range = 0.2–45.7). Conclusions: Medial tarsorrhaphy is a safe and effective primary or salvage technique to address complex causes of eyelid retraction, lagophthalmos, ectropion, and exposure keratopathy. Accepted for publication October 9, 2018. The authors have no financial or conflicts of interest to disclose. A portion of this study was presented at the following meeting: American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) (Poster) on November 10, 2017 in New Orleans, LA. Address correspondence and reprint requests to Kira L. Segal, M.D., Department of Ophthalmology, Weill Cornell Medical College/New York-Presbyterian Hospital, 1305 York Avenue, 11th and 12th Floors, New York, NY, 10021, U.S.A. Email: kls2003@med.cornell.edu. © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Styloid-stylohyoid syndrome: a rare cause of cranio-facial pain—a retrospective case series of 12 patients

Abstract

Purpose

Elongated styloid process results in severe cranio-facial/cervico-facial pain. The purpose of this study is to determine the efficacy of treatment outcomes using transcervical approach in the management of styloid-stylohyoid syndrome/styloid syndrome.

Study design

This is a retrospective cohort study. Subjects were enrolled from out-patient clinics reporting between the periods Jan 2016–Jan 2018.

Methods & methods

Twelve patients diagnosed with styloid syndrome based on history, thorough clinical workup, and assessment were included in the study. The primary outcomes—improvement in pain and regression of chief complaints following surgery were assessed. Elongated styloid was resected using transcervical approach under general anesthesia.

Results

The intra-operative lengths of the styloid process varied from 40 to 43 mm. No post-operative complications were encountered and the symptoms regressed completely after surgery in all the patients at follow-up of 6 months.

Conclusions

Transcervical styloidectomy is an effective treatment for exposure and resection of the styloid process with minimal complications in patients with stylo-stylohyoid syndrome.

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Technique and Results of Permanent Medial Tarsorrhaphy for Complex Eyelid Malposition

Purpose: To evaluate the results of permanent medial tarsorrhaphy and to describe the surgical technique. Methods: Medial tarsorrhaphy was performed on 30 eyelids with symptomatic exposure keratopathy secondary to eyelid malposition. Observational, retrospective review of preoperative and postoperative examination findings was performed. Results: Average age of the cohort was 66 years (31–91). Medial tarsorrhaphy was performed to correct eyelid retraction (100%), exposure keratopathy (80%), lagophthalmos (57%), and ectropion (17%) in patients with cranial nerve VII palsy (47%), Graves eye disease (13%), eczema (7%), floppy eyelid syndrome (7%), after Mohs reconstruction (7%), orbital myositis (3%), and neurofibromatosis (3%). Seventy-three percent (73%) of patients had an average of 3 surgeries (N = 22, standard deviation = 1.12, range = 2–7) before undergoing medial tarsorrhaphy. Medial tarsorrhaphy was performed in combination with another procedure in 53% of cases. Palpebral fissure decreased postoperatively an average of 1.1 mm (N = 20; p = 0.005), inferior scleral show decreased 0.72 mm (N = 22; p = 0.03), lagophthalmos decreased 0.4 mm (N = 15; p = 0.27), and superficial punctate keratopathy improved by 61% (N = 27; p = 0.009). Ectropion completely resolved in 4 of 10 patients (40%). Seven patients (23%) required additional surgery following tarsorrhaphy an average of 8 months later (range = 2–16). In 1 patient (3%), a tarsorrhaphy opened prematurely, and 1 patient (3%) requested partial opening of the tarsorrhaphy. Average duration of follow up was 13 months (N = 30, standard deviation = 14.97, range = 0.2–45.7). Conclusions: Medial tarsorrhaphy is a safe and effective primary or salvage technique to address complex causes of eyelid retraction, lagophthalmos, ectropion, and exposure keratopathy. Accepted for publication October 9, 2018. The authors have no financial or conflicts of interest to disclose. A portion of this study was presented at the following meeting: American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) (Poster) on November 10, 2017 in New Orleans, LA. Address correspondence and reprint requests to Kira L. Segal, M.D., Department of Ophthalmology, Weill Cornell Medical College/New York-Presbyterian Hospital, 1305 York Avenue, 11th and 12th Floors, New York, NY, 10021, U.S.A. Email: kls2003@med.cornell.edu. © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Styloid-stylohyoid syndrome: a rare cause of cranio-facial pain—a retrospective case series of 12 patients

Abstract

Purpose

Elongated styloid process results in severe cranio-facial/cervico-facial pain. The purpose of this study is to determine the efficacy of treatment outcomes using transcervical approach in the management of styloid-stylohyoid syndrome/styloid syndrome.

Study design

This is a retrospective cohort study. Subjects were enrolled from out-patient clinics reporting between the periods Jan 2016–Jan 2018.

Methods & methods

Twelve patients diagnosed with styloid syndrome based on history, thorough clinical workup, and assessment were included in the study. The primary outcomes—improvement in pain and regression of chief complaints following surgery were assessed. Elongated styloid was resected using transcervical approach under general anesthesia.

Results

The intra-operative lengths of the styloid process varied from 40 to 43 mm. No post-operative complications were encountered and the symptoms regressed completely after surgery in all the patients at follow-up of 6 months.

Conclusions

Transcervical styloidectomy is an effective treatment for exposure and resection of the styloid process with minimal complications in patients with stylo-stylohyoid syndrome.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E5m6xy

Styloid-stylohyoid syndrome: a rare cause of cranio-facial pain—a retrospective case series of 12 patients

Abstract

Purpose

Elongated styloid process results in severe cranio-facial/cervico-facial pain. The purpose of this study is to determine the efficacy of treatment outcomes using transcervical approach in the management of styloid-stylohyoid syndrome/styloid syndrome.

Study design

This is a retrospective cohort study. Subjects were enrolled from out-patient clinics reporting between the periods Jan 2016–Jan 2018.

Methods & methods

Twelve patients diagnosed with styloid syndrome based on history, thorough clinical workup, and assessment were included in the study. The primary outcomes—improvement in pain and regression of chief complaints following surgery were assessed. Elongated styloid was resected using transcervical approach under general anesthesia.

Results

The intra-operative lengths of the styloid process varied from 40 to 43 mm. No post-operative complications were encountered and the symptoms regressed completely after surgery in all the patients at follow-up of 6 months.

Conclusions

Transcervical styloidectomy is an effective treatment for exposure and resection of the styloid process with minimal complications in patients with stylo-stylohyoid syndrome.

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ALLERGY RELIEF (Loratadine) Tablet [Geri-Care Pharmaceutical Corp]

Updated Date: Nov 29, 2018 EST (Source: DailyMed Drug Label Updates)

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ALLERGY RELIEF (Loratadine) Tablet [Geri-Care Pharmaceutical Corp]

Updated Date: Nov 29, 2018 EST (Source: DailyMed Drug Label Updates)

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INDOOR OUTDOOR ALLERGY RELIEF (Loratadine) Tablet [Walgreens]

Updated Date: Nov 29, 2018 EST (Source: DailyMed Drug Label Updates)

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INDOOR OUTDOOR ALLERGY RELIEF (Loratadine) Tablet [Walgreens]

Updated Date: Nov 29, 2018 EST (Source: DailyMed Drug Label Updates)

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Mast Cell-Mediated Orchestration of the Immune Responses in Human Allergic Asthma: Current Insights

Abstract

Improving the lung function after experimental allergen challenge by blocking of mast cell (MC) mediators and the capability of MC mediators (including histamine, prostaglandin (PG) D2, and leukotriene (LT) C4) in induction of mucosal edema, bronchoconstriction, and mucus secretion provide evidence that MCs play a key role in pathophysiology of asthma. In asthma, the number of MCs increases in the airways and infiltration of MCs in a variety of anatomical sites including the epithelium, the submucosal glands, and the smooth muscle bundles occurs. MC localization within the ASM is accompanied with the hypertrophy and hyperplasia of the layer, and smooth muscle dysfunction that is mainly observed in forms of bronchial hyperresponsiveness, and variable airflow obstruction. Owing to the expression of a wide range of surface receptors and releasing various cytoplasmic mediators, MCs orchestrate the pathologic events of the disease. MC-released preformed mediators including chymase, tryptase, and histamine and de novo synthesized mediators such as PGD2, LTC4, and LTE4 in addition of cytokines mainly TGFβ1, TSLP, IL-33, IL-4, and IL-13 participate in pathogenesis of asthma. The release of MC mediators and MC/airway cell interactions during remodeling phase of asthma results in persistent cellular and structural changes in the airway wall mainly epithelial cell shedding, goblet cell hyperplasia, hypertrophy of ASM bundles, fibrosis in subepithelial region, abnormal deposition of extracellular matrix (ECM), increased tissue vascularity, and basement membrane thickening. We will review the current knowledge regarding the participation of MCs in each stage of asthma pathophysiology including the releasing mediators and their mechanism of action, expression of receptors by which they respond to stimuli, and finally the pharmaceutical products designed based on the strategy of blocking MC activation and mediator release.

