Purpose of the review There is increasing interest in the use of noncerebral somatic tissue oxygen saturation (SstO2) monitoring on the basis of near-infrared spectroscopy in patients undergoing surgery or residing in intensive care unit. The relevant question is whether SstO2 monitoring can improve the quality of care. In this article, we reviewed the clinical application of SstO2 monitoring in acute care, focusing on its use in patients undergoing surgery. Recent findings Multiple small cohort studies conducted on pediatric patients reported close associations of SstO2 measurements over different regions such as the splanchnic and renal tissue beds with systemic oxygenation, transfusion, hemodynamic indices, morbidity, and mortality. Conversely, there is paucity of literature on SstO2 monitoring in adult patients. The limited number of reports suggests that SstO2 levels over bulk muscles such as the thenar eminence, forearm, and lower leg during surgery are correlated with postoperative outcomes including postoperative nausea and vomiting and the length of hospital stay in adult patients undergoing surgery. The only pilot, randomized interventional study based on 50 patients undergoing surgery did not find a difference in outcomes on the basis of the use of SstO2 monitoring. Summary Somatic tissue oxygenation may represent an essential aspect of human physiology in acute care, and it is likely outcome-relevant based on observational cohort studies. Future research should examine whether SstO2-guided care can further improve patient outcomes using randomized controlled trials. Correspondence to Lingzhong Meng, MD, Professor and Division Chief, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520, USA. Tel: +1 203 785 2802; e-mail: lingzhong.meng@yale.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Σάββατο 1 Δεκεμβρίου 2018
Extravascular lung water monitoring for thoracic and lung transplant surgeries
Purpose of review Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates. In this review, we focus on the emergence of transpulmonary thermodilution (TPTD) and lung ultrasound with a focus on the clinical integration of these modalities into current intraoperative and critical care practices. Recent findings Recent studies demonstrate transpulmonary thermodilution and lung ultrasound provide greater sensitivity and earlier detection of lung water accumulation and are useful to guide clinical management. Assessments from these techniques have predictive value of postoperative outcome. Further, EVLW assessment shows promise as a preoperative screening tool in lung transplant patients. Summary Monitoring EVLW in the perioperative period offers clinicians a powerful tool to guide fluid therapy and manage pulmonary edema. Both TPTD and lung ultrasound have unique attributes in the care of thoracic surgery and lung transplant patients. Correspondence to Sherif Assaad, MD, Department of Anesthesiology, Yale University School of Medicine, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA. Tel: +1 203 932 5711; fax: +1 203 937 4803; e-mail: sherif.assaad@yale.ed Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Spinal cord perfusion protection for thoraco-abdominal aortic aneurysm surgery
Purpose of Review Spinal cord ischemia (SCI) is a devastating complication after open or endovascular aortic repair for thoracoabdominal aortic disease. The underlying pathogenesis is not fully understood but appears multifactorial. Multiple spinal cord protection strategies and monitoring techniques are currently utilized with variable results seen. The purpose of this review is to summarize important and recent findings related to cause, monitoring and impact of multiple spinal cord protection strategies. Recent Findings Recent data suggests collateral blood flow as the major determinant of spinal cord perfusion instead of individual