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Mast Cell-Mediated Orchestration of the Immune Responses in Human Allergic Asthma: Current Insights

Abstract

Improving the lung function after experimental allergen challenge by blocking of mast cell (MC) mediators and the capability of MC mediators (including histamine, prostaglandin (PG) D2, and leukotriene (LT) C4) in induction of mucosal edema, bronchoconstriction, and mucus secretion provide evidence that MCs play a key role in pathophysiology of asthma. In asthma, the number of MCs increases in the airways and infiltration of MCs in a variety of anatomical sites including the epithelium, the submucosal glands, and the smooth muscle bundles occurs. MC localization within the ASM is accompanied with the hypertrophy and hyperplasia of the layer, and smooth muscle dysfunction that is mainly observed in forms of bronchial hyperresponsiveness, and variable airflow obstruction. Owing to the expression of a wide range of surface receptors and releasing various cytoplasmic mediators, MCs orchestrate the pathologic events of the disease. MC-released preformed mediators including chymase, tryptase, and histamine and de novo synthesized mediators such as PGD2, LTC4, and LTE4 in addition of cytokines mainly TGFβ1, TSLP, IL-33, IL-4, and IL-13 participate in pathogenesis of asthma. The release of MC mediators and MC/airway cell interactions during remodeling phase of asthma results in persistent cellular and structural changes in the airway wall mainly epithelial cell shedding, goblet cell hyperplasia, hypertrophy of ASM bundles, fibrosis in subepithelial region, abnormal deposition of extracellular matrix (ECM), increased tissue vascularity, and basement membrane thickening. We will review the current knowledge regarding the participation of MCs in each stage of asthma pathophysiology including the releasing mediators and their mechanism of action, expression of receptors by which they respond to stimuli, and finally the pharmaceutical products designed based on the strategy of blocking MC activation and mediator release.

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Here are some natural allergy relief strategies that really work

(Natural News) Seasonal allergies cause sneezing, coughing, and watery eyes. They can also cause serious brain fog, difficulty concentrating and focusing, fatigue, irritability, and depression. Fortunately, natural remedies for allergies are available. To relieve your allergy, here are five natural strategies you can try. Reduce exposure to allergens An allergy occurs when the immune system... (Source: NaturalNews.com)

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Corrigendum to “National Wisdom Tooth Treatment Audit” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) e71]

The authors regret that Kate Matin 's name was missed of the author list in the original article. It appears correctly above. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Mast Cell-Mediated Orchestration of the Immune Responses in Human Allergic Asthma: Current Insights

Abstract

Improving the lung function after experimental allergen challenge by blocking of mast cell (MC) mediators and the capability of MC mediators (including histamine, prostaglandin (PG) D2, and leukotriene (LT) C4) in induction of mucosal edema, bronchoconstriction, and mucus secretion provide evidence that MCs play a key role in pathophysiology of asthma. In asthma, the number of MCs increases in the airways and infiltration of MCs in a variety of anatomical sites including the epithelium, the submucosal glands, and the smooth muscle bundles occurs. MC localization within the ASM is accompanied with the hypertrophy and hyperplasia of the layer, and smooth muscle dysfunction that is mainly observed in forms of bronchial hyperresponsiveness, and variable airflow obstruction. Owing to the expression of a wide range of surface receptors and releasing various cytoplasmic mediators, MCs orchestrate the pathologic events of the disease. MC-released preformed mediators including chymase, tryptase, and histamine and de novo synthesized mediators such as PGD2, LTC4, and LTE4 in addition of cytokines mainly TGFβ1, TSLP, IL-33, IL-4, and IL-13 participate in pathogenesis of asthma. The release of MC mediators and MC/airway cell interactions during remodeling phase of asthma results in persistent cellular and structural changes in the airway wall mainly epithelial cell shedding, goblet cell hyperplasia, hypertrophy of ASM bundles, fibrosis in subepithelial region, abnormal deposition of extracellular matrix (ECM), increased tissue vascularity, and basement membrane thickening. We will review the current knowledge regarding the participation of MCs in each stage of asthma pathophysiology including the releasing mediators and their mechanism of action, expression of receptors by which they respond to stimuli, and finally the pharmaceutical products designed based on the strategy of blocking MC activation and mediator release.

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Here are some natural allergy relief strategies that really work

(Natural News) Seasonal allergies cause sneezing, coughing, and watery eyes. They can also cause serious brain fog, difficulty concentrating and focusing, fatigue, irritability, and depression. Fortunately, natural remedies for allergies are available. To relieve your allergy, here are five natural strategies you can try. Reduce exposure to allergens An allergy occurs when the immune system... (Source: NaturalNews.com)

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Mast Cell-Mediated Orchestration of the Immune Responses in Human Allergic Asthma: Current Insights

Abstract

Improving the lung function after experimental allergen challenge by blocking of mast cell (MC) mediators and the capability of MC mediators (including histamine, prostaglandin (PG) D2, and leukotriene (LT) C4) in induction of mucosal edema, bronchoconstriction, and mucus secretion provide evidence that MCs play a key role in pathophysiology of asthma. In asthma, the number of MCs increases in the airways and infiltration of MCs in a variety of anatomical sites including the epithelium, the submucosal glands, and the smooth muscle bundles occurs. MC localization within the ASM is accompanied with the hypertrophy and hyperplasia of the layer, and smooth muscle dysfunction that is mainly observed in forms of bronchial hyperresponsiveness, and variable airflow obstruction. Owing to the expression of a wide range of surface receptors and releasing various cytoplasmic mediators, MCs orchestrate the pathologic events of the disease. MC-released preformed mediators including chymase, tryptase, and histamine and de novo synthesized mediators such as PGD2, LTC4, and LTE4 in addition of cytokines mainly TGFβ1, TSLP, IL-33, IL-4, and IL-13 participate in pathogenesis of asthma. The release of MC mediators and MC/airway cell interactions during remodeling phase of asthma results in persistent cellular and structural changes in the airway wall mainly epithelial cell shedding, goblet cell hyperplasia, hypertrophy of ASM bundles, fibrosis in subepithelial region, abnormal deposition of extracellular matrix (ECM), increased tissue vascularity, and basement membrane thickening. We will review the current knowledge regarding the participation of MCs in each stage of asthma pathophysiology including the releasing mediators and their mechanism of action, expression of receptors by which they respond to stimuli, and finally the pharmaceutical products designed based on the strategy of blocking MC activation and mediator release.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q75vQB

Here are some natural allergy relief strategies that really work

(Natural News) Seasonal allergies cause sneezing, coughing, and watery eyes. They can also cause serious brain fog, difficulty concentrating and focusing, fatigue, irritability, and depression. Fortunately, natural remedies for allergies are available. To relieve your allergy, here are five natural strategies you can try. Reduce exposure to allergens An allergy occurs when the immune system... (Source: NaturalNews.com)

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Pathogen blockade of TAK1 triggers caspase-8-dependent cleavage of gasdermin D and cell death

Limited proteolysis of gasdermin D (GSDMD) generates an N-terminal pore-forming fragment that controls pyroptosis in macrophages. GSDMD is processed via inflammasome-activated caspase-1 or -11. It is currently unknown whether macrophage GSDMD can be processed by other mechanisms. Here, we describe an additional pathway controlling GSDMD processing. The inhibition of TAK1 or IB kinase (IKK) by the Yersinia effector protein YopJ elicits RIPK1- and caspase-8–dependent cleavage of GSDMD, which subsequently results in cell death. GSDMD processing also contributes to the NLRP3 inflammasome–dependent release of interleukin-1β (IL-1β). Thus, caspase-8 acts as a regulator of GSDMD-driven cell death. Furthermore, this study establishes the importance of TAK1 and IKK activity in...

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Caspase-8 is a player in pyroptosis

(Source: ScienceNOW)

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Here are some natural allergy relief strategies that really work

(Natural News) Seasonal allergies cause sneezing, coughing, and watery eyes. They can also cause serious brain fog, difficulty concentrating and focusing, fatigue, irritability, and depression. Fortunately, natural remedies for allergies are available. To relieve your allergy, here are five natural strategies you can try. Reduce exposure to allergens An allergy occurs when the immune system... (Source: NaturalNews.com)

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Pathogen blockade of TAK1 triggers caspase-8-dependent cleavage of gasdermin D and cell death

Limited proteolysis of gasdermin D (GSDMD) generates an N-terminal pore-forming fragment that controls pyroptosis in macrophages. GSDMD is processed via inflammasome-activated caspase-1 or -11. It is currently unknown whether macrophage GSDMD can be processed by other mechanisms. Here, we describe an additional pathway controlling GSDMD processing. The inhibition of TAK1 or IB kinase (IKK) by the Yersinia effector protein YopJ elicits RIPK1- and caspase-8–dependent cleavage of GSDMD, which subsequently results in cell death. GSDMD processing also contributes to the NLRP3 inflammasome–dependent release of interleukin-1β (IL-1β). Thus, caspase-8 acts as a regulator of GSDMD-driven cell death. Furthermore, this study establishes the importance of TAK1 and IKK activity in...

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Caspase-8 is a player in pyroptosis

(Source: ScienceNOW)

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Caspase-8 is a player in pyroptosis

(Source: ScienceNOW)

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Pathogen blockade of TAK1 triggers caspase-8-dependent cleavage of gasdermin D and cell death

Limited proteolysis of gasdermin D (GSDMD) generates an N-terminal pore-forming fragment that controls pyroptosis in macrophages. GSDMD is processed via inflammasome-activated caspase-1 or -11. It is currently unknown whether macrophage GSDMD can be processed by other mechanisms. Here, we describe an additional pathway controlling GSDMD processing. The inhibition of TAK1 or IB kinase (IKK) by the Yersinia effector protein YopJ elicits RIPK1- and caspase-8–dependent cleavage of GSDMD, which subsequently results in cell death. GSDMD processing also contributes to the NLRP3 inflammasome–dependent release of interleukin-1β (IL-1β). Thus, caspase-8 acts as a regulator of GSDMD-driven cell death. Furthermore, this study establishes the importance of TAK1 and IKK activity in...

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Caspase-8 is a player in pyroptosis

(Source: ScienceNOW)

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Pathogen blockade of TAK1 triggers caspase-8-dependent cleavage of gasdermin D and cell death

Limited proteolysis of gasdermin D (GSDMD) generates an N-terminal pore-forming fragment that controls pyroptosis in macrophages. GSDMD is processed via inflammasome-activated caspase-1 or -11. It is currently unknown whether macrophage GSDMD can be processed by other mechanisms. Here, we describe an additional pathway controlling GSDMD processing. The inhibition of TAK1 or IB kinase (IKK) by the Yersinia effector protein YopJ elicits RIPK1- and caspase-8–dependent cleavage of GSDMD, which subsequently results in cell death. GSDMD processing also contributes to the NLRP3 inflammasome–dependent release of interleukin-1β (IL-1β). Thus, caspase-8 acts as a regulator of GSDMD-driven cell death. Furthermore, this study establishes the importance of TAK1 and IKK activity in...

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Effects of prebiotic galacto-oligosaccharide on postoperative cognitive dysfunction and neuroinflammation through targeting of the gut-brain axis

Abstract

Background

Surgery-induced neuroinflammation plays an important role in postoperative cognitive dysfunction (POCD). Gut microbiota is a key regulator of neurological inflammation. Nurturing with prebiotics is an effective microbiota manipulation that can regulate host immunity and cognition. The aim of the present study was to test whether administration of the prebiotic Bimuno® (galactooligosaccharide (B-GOS) mixture) could ameliorate POCD and attenuate surgery-induced neuroinflammation through the microbiota-brain-axis.

Methods

Adult rats undergoing abdominal surgery under isoflurane anesthesia were fed with water or prebiotic B-GOS supplementation (15 g/L) for 3 weeks. Novel objective recognition task was employed for testing cognitive changes on postoperative day three. Expression of microglial marker Iba-1 in the hippocampus was assessed by immunohistochemical staining. Expression levels of phenotypic gene markers of activated microglia (M1: iNOS, CD68, CD32; M2: Ym1, CD206, and SOCS3) in hippocampus were determined by quantitative polymerase chain reaction (qPCR). Inflammatory cytokines in the hippocampus were assessed using enzyme-linked immunosorbent assay (ELISA). Feces were collected for microbial community analysis.

Results

Rats exhibited an impairment in novel objective recognition 3 days after surgery compared with control rats (P < .01). In the hippocampus, expressions of Iba-1 and M1 markers of surgical rats were significantly upregulated. Similarly, expressions of SOCS3 and CD206 in the hippocampus were upregulated. Additionally, increasing levels of IL-6 and IL-4 were evident in the hippocampus. Administration of B-GOS significantly alleviated cognitive decline induced by surgery (P < .01). B-GOS-fed rats showed a significantly downregulated activation of microglia and expressions of M1-related genes and SOCS3 and IL-6. While there was no significant difference in expressions of CD206 and Ym1 and IL-4 between the surgical and B-GOS groups. Analysis of gut microbiome found that administration of B-GOS induced a significant change beta diversity of the gut microbiome and proliferation of Bifidobacterium and other potentially anti-inflammatory microbes.

Conclusions

Administration of B-GOS has a beneficial effect on regulating neuroinflammatory and cognitive impairment in a rat model of abdominal surgery and was associated with the manipulation of gut microbiota.

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Effects of prebiotic galacto-oligosaccharide on postoperative cognitive dysfunction and neuroinflammation through targeting of the gut-brain axis

Abstract

Background

Surgery-induced neuroinflammation plays an important role in postoperative cognitive dysfunction (POCD). Gut microbiota is a key regulator of neurological inflammation. Nurturing with prebiotics is an effective microbiota manipulation that can regulate host immunity and cognition. The aim of the present study was to test whether administration of the prebiotic Bimuno® (galactooligosaccharide (B-GOS) mixture) could ameliorate POCD and attenuate surgery-induced neuroinflammation through the microbiota-brain-axis.

Methods

Adult rats undergoing abdominal surgery under isoflurane anesthesia were fed with water or prebiotic B-GOS supplementation (15 g/L) for 3 weeks. Novel objective recognition task was employed for testing cognitive changes on postoperative day three. Expression of microglial marker Iba-1 in the hippocampus was assessed by immunohistochemical staining. Expression levels of phenotypic gene markers of activated microglia (M1: iNOS, CD68, CD32; M2: Ym1, CD206, and SOCS3) in hippocampus were determined by quantitative polymerase chain reaction (qPCR). Inflammatory cytokines in the hippocampus were assessed using enzyme-linked immunosorbent assay (ELISA). Feces were collected for microbial community analysis.

Results

Rats exhibited an impairment in novel objective recognition 3 days after surgery compared with control rats (P < .01). In the hippocampus, expressions of Iba-1 and M1 markers of surgical rats were significantly upregulated. Similarly, expressions of SOCS3 and CD206 in the hippocampus were upregulated. Additionally, increasing levels of IL-6 and IL-4 were evident in the hippocampus. Administration of B-GOS significantly alleviated cognitive decline induced by surgery (P < .01). B-GOS-fed rats showed a significantly downregulated activation of microglia and expressions of M1-related genes and SOCS3 and IL-6. While there was no significant difference in expressions of CD206 and Ym1 and IL-4 between the surgical and B-GOS groups. Analysis of gut microbiome found that administration of B-GOS induced a significant change beta diversity of the gut microbiome and proliferation of Bifidobacterium and other potentially anti-inflammatory microbes.

Conclusions

Administration of B-GOS has a beneficial effect on regulating neuroinflammatory and cognitive impairment in a rat model of abdominal surgery and was associated with the manipulation of gut microbiota.

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Alterations of the default mode network and cognitive impairment in patients with unilateral chronic tinnitus

Background: Previous studies have demonstrated that cognitive impairment is linked with neurophysiological alterations in chronic tinnitus. This study aimed to investigate the intrinsic functional connectivity (FC) pattern within the default mode network (DMN) and its associations with cognitive impairment in tinnitus patients using a resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Thirty-five chronic unilateral tinnitus patients, and 50 healthy controls were recruited for rsfMRI scanning. Both groups were age, gender and education level well-matched. The posterior cingulate cortex (PCC) was chosen as the region of interest (ROI) for detecting the FC changes, and determining if these abnormalities were related to a specific cognitive performance and tinnitus characteristic. Results: Relative to the healthy controls, tinnitus patients showed increased FC between the PCC and the right medial prefrontal cortex (mPFC). Moreover, the enhanced FC between the PCC and right mPFC was correlated with the poorer TMT-B scores (r=0.474, P=0.008). These correlations were adjusted by age, gender, education level, GM volume, and mean hearing thresholds. The enhanced FC was not correlated with other tinnitus characteristics or cognitive performances. Conclusions: The enhanced FC pattern of the PCC that is correlated with cognitive impairment in chronic tinnitus patients, especially the executive dysfunction. Enhanced connectivity pattern within the DMN may play a crucial role in neurophysiological mechanism in tinnitus patients with cognitive dysfunction.

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

Brain morphological alteration and cognitive dysfunction in multiple system atrophy

Multiple system atrophy (MSA) is a progressive neurodegenerative disease in adults, manifesting various clinical symptoms including autonomic nerve dysfunction, Parkinson's syndrome, cerebellar ataxia, and pyramidal sign. The clinical diagnosis and classification of MSA are mainly dependent on motion and non-motion symptoms, such as autonomic nerve dysfunction. In addition, an increasing amount of clinical and pathological evidence has shown that about half of the MSA patients exhibit distinct types and levels of cognitive dysfunction. However, cognitive dysfunction has not been included in the current diagnosis criteria of MSA. In most cases, it was even used as an exclusion criterion of MSA. Based on the neuroimaging, neuropathology and neuropsychology, this review summarized the morphological changes of the brain in the patients with MSA, and discussed possible brain regions that could be associated with cognitive impairment. The article may provide a theoretical basis for incorporating cognitive dysfunction into the criteria of MSA diagnosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3MtZE

Discrimination and conversion prediction of mild cognitive impairment using convolutional neural networks

Background: Recently, studies have demonstrated that machine learning techniques, particularly cutting-edge deep learning technology, have achieved significant progression on the classification of Alzheimer's disease (AD) and its prodromal phase, mild cognitive impairment (MCI). Moreover, accurate prediction of the progress and the conversion risk from MCI to probable AD has been of great importance in clinical application. Methods: In this study, the baseline MR images and follow-up information during 3 years of 150 normal controls (NC), 150 patients with stable MCI (sMCI) and 157 converted MCI (cMCI) were collected from the Alzheimer's Disease Neuroimaging Initiative (ADNI). The deep convolutional neural networks (CNNs) were adopted to distinguish different stages of MCI from the NC group, and predict the conversion time from MCI to AD. Two CNN architectures including GoogleNet and CaffeNet were explored and evaluated in multiple classifications and estimations of conversion risk using transfer learning from pre-trained ImageNet (via fine-tuning) and five-fold cross-validation. A novel data augmentation approach using random views aggregation was applied to generate abundant image patches from the original MR scans. Results: The GoogleNet acquired accuracies with 97.58%, 67.33% and 84.71% in three-way discrimination among the NC, sMCI and cMCI groups respectively, whereas the CaffeNet obtained promising accuracies of 98.71%, 72.04% and 92.35% in the NC, sMCI and cMCI classifications. Furthermore, the accuracy measures of conversion risk of patients with cMCI ranged from 71.25% to 83.25% in different time points using GoogleNet, whereas the CaffeNet achieved remarkable accuracy measures from 95.42% to 97.01% in conversion risk prediction. Conclusions: The experimental results demonstrated that the proposed methods had prominent capability in classification among the 3 groups such as sMCI, cMCI and NC, and exhibited significant ability in conversion risk prediction of patients with MCI.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2AzG9zX

Unusual magnetic resonance imaging findings in a patient with posterior reversible encephalopathy syndrome

A 37-year-old male presented to the neurology department after developing sudden headache, nausea, and visual disturbances. The patient had been diagnosed with hypertension 5 years previously, but was not currently taking appropriate medication; he also had a 20-pack/year history of smoking.

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

Quantitative diffusion magnetic resonance imaging in head and neck tumors

In patients with head and neck cancer, conventional anatomical magnetic resonance imaging (MRI) scans are commonly used for identification of primary lesion, assessment of structural distortion, and presence of metastatic lymph nodes. However, quantitative analysis of diffusion MRI can provide added value to structural and anatomical evaluation of head and neck tumors (HNT), by differentiation of primary malignant process, prognostic prediction, and treatment monitoring. In this article, we will review the applications of quantitative diffusion MRI in identification of primary malignant tissue, differentiation of tumor pathology, prediction of molecular phenotype, monitoring of treatment response, and evaluation of posttreatment changes in patient with HNT.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3Mixs

Atrophied brain lesion volume, a magnetic resonance imaging biomarker for monitoring neurodegenerative changes in multiple sclerosis

Multiple sclerosis (MS) is a chronic, autoimmune disease of the central nervous system (CNS) that is characterized by inflammation, demyelination and axonal loss (1). Since its discovery, magnetic resonance imaging (MRI) has revolutionized the diagnosis and monitoring of patients with MS (2). Conventional MRI measures, like T2 hyperintense lesions on T2-weighted images (WI) and contrast enhancing (CE) lesions on post-contrast T1-WI are now routinely used to detect therapeutic effects and extend clinical observations (3).

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

A case of multinucleate cell angiohistiocytoma in a 14‐year old boy showing two different clinical and histopathological findings

Multinucleate cell angiohistiocytoma (MCAH) is a rare cutaneous disease entity characterized by multiple red‐to‐brown or violaceous papules usually located on the acral regions such as the face and the distal arms and legs. It affects elderly women more than men and hardly occurs at a young age. The exact pathogenic mechanism of MCAH is not yet clearly understood.

We report an exceptionally rare case of a 14‐year old boy who presented with multiple asymptomatic erythematous papules and a single flat brownish plaque on the left chest. The brownish plaque lesion histologically showed proliferation of dilated small vessels in the upper‐mid dermis and numerous oddly shaped multinucleate cells intermingled with lymphocytes and macrophages. The erythematous papules also showed dilated small vessels in the upper‐mid dermis and multiple interstitial histiocytic infiltrations, but no multinucleate cells were detected. In immunohistochemistry studies, CD68 and vimentin staining were positive for both specimens. Based on the clinicopathological findings and immunohistochemistry studies, MCAH was diagnosed.

To the best of our knowledge, this is the first case report of MCAH occurring in young age and showing two different clinical and histological phases at the same time.

This article is protected by copyright. All rights reserved.

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

Alterations of the default mode network and cognitive impairment in patients with unilateral chronic tinnitus

Background: Previous studies have demonstrated that cognitive impairment is linked with neurophysiological alterations in chronic tinnitus. This study aimed to investigate the intrinsic functional connectivity (FC) pattern within the default mode network (DMN) and its associations with cognitive impairment in tinnitus patients using a resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Thirty-five chronic unilateral tinnitus patients, and 50 healthy controls were recruited for rsfMRI scanning. Both groups were age, gender and education level well-matched. The posterior cingulate cortex (PCC) was chosen as the region of interest (ROI) for detecting the FC changes, and determining if these abnormalities were related to a specific cognitive performance and tinnitus characteristic. Results: Relative to the healthy controls, tinnitus patients showed increased FC between the PCC and the right medial prefrontal cortex (mPFC). Moreover, the enhanced FC between the PCC and right mPFC was correlated with the poorer TMT-B scores (r=0.474, P=0.008). These correlations were adjusted by age, gender, education level, GM volume, and mean hearing thresholds. The enhanced FC was not correlated with other tinnitus characteristics or cognitive performances. Conclusions: The enhanced FC pattern of the PCC that is correlated with cognitive impairment in chronic tinnitus patients, especially the executive dysfunction. Enhanced connectivity pattern within the DMN may play a crucial role in neurophysiological mechanism in tinnitus patients with cognitive dysfunction.

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

Pediatric stroke: current diagnostic and management challenges

Stroke is not a diagnosis which springs to mind within the pediatric age group. Nonetheless, the combined incidence of ischemic and hemorrhagic stroke is estimated at 1.3 to 13.0 children per 100,000 (1) and the overall incidence is increasing (2) due to a combination of improved survival of those with risk factors and increased recognition.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2TXcU35

Imaging of cerebrovascular complications of infection

Cerebrovascular complications may occur in infectious diseases in the setting of infective endocarditis, central nervous system (CNS) infections, systemic bacteremia and sepsis. Cerebrovascular complications of infections include vasculitis, mycotic aneurysms, and thrombophlebitis. Infectious vasculitis of the CNS may cause cerebral hemorrhage, infarction or ischemia. Ruptured aneurysms may endanger the patient's life. Infectious thrombophlebitis may cause intracranial pressure to increase and lead to cerebral hemorrhage. These cerebrovascular complications are associated with a poor prognosis and often cause irreversible neurological deficits. Cerebrovascular events secondary to infection are not easily distinguishable from the more common cerebral infarct and non-infectious vasculitis. In addition, the clinical manifestations of cerebrovascular complications of infections are non-specific and highly variable. Therefore, early imaging, antibiotics, and anticoagulation may be lifesaving the patient's life and prevent disability. The main focus of this article is to review imaging analysis of the cerebrovascular complications of infections and imaging features that help differentiate them from non-infectious vascular diseases.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2AzGd2F

Brain morphological alteration and cognitive dysfunction in multiple system atrophy

Multiple system atrophy (MSA) is a progressive neurodegenerative disease in adults, manifesting various clinical symptoms including autonomic nerve dysfunction, Parkinson's syndrome, cerebellar ataxia, and pyramidal sign. The clinical diagnosis and classification of MSA are mainly dependent on motion and non-motion symptoms, such as autonomic nerve dysfunction. In addition, an increasing amount of clinical and pathological evidence has shown that about half of the MSA patients exhibit distinct types and levels of cognitive dysfunction. However, cognitive dysfunction has not been included in the current diagnosis criteria of MSA. In most cases, it was even used as an exclusion criterion of MSA. Based on the neuroimaging, neuropathology and neuropsychology, this review summarized the morphological changes of the brain in the patients with MSA, and discussed possible brain regions that could be associated with cognitive impairment. The article may provide a theoretical basis for incorporating cognitive dysfunction into the criteria of MSA diagnosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3MtZE

Discrimination and conversion prediction of mild cognitive impairment using convolutional neural networks

Background: Recently, studies have demonstrated that machine learning techniques, particularly cutting-edge deep learning technology, have achieved significant progression on the classification of Alzheimer's disease (AD) and its prodromal phase, mild cognitive impairment (MCI). Moreover, accurate prediction of the progress and the conversion risk from MCI to probable AD has been of great importance in clinical application. Methods: In this study, the baseline MR images and follow-up information during 3 years of 150 normal controls (NC), 150 patients with stable MCI (sMCI) and 157 converted MCI (cMCI) were collected from the Alzheimer's Disease Neuroimaging Initiative (ADNI). The deep convolutional neural networks (CNNs) were adopted to distinguish different stages of MCI from the NC group, and predict the conversion time from MCI to AD. Two CNN architectures including GoogleNet and CaffeNet were explored and evaluated in multiple classifications and estimations of conversion risk using transfer learning from pre-trained ImageNet (via fine-tuning) and five-fold cross-validation. A novel data augmentation approach using random views aggregation was applied to generate abundant image patches from the original MR scans. Results: The GoogleNet acquired accuracies with 97.58%, 67.33% and 84.71% in three-way discrimination among the NC, sMCI and cMCI groups respectively, whereas the CaffeNet obtained promising accuracies of 98.71%, 72.04% and 92.35% in the NC, sMCI and cMCI classifications. Furthermore, the accuracy measures of conversion risk of patients with cMCI ranged from 71.25% to 83.25% in different time points using GoogleNet, whereas the CaffeNet achieved remarkable accuracy measures from 95.42% to 97.01% in conversion risk prediction. Conclusions: The experimental results demonstrated that the proposed methods had prominent capability in classification among the 3 groups such as sMCI, cMCI and NC, and exhibited significant ability in conversion risk prediction of patients with MCI.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2AzG9zX

The structural MRI markers and cognitive decline in prodromal Alzheimer’s disease: a 2-year longitudinal study

Background: Being clinically diagnosed with a mild cognitive impairment (MCI) due to Alzheimer's disease (AD) is widely studied. Yet, the clinical and structural neuroimaging characteristics for prodromal AD, which are defined as A+T+MCI based on the AT (N) system are still highly desirable. This study evaluates the differences of the cognitive assessments and structural magnetic resonance imaging (MRI) between the early MCI (EMCI) and late MCI (LMCI) participants based on the AT (N) system. The potential clinical value of the structural MRI as a predictor of cognitive decline during follow-up in prodromal AD is further investigated. Methods: A total of 406 MCI participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database were chosen and dichotomized into EMCI and LMCI groups according to the Second Edition (Logical Memory II) Wechsler Memory Scale. Multiple markers' data was collected, including age, sex, years of education, ApoE4 status, cerebrospinal fluid (CSF) biomarkers, standardized uptake values ratios (SUVR) means of florbetapir-PET-AV45, cognitive measures, and structural MRI. We chose 197 A+T+MCI participants (prodromal AD) with positive biomarkers of Aβ plaques (labeled "A") and fibrillar tau (labeled "T"). We diagnosed Aβ plaques positive by the SUVR means of florbetapir-PET-AV45 (cut-off >1.1) and fibrillar tau positive by CSF phosphorylated-tau at threonine 181 (p-tau) (cut-off >23 pg/mL). The differences of cognitive assessments and regions of interest (ROIs) defined on the MRI template between EMCI and LMCI were compared. Furthermore, the potential clinical utility of the MRI as the predictor of cognitive decline in prodromal AD was evaluated by investigating the relationship between baseline MRI markers and cognition decline at the follow-up period, through a linear regression model. Results: The LMCI participants had a significantly more amyloid burden and CSF levels of total t-tau than the EMCI participants. The LMCI participants scored a lower result than the EMCI group in the global cognition scales and subscales which included tests for memory, delayed recall memory, executive function, language, attention and visuospatial skills. The cognition levels declined faster in the LMCI participants during the 12- and 24-month follow-up. There were significant differences in ROIs on the structural MRI between the two groups, including a bilateral entorhinal, a bilateral hippocampus, a bilateral amygdala, a bilateral lateral ventricle and cingulate, a corpus callosum, and a left temporal. The thickness average of the left entorhinal, the left middle temporal, the left superior temporal, and the right isthmus cingulate was a main contributor to the decreased global cognition levels. The thickness average of the left superior temporal and bilateral entorhinal played a key role in the memory domain decline. The thickness average of the left middle temporal, and the right isthmus cingulate was significantly associated with an executive function decline. Conclusions: Based on the AT (N) system, surely, both the EMCI and LMCI diagnoses presented significant differences in multiple cognition domains. Signature ROIs from the structural MRI tests had correlated a cognitive decline, and could act as one potential predictive marker.

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Unusual magnetic resonance imaging findings in a patient with posterior reversible encephalopathy syndrome

A 37-year-old male presented to the neurology department after developing sudden headache, nausea, and visual disturbances. The patient had been diagnosed with hypertension 5 years previously, but was not currently taking appropriate medication; he also had a 20-pack/year history of smoking.

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

Quantitative diffusion magnetic resonance imaging in head and neck tumors

In patients with head and neck cancer, conventional anatomical magnetic resonance imaging (MRI) scans are commonly used for identification of primary lesion, assessment of structural distortion, and presence of metastatic lymph nodes. However, quantitative analysis of diffusion MRI can provide added value to structural and anatomical evaluation of head and neck tumors (HNT), by differentiation of primary malignant process, prognostic prediction, and treatment monitoring. In this article, we will review the applications of quantitative diffusion MRI in identification of primary malignant tissue, differentiation of tumor pathology, prediction of molecular phenotype, monitoring of treatment response, and evaluation of posttreatment changes in patient with HNT.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3Mixs

Atrophied brain lesion volume, a magnetic resonance imaging biomarker for monitoring neurodegenerative changes in multiple sclerosis

Multiple sclerosis (MS) is a chronic, autoimmune disease of the central nervous system (CNS) that is characterized by inflammation, demyelination and axonal loss (1). Since its discovery, magnetic resonance imaging (MRI) has revolutionized the diagnosis and monitoring of patients with MS (2). Conventional MRI measures, like T2 hyperintense lesions on T2-weighted images (WI) and contrast enhancing (CE) lesions on post-contrast T1-WI are now routinely used to detect therapeutic effects and extend clinical observations (3).

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

A case of multinucleate cell angiohistiocytoma in a 14‐year old boy showing two different clinical and histopathological findings

Multinucleate cell angiohistiocytoma (MCAH) is a rare cutaneous disease entity characterized by multiple red‐to‐brown or violaceous papules usually located on the acral regions such as the face and the distal arms and legs. It affects elderly women more than men and hardly occurs at a young age. The exact pathogenic mechanism of MCAH is not yet clearly understood.

We report an exceptionally rare case of a 14‐year old boy who presented with multiple asymptomatic erythematous papules and a single flat brownish plaque on the left chest. The brownish plaque lesion histologically showed proliferation of dilated small vessels in the upper‐mid dermis and numerous oddly shaped multinucleate cells intermingled with lymphocytes and macrophages. The erythematous papules also showed dilated small vessels in the upper‐mid dermis and multiple interstitial histiocytic infiltrations, but no multinucleate cells were detected. In immunohistochemistry studies, CD68 and vimentin staining were positive for both specimens. Based on the clinicopathological findings and immunohistochemistry studies, MCAH was diagnosed.

To the best of our knowledge, this is the first case report of MCAH occurring in young age and showing two different clinical and histological phases at the same time.

This article is protected by copyright. All rights reserved.

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

Towards Reproducible Results: Validating CT Hemorrhage-Detection Algorithms on Standard Datasets [LETTERS]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ADF0ro

Automated ASPECTS on Noncontrast CT Scans in Patients with Acute Ischemic Stroke Using Machine Learning [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Alberta Stroke Program Early CT Score (ASPECTS) was devised as a systematic method to assess the extent of early ischemic change on noncontrast CT (NCCT) in patients with acute ischemic stroke (AIS). Our aim was to automate ASPECTS to objectively score NCCT of AIS patients.

MATERIALS AND METHODS:

We collected NCCT images with a 5-mm thickness of 257 patients with acute ischemic stroke (<8 hours from onset to scans) followed by a diffusion-weighted imaging acquisition within 1 hour. Expert ASPECTS readings on DWI were used as ground truth. Texture features were extracted from each ASPECTS region of the 157 training patient images to train a random forest classifier. The unseen 100 testing patient images were used to evaluate the performance of the trained classifier. Statistical analyses on the total ASPECTS and region-level ASPECTS were conducted.

RESULTS:

For the total ASPECTS of the unseen 100 patients, the intraclass correlation coefficient between the automated ASPECTS method and DWI ASPECTS scores of expert readings was 0.76 (95% confidence interval, 0.67–0.83) and the mean ASPECTS difference in the Bland-Altman plot was 0.3 (limits of agreement, –3.3, 2.6). Individual ASPECTS region-level analysis showed that our method yielded = 0.60, sensitivity of 66.2%, specificity of 91.8%, and area under curve of 0.79 for 100 x 10 ASPECTS regions. Additionally, when ASPECTS was dichotomized (>4 and ≤4), = 0.78, sensitivity of 97.8%, specificity of 80%, and area under the curve of 0.89 were generated between the proposed method and expert readings on DWI.

CONCLUSIONS:

The proposed automated ASPECTS scoring approach shows reasonable ability to determine ASPECTS on NCCT images in patients presenting with acute ischemic stroke.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2TYZ009

Value of BRAF V600E in High-Risk Thyroid Nodules with Benign Cytology Results [HEAD & NECK]

BACKGROUND AND PURPOSE:

Limitations of ultrasound-guided fine-needle aspiration include nondiagnostic, indeterminate cytology and false-negative results. The BRAF V600E mutation is a specific biomarker for papillary thyroid carcinoma. This study aimed to investigate the additional diagnostic role of the BRAF V600E mutation in high-risk thyroid nodules with benign cytology results.

MATERIALS AND METHODS:

A total of 787 high-risk nodules in 720 patients underwent ultrasound–fine-needle aspiration. A subsequent BRAF V600E mutation test was performed on thyroid nodules with benign cytology. Final pathology confirmed thyroid nodules with benign cytology that were positive for the BRAF V600E mutation. Ultrasound was performed on thyroid nodules with benign cytology results that were negative for the BRAF V600E mutation. Fine-needle aspiration was repeated on thyroid nodules with enlarged size or changed ultrasound features.

RESULTS:

Among the 787 nodules, 292 thyroid nodules had benign cytology results with 256 nodules negative for the BRAF V600E mutation and 36 nodules positive for the BRAF V600E mutation. Thirty-one nodules positive for the BRAF V600E mutation were confirmed malignant, and 5 nodules were confirmed benign by pathology. Fine-needle aspiration was repeated on 11 enlarged thyroid nodules with benign cytology findings that were negative for the BRAF V600E mutation. The results of repeat fine-needle aspiration were 4 benign nodules, 2 follicular neoplasms or suspected follicular neoplasms, 3 suspected malignancies, and 2 malignant nodules. Among the 36 thyroid nodules positive for the BRAF V600E mutation, 25 (69.4%) had ≥2 suspicious ultrasound features and 11 (30.6%) nodules had 1 suspicious ultrasound feature.

CONCLUSIONS:

The BRAF V600E mutation test can detect papillary thyroid carcinomas that might be missed by fine-needle aspiration. We recommend that fine-needle aspiration be routinely accompanied by the BRAF V600E mutation test in high-risk thyroid nodules with ≥2 suspicious ultrasound features.

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Reply: [LETTERS]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3I9JU

MRI Evidence of Altered Callosal Sodium in Mild Traumatic Brain Injury [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Mild traumatic brain injury is a leading cause of death and disability worldwide with 42 million cases reported annually, increasing the need to understand the underlying pathophysiology because this could help guide the development of targeted therapy. White matter, particularly the corpus callosum, is susceptible to injury. Animal models suggest stretch-induced mechanoporation of the axonal membrane resulting in ionic shifts and altered sodium ion distribution. The purpose of this study was to compare the distribution of total sodium concentration in the corpus callosum between patients with mild traumatic brain injury and controls using sodium (²³Na) MR imaging.

MATERIALS AND METHODS:

Eleven patients with a history of mild traumatic brain injury and 10 age- and sex-matched controls underwent sodium (²³Na) MR imaging using a 3T scanner. Total sodium concentration was measured in the genu, body, and splenium of the corpus callosum with 5-mm ROIs; total sodium concentration of the genu-to-splenium ratio was calculated and compared between patients and controls.

RESULTS:

Higher total sodium concentration in the genu (49.28 versus 43.29 mmol/L, P = .01) and lower total sodium concentration in the splenium (which was not statistically significant; 38.35 versus 44.06 mmol/L, P = .08) was seen in patients with mild traumatic brain injury compared with controls. The ratio of genu total sodium concentration to splenium total sodium concentration was also higher in patients with mild traumatic brain injury (1.3 versus 1.01, P = .001).

CONCLUSIONS:

Complex differences are seen in callosal total sodium concentration in symptomatic patients with mild traumatic brain injury, supporting the notion of ionic dysfunction in the pathogenesis of mild traumatic brain injury. The total sodium concentration appears to be altered beyond the immediate postinjury phase, and further work is needed to understand the relationship to persistent symptoms and outcome.

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

Towards Reproducible Results: Validating CT Hemorrhage-Detection Algorithms on Standard Datasets [LETTERS]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ADF0ro

Automated ASPECTS on Noncontrast CT Scans in Patients with Acute Ischemic Stroke Using Machine Learning [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Alberta Stroke Program Early CT Score (ASPECTS) was devised as a systematic method to assess the extent of early ischemic change on noncontrast CT (NCCT) in patients with acute ischemic stroke (AIS). Our aim was to automate ASPECTS to objectively score NCCT of AIS patients.

MATERIALS AND METHODS:

We collected NCCT images with a 5-mm thickness of 257 patients with acute ischemic stroke (<8 hours from onset to scans) followed by a diffusion-weighted imaging acquisition within 1 hour. Expert ASPECTS readings on DWI were used as ground truth. Texture features were extracted from each ASPECTS region of the 157 training patient images to train a random forest classifier. The unseen 100 testing patient images were used to evaluate the performance of the trained classifier. Statistical analyses on the total ASPECTS and region-level ASPECTS were conducted.

RESULTS:

For the total ASPECTS of the unseen 100 patients, the intraclass correlation coefficient between the automated ASPECTS method and DWI ASPECTS scores of expert readings was 0.76 (95% confidence interval, 0.67–0.83) and the mean ASPECTS difference in the Bland-Altman plot was 0.3 (limits of agreement, –3.3, 2.6). Individual ASPECTS region-level analysis showed that our method yielded = 0.60, sensitivity of 66.2%, specificity of 91.8%, and area under curve of 0.79 for 100 x 10 ASPECTS regions. Additionally, when ASPECTS was dichotomized (>4 and ≤4), = 0.78, sensitivity of 97.8%, specificity of 80%, and area under the curve of 0.89 were generated between the proposed method and expert readings on DWI.

CONCLUSIONS:

The proposed automated ASPECTS scoring approach shows reasonable ability to determine ASPECTS on NCCT images in patients presenting with acute ischemic stroke.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2TYZ009

Value of BRAF V600E in High-Risk Thyroid Nodules with Benign Cytology Results [HEAD & NECK]

BACKGROUND AND PURPOSE:

Limitations of ultrasound-guided fine-needle aspiration include nondiagnostic, indeterminate cytology and false-negative results. The BRAF V600E mutation is a specific biomarker for papillary thyroid carcinoma. This study aimed to investigate the additional diagnostic role of the BRAF V600E mutation in high-risk thyroid nodules with benign cytology results.

MATERIALS AND METHODS:

A total of 787 high-risk nodules in 720 patients underwent ultrasound–fine-needle aspiration. A subsequent BRAF V600E mutation test was performed on thyroid nodules with benign cytology. Final pathology confirmed thyroid nodules with benign cytology that were positive for the BRAF V600E mutation. Ultrasound was performed on thyroid nodules with benign cytology results that were negative for the BRAF V600E mutation. Fine-needle aspiration was repeated on thyroid nodules with enlarged size or changed ultrasound features.

RESULTS:

Among the 787 nodules, 292 thyroid nodules had benign cytology results with 256 nodules negative for the BRAF V600E mutation and 36 nodules positive for the BRAF V600E mutation. Thirty-one nodules positive for the BRAF V600E mutation were confirmed malignant, and 5 nodules were confirmed benign by pathology. Fine-needle aspiration was repeated on 11 enlarged thyroid nodules with benign cytology findings that were negative for the BRAF V600E mutation. The results of repeat fine-needle aspiration were 4 benign nodules, 2 follicular neoplasms or suspected follicular neoplasms, 3 suspected malignancies, and 2 malignant nodules. Among the 36 thyroid nodules positive for the BRAF V600E mutation, 25 (69.4%) had ≥2 suspicious ultrasound features and 11 (30.6%) nodules had 1 suspicious ultrasound feature.

CONCLUSIONS:

The BRAF V600E mutation test can detect papillary thyroid carcinomas that might be missed by fine-needle aspiration. We recommend that fine-needle aspiration be routinely accompanied by the BRAF V600E mutation test in high-risk thyroid nodules with ≥2 suspicious ultrasound features.

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

Reply: [LETTERS]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U3I9JU

MRI Evidence of Altered Callosal Sodium in Mild Traumatic Brain Injury [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Mild traumatic brain injury is a leading cause of death and disability worldwide with 42 million cases reported annually, increasing the need to understand the underlying pathophysiology because this could help guide the development of targeted therapy. White matter, particularly the corpus callosum, is susceptible to injury. Animal models suggest stretch-induced mechanoporation of the axonal membrane resulting in ionic shifts and altered sodium ion distribution. The purpose of this study was to compare the distribution of total sodium concentration in the corpus callosum between patients with mild traumatic brain injury and controls using sodium (²³Na) MR imaging.

MATERIALS AND METHODS:

Eleven patients with a history of mild traumatic brain injury and 10 age- and sex-matched controls underwent sodium (²³Na) MR imaging using a 3T scanner. Total sodium concentration was measured in the genu, body, and splenium of the corpus callosum with 5-mm ROIs; total sodium concentration of the genu-to-splenium ratio was calculated and compared between patients and controls.

RESULTS:

Higher total sodium concentration in the genu (49.28 versus 43.29 mmol/L, P = .01) and lower total sodium concentration in the splenium (which was not statistically significant; 38.35 versus 44.06 mmol/L, P = .08) was seen in patients with mild traumatic brain injury compared with controls. The ratio of genu total sodium concentration to splenium total sodium concentration was also higher in patients with mild traumatic brain injury (1.3 versus 1.01, P = .001).

CONCLUSIONS:

Complex differences are seen in callosal total sodium concentration in symptomatic patients with mild traumatic brain injury, supporting the notion of ionic dysfunction in the pathogenesis of mild traumatic brain injury. The total sodium concentration appears to be altered beyond the immediate postinjury phase, and further work is needed to understand the relationship to persistent symptoms and outcome.

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

Sex, Eggs, and Parasites: How the Journey of Plasmodium falciparum in Anopheles is Affected by Mosquito Reproduction

Date: Tuesday, 12 11, 2018; Speaker: Flaminia Catteruccia, Professor of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health ; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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T-bet-dependent NKp46+ ILCs Control the Onset of Neuroinflammation

Date: Tuesday, 12 04, 2018; Speaker: Vanja Lazarevic, Investigator, Experimental Immunology Branch, National Cancer Center; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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Sex, Eggs, and Parasites: How the Journey of Plasmodium falciparum in Anopheles is Affected by Mosquito Reproduction

Date: Tuesday, 12 11, 2018; Speaker: Flaminia Catteruccia, Professor of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health ; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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T-bet-dependent NKp46+ ILCs Control the Onset of Neuroinflammation

Date: Tuesday, 12 04, 2018; Speaker: Vanja Lazarevic, Investigator, Experimental Immunology Branch, National Cancer Center; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysis

ConclusionsMarsupialization followed by enucleation after 12 to 18  months reduces the recurrence rate, but more studies are necessary to support this statement. (Source: Oral and Maxillofacial Surgery)

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Recurrence of nonsyndromic odontogenic keratocyst after marsupialization and delayed enucleation vs. enucleation alone: a systematic review and meta-analysis

ConclusionsMarsupialization followed by enucleation after 12 to 18  months reduces the recurrence rate, but more studies are necessary to support this statement. (Source: Oral and Maxillofacial Surgery)

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HAL-MRE1 Subcutaneous Immunotherapy in Ragweed Allergic Patients First-in-human

Conditions:   Rhinitis, Allergic;   Rhinoconjunctivitis, Allergic Intervention:   Biological: HAL-MRE1 Sponsor:   HAL Allergy Not yet recruiting (Source: ClinicalTrials.gov)

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Comparison of Dendritic Cell-Based Therapeutic Vaccine Strategies for HIV Functional Cure

Condition:   HIV Infections Interventions:   Biological: a1DC + inactivated whole autologous HIV;   Biological: a1DC + conserved HIV peptides;   Biological: a1DC + no antigen;   Biological: pgDC + inactivated whole autologous HIV;   Biological: pgDC + conserved HIV peptides;   Biological: pgDC + no antigen Sponsors:   Sharon Riddler;   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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A Study to Evaluate Safety, Tolerability and Immune Response in Adolescents Allergic to Peanut After Receiving Intradermal Administration of ASP0892 (ARA-LAMP-vax), a Single Multivalent Peanut (Ara h1, h2, h3) Lysosomal Associated Membrane Protein DNA Plasmid Vaccine

Condition:   Peanut Allergy Interventions:   Drug: ASP0892;   Drug: Placebo Sponsor:   Astellas Pharma Global Development, Inc. Not yet recruiting (Source: ClinicalTrials.gov)

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Amoxicillin Challenge for Penicillin Allergy Diagnosis

Condition:   Penicillin Allergy Intervention:   Diagnostic Test: Penicillin Skin Testing Sponsor:   CHU de Quebec-Universite Laval Not yet recruiting (Source: ClinicalTrials.gov)

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BPF Genetics of ILD Study

Conditions:   Lung; Disease, Interstitial, With Fibrosis;   Alveolitis, Extrinsic Allergic;   Bird Fancier's Lung;   Idiopathic Interstitial Pneumonias;   Lung Diseases, Interstitial;   Idiopathic Pulmonary Fibrosis Intervention:   Diagnostic Test: Genetic profiling Sponsors:   NHS Forth Valley;   University of Leicester;   University of Glasgow;   Newcastle University;   British Lung Foundation;   British Pigeon Fanciers Medical Research Not yet recruiting (Source: ClinicalTrials.gov)

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HAL-MRE1 Subcutaneous Immunotherapy in Ragweed Allergic Patients First-in-human

Conditions:   Rhinitis, Allergic;   Rhinoconjunctivitis, Allergic Intervention:   Biological: HAL-MRE1 Sponsor:   HAL Allergy Not yet recruiting (Source: ClinicalTrials.gov)

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Comparison of Dendritic Cell-Based Therapeutic Vaccine Strategies for HIV Functional Cure

Condition:   HIV Infections Interventions:   Biological: a1DC + inactivated whole autologous HIV;   Biological: a1DC + conserved HIV peptides;   Biological: a1DC + no antigen;   Biological: pgDC + inactivated whole autologous HIV;   Biological: pgDC + conserved HIV peptides;   Biological: pgDC + no antigen Sponsors:   Sharon Riddler;   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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A Study to Evaluate Safety, Tolerability and Immune Response in Adolescents Allergic to Peanut After Receiving Intradermal Administration of ASP0892 (ARA-LAMP-vax), a Single Multivalent Peanut (Ara h1, h2, h3) Lysosomal Associated Membrane Protein DNA Plasmid Vaccine

Condition:   Peanut Allergy Interventions:   Drug: ASP0892;   Drug: Placebo Sponsor:   Astellas Pharma Global Development, Inc. Not yet recruiting (Source: ClinicalTrials.gov)

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Demonstration of Equivalent Effectiveness of a Novel Anti-allergic Nasal Spray and a Marketed Nasal Product as Well as Demonstration of Fast Symptom Reduction in Allergic Patients

Conditions:   Allergic Rhinitis;   Allergic Conjunctivitis;   Hayfever Interventions:   Drug: Rhinocort;   Drug: Budesolv;   Other: Placebo Sponsor:   Marinomed Biotech AG Enrolling by invitation (Source: ClinicalTrials.gov)

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Amoxicillin Challenge for Penicillin Allergy Diagnosis

Condition:   Penicillin Allergy Intervention:   Diagnostic Test: Penicillin Skin Testing Sponsor:   CHU de Quebec-Universite Laval Not yet recruiting (Source: ClinicalTrials.gov)

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Development and validation of a predictive risk factor model for epidural re-siting in women undergoing labour epidural analgesia: a retrospective cohort study

Abstract

Background

Epidural catheter re-siting in parturients receiving labour epidural analgesia is distressing to the parturient and places them at increased complications from a repeat procedure. The aim of this study was to develop and validate a clinical risk factor model to predict the incidence of epidural catheter re-siting in labour analgesia.

Methods

The data from parturients that received labour epidural analgesia in our centre during 2014–2015 was used to develop a predictive model for epidural catheter re-siting during labour analgesia. Multivariate logistic regression analysis was used to identify factors that were predictive of epidural catheter re-siting. The forward, backward and stepwise variable selection methods were applied to build a predictive model, which was internally validated. The final multivariate model was externally validated with the data collected from 10,170 parturients during 2012–2013 in our centre.

Results

Ninety-three (0.88%) parturients in 2014–2015 required re-siting of their epidural catheter. The training data set included 7439 paturients in 2014–2015. A higher incidence of breakthrough pain (OR = 4.42), increasing age (OR = 1.07), an increased pain score post-epidural catheter insertion (OR = 1.35) and problems such as inability to obtain cerebrospinal fluid in combined spinal epidural technique (OR = 2.06) and venous puncture (OR = 1.70) were found to be significantly predictive of epidural catheter re-siting, while spontaneous onset of labour (OR = 0.31) was found to be protective. The predictive model was validated internally on a further 3189 paturients from the data of 2014–2015 and externally on 10,170 paturients from the data of 2012–2013. Predictive accuracy of the model based on C-statistic were 0.89 (0.86, 0.93) and 0.92 (0.88, 0.97) for training and internal validation data respectively. Similarly, predictive accuracy in terms of C-statistic was 0.89 (0.86, 0.92) based on 2012–2013 data.

Conclusion

Our predictive model of epidural re-siting in parturients receiving labour epidural analgesia could provide timely identification of high-risk paturients required epidural re-siting.

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Food TASTES better on the Wheat Belly lifestyle

"Almonds are sweet." "Foods taste better." "Candy now tastes sickeningly sweet." "My daughter now loves asparagus." I've heard these comments from Wheat Belly lifestyle followers numerous times over the years, observations that reflect the change in taste perception that develops with wheat and grain elimination from the diet. It is a consistent effect observed by so many people: the perception of taste changes with elimination of wheat and grains. It represents restoration of taste perception back to the way it was supposed to have been all along, an effect that reflects healing of the gastrointestinal tract (since the tongue is one of the entry points of the gastrointestinal system, a useful safety, as well as gastronomic, device) alongside relief from acid reflu...

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Development and validation of a predictive risk factor model for epidural re-siting in women undergoing labour epidural analgesia: a retrospective cohort study

Abstract

Background

Epidural catheter re-siting in parturients receiving labour epidural analgesia is distressing to the parturient and places them at increased complications from a repeat procedure. The aim of this study was to develop and validate a clinical risk factor model to predict the incidence of epidural catheter re-siting in labour analgesia.

Methods

The data from parturients that received labour epidural analgesia in our centre during 2014–2015 was used to develop a predictive model for epidural catheter re-siting during labour analgesia. Multivariate logistic regression analysis was used to identify factors that were predictive of epidural catheter re-siting. The forward, backward and stepwise variable selection methods were applied to build a predictive model, which was internally validated. The final multivariate model was externally validated with the data collected from 10,170 parturients during 2012–2013 in our centre.

Results

Ninety-three (0.88%) parturients in 2014–2015 required re-siting of their epidural catheter. The training data set included 7439 paturients in 2014–2015. A higher incidence of breakthrough pain (OR = 4.42), increasing age (OR = 1.07), an increased pain score post-epidural catheter insertion (OR = 1.35) and problems such as inability to obtain cerebrospinal fluid in combined spinal epidural technique (OR = 2.06) and venous puncture (OR = 1.70) were found to be significantly predictive of epidural catheter re-siting, while spontaneous onset of labour (OR = 0.31) was found to be protective. The predictive model was validated internally on a further 3189 paturients from the data of 2014–2015 and externally on 10,170 paturients from the data of 2012–2013. Predictive accuracy of the model based on C-statistic were 0.89 (0.86, 0.93) and 0.92 (0.88, 0.97) for training and internal validation data respectively. Similarly, predictive accuracy in terms of C-statistic was 0.89 (0.86, 0.92) based on 2012–2013 data.

Conclusion

Our predictive model of epidural re-siting in parturients receiving labour epidural analgesia could provide timely identification of high-risk paturients required epidural re-siting.

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Food TASTES better on the Wheat Belly lifestyle

"Almonds are sweet." "Foods taste better." "Candy now tastes sickeningly sweet." "My daughter now loves asparagus." I've heard these comments from Wheat Belly lifestyle followers numerous times over the years, observations that reflect the change in taste perception that develops with wheat and grain elimination from the diet. It is a consistent effect observed by so many people: the perception of taste changes with elimination of wheat and grains. It represents restoration of taste perception back to the way it was supposed to have been all along, an effect that reflects healing of the gastrointestinal tract (since the tongue is one of the entry points of the gastrointestinal system, a useful safety, as well as gastronomic, device) alongside relief from acid reflu...

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Role of phosphorylcholine in Streptococcus pneumoniae and nontypeable Haemophilus influenzae adherence to epithelial cells

Phosphorylcholine (PC) is a structural component of Streptococcus pneumoniae (Spn) and nontypeable Haemophilus influenzae (NTHi), and is known to be associated with adherence through the platelet activating factor receptor (PAF-R). Furthermore, high PC expression is considered to be involved in Spn and NTHi virulence. In this study, we examined the influence of PC expression on the adherence of Spn and NTHi to epithelial cells in order to clarify the potential effectiveness of a vaccine targeting PC.

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Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases

To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.

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Corrigendum to “Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study” [Auris Nasus Larynx 45 (2018) 1006–1013]

In the ethical considerations section of the article, the ethical committee should read as follows: "The University of Tokyo, Graduate School of Medicine".

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Role of phosphorylcholine in Streptococcus pneumoniae and nontypeable Haemophilus influenzae adherence to epithelial cells

Phosphorylcholine (PC) is a structural component of Streptococcus pneumoniae (Spn) and nontypeable Haemophilus influenzae (NTHi), and is known to be associated with adherence through the platelet activating factor receptor (PAF-R). Furthermore, high PC expression is considered to be involved in Spn and NTHi virulence. In this study, we examined the influence of PC expression on the adherence of Spn and NTHi to epithelial cells in order to clarify the potential effectiveness of a vaccine targeting PC.

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Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases

To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.

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Corrigendum to “Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study” [Auris Nasus Larynx 45 (2018) 1006–1013]

In the ethical considerations section of the article, the ethical committee should read as follows: "The University of Tokyo, Graduate School of Medicine".

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CC Grand Rounds: Ethics Rounds: Capacity to Consent: What is it? Who has it?

Ethical clinical care and ethical clinical research depend on obtaining appropriate informed consent. However, obtaining consent in practice raises a number of challenges. What is required to give consent for clinical care, what is required to give consent for research, and how do they differ? Doe s an underlying cognitive impairment or psychiatric condition undermine the capacity to consent? Please join us to discuss these and other challenges clinicians face when obtaining informed consent. Presenter: Christa Zerbe, MD National Institute of Allergy and Infectious Diseases Discussant: Paul Appelbaum, MD Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law Director, Division of Law, Ethics and Psychiatry Columbia University For more information go tohttps://www.cc.nih.gov/ab...

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CC Grand Rounds: Ethics Rounds: Capacity to Consent: What is it? Who has it?

Ethical clinical care and ethical clinical research depend on obtaining appropriate informed consent. However, obtaining consent in practice raises a number of challenges. What is required to give consent for clinical care, what is required to give consent for research, and how do they differ? Doe s an underlying cognitive impairment or psychiatric condition undermine the capacity to consent? Please join us to discuss these and other challenges clinicians face when obtaining informed consent. Presenter: Christa Zerbe, MD National Institute of Allergy and Infectious Diseases Discussant: Paul Appelbaum, MD Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law Director, Division of Law, Ethics and Psychiatry Columbia University For more information go tohttps://www.cc.nih.gov/ab...

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The Quality of Systematic Reviews Addressing Peripheral Nerve Repair and Reconstruction

While systematic reviews are regarded as the strongest level of medical evidence, inconsistency in the quality and rigor of systematic reviews raises concerns about their use as a tool in guiding quality delivery in evidence-based clinical practice. The objective of this present study was to assess methodological soundness of systematic reviews with a particular focus on peripheral nerve repair and reconstruction.We performed a comprehensive search using PubMed and Scopus to identify all systematic reviews published on peripheral nerve reconstruction in 9 high-impact surgical journals.

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The Quality of Systematic Reviews Addressing Peripheral Nerve Repair and Reconstruction

While systematic reviews are regarded as the strongest level of medical evidence, inconsistency in the quality and rigor of systematic reviews raises concerns about their use as a tool in guiding quality delivery in evidence-based clinical practice. The objective of this present study was to assess methodological soundness of systematic reviews with a particular focus on peripheral nerve repair and reconstruction.We performed a comprehensive search using PubMed and Scopus to identify all systematic reviews published on peripheral nerve reconstruction in 9 high-impact surgical journals.

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Teva launches generic EpiPen at the same price as existing device

Teva (NYSE:TEVA) this week launched its generic version of Mylan's (NSDQ:MYL) EpiPen auto-injector and announced that it would sell the emergency allergy therapy for $300 – the same price as Mylan's own generic EpiPen product. The price for Teva's product inspired some head-scratching among patient advocates and healthcare professionals. After all, when the FDA first approved Teva's generic EpiPen, the agency highlighted the notion that boosting competition with generics would ultimately make the product more accessible to a general population. But, at the same price as Mylan's discounted EpiPen, some are wondering how Teva's product will reach patients who couldn't afford Mylan's device. Get the full story at our sister site, Drug Delivery Business News. The post Teva ...

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Teva launches generic EpiPen at the same price as existing device

Teva (NYSE:TEVA) this week launched its generic version of Mylan's (NSDQ:MYL) EpiPen auto-injector and announced that it would sell the emergency allergy therapy for $300 – the same price as Mylan's own generic EpiPen product. The price for Teva's product inspired some head-scratching among patient advocates and healthcare professionals. After all, when the FDA first approved Teva's generic EpiPen, the agency highlighted the notion that boosting competition with generics would ultimately make the product more accessible to a general population. But, at the same price as Mylan's discounted EpiPen, some are wondering how Teva's product will reach patients who couldn't afford Mylan's device. Get the full story at our sister site, Drug Delivery Business News. The post Teva ...

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Corrigendum to “National Wisdom Tooth Treatment Audit” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) e71]

The authors regret that Kate Matin's name was missed of the author list in the original article. It appears correctly above.

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Teva launches generic EpiPen at the same price as existing device

Teva (NYSE:TEVA) this week launched its generic version of Mylan's (NSDQ:MYL) EpiPen auto-injector and announced that it would sell the emergency allergy therapy for $300 – the same price as Mylan's own generic EpiPen product. The price for Teva's product inspired some head-scratching among patient advocates and healthcare professionals. After all, when the FDA first approved Teva's generic EpiPen, the agency highlighted the notion that boosting competition with generics would ultimately make the product more accessible to a general population. But, at the same price as Mylan's discounted EpiPen, some are wondering how Teva's product will reach patients who couldn't afford Mylan's device. Get the full story at our sister site, Drug Delivery Business News. The post Teva ...

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Corrigendum to “National Wisdom Tooth Treatment Audit” [Br. J. Oral Maxillofac. Surg. 54 (10) (December 2016) e71]

The authors regret that Kate Matin's name was missed of the author list in the original article. It appears correctly above.

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

Teva launches generic EpiPen at the same price as existing device

Teva (NYSE:TEVA) this week launched its generic version of Mylan's (NSDQ:MYL) EpiPen auto-injector and announced that it would sell the emergency allergy therapy for $300 – the same price as Mylan's own generic EpiPen product. The price for Teva's product inspired some head-scratching among patient advocates and healthcare professionals. After all, when the FDA first approved Teva's generic EpiPen, the agency highlighted the notion that boosting competition with generics would ultimately make the product more accessible to a general population. But, at the same price as Mylan's discounted EpiPen, some are wondering how Teva's product will reach patients who couldn't afford Mylan's device. Get the full story at our sister site, Drug Delivery Business News. The post Teva ...

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Clinical Application of Three-Dimensionally Printed Biomaterial Polycaprolactone (PCL) in Augmentation Rhinoplasty

Abstract

Background

This clinical study aimed to investigate the safety and surgical outcome of three-dimensionally (3D) fabricated polycaprolactone (PCL) mesh in rhinoplasty. In particular, this study explored how a 3D-printed PCL mesh performs as a bioabsorbable scaffold after a long period following implantation.

Methods

A retrospective review of 101 patients who received primary or secondary rhinoplasty with a PCL mesh was performed. Patient demographics and surgery-related outcomes were examined. Clinical efficacy and safety were evaluated using the Global Aesthetic Improvement Scale at postoperative 18 months. From two revisional cases, a biopsy specimen of implanted PCL was acquired and histopathological analysis was performed.

Results

Of all the patients, 98.0% showed no postoperative infection-related foreign body reaction or distinct abnormal reaction, and the implants were observed to maintain long-term efficacy until 18-month follow-up. In patients who received spreader grafts, significant differences between preoperative and postoperative Cottle sign scores were found. Histopathological analysis showed features of adjacent tissue infiltration into pores of the PCL mesh and regeneration of neo-cartilaginous tissue and collagen around the mesh 20 months after implantation.

Conclusion

This study demonstrates that a novel biodegradable PCL mesh with a 3D structure is a safe and effective material for corrective rhinoplasty because it is easy to use and capable of maintaining its volume in the long term without foreign body response. This biocompatible material will have a wide range of applications as the most suitable alternative to nonabsorbable materials in rhinoplasty and reconstruction surgeries, such as fashioning spreader grafts and septal extension grafts.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Clinical Application of Three-Dimensionally Printed Biomaterial Polycaprolactone (PCL) in Augmentation Rhinoplasty

Abstract

Background

This clinical study aimed to investigate the safety and surgical outcome of three-dimensionally (3D) fabricated polycaprolactone (PCL) mesh in rhinoplasty. In particular, this study explored how a 3D-printed PCL mesh performs as a bioabsorbable scaffold after a long period following implantation.

Methods

A retrospective review of 101 patients who received primary or secondary rhinoplasty with a PCL mesh was performed. Patient demographics and surgery-related outcomes were examined. Clinical efficacy and safety were evaluated using the Global Aesthetic Improvement Scale at postoperative 18 months. From two revisional cases, a biopsy specimen of implanted PCL was acquired and histopathological analysis was performed.

Results

Of all the patients, 98.0% showed no postoperative infection-related foreign body reaction or distinct abnormal reaction, and the implants were observed to maintain long-term efficacy until 18-month follow-up. In patients who received spreader grafts, significant differences between preoperative and postoperative Cottle sign scores were found. Histopathological analysis showed features of adjacent tissue infiltration into pores of the PCL mesh and regeneration of neo-cartilaginous tissue and collagen around the mesh 20 months after implantation.

Conclusion

This study demonstrates that a novel biodegradable PCL mesh with a 3D structure is a safe and effective material for corrective rhinoplasty because it is easy to use and capable of maintaining its volume in the long term without foreign body response. This biocompatible material will have a wide range of applications as the most suitable alternative to nonabsorbable materials in rhinoplasty and reconstruction surgeries, such as fashioning spreader grafts and septal extension grafts.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Smoking, alcohol consumption, and illicit substances use among adolescents in Poland

The use of alcohol, tobacco, and illicit substances typically first occurs in adolescence. The purpose of this study was to examine alcohol, cigarette, and illicit substance use among adolescents in Poland, in...

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Smoking, alcohol consumption, and illicit substances use among adolescents in Poland

The use of alcohol, tobacco, and illicit substances typically first occurs in adolescence. The purpose of this study was to examine alcohol, cigarette, and illicit substance use among adolescents in Poland, in...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ABu9xM

Dexamethasone and Dexamethasone Phosphate Entry into Perilymph Compared for Middle Ear Applications in Guinea Pigs

Dexamethasone phosphate is widely used for intratympanic therapy in humans. We assessed the pharmacokinetics of dexamethasone entry into perilymph when administered as a dexamethasone phosphate solution or as a micronized dexamethasone suspension, with and without inclusion of poloxamer gel in the medium. After a 1-h application to guinea pigs, 10 independent samples of perilymph were collected from the lateral semicircular canal of each animal, allowing entry at the round window and stapes to be independently assessed. Both forms of dexamethasone entered the perilymph predominantly at the round window (73%), with a lower proportion entering at the stapes (22%). When normalized by applied concentration, dexamethasone phosphate was found to enter perilymph far more slowly than dexamethasone...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E2OnF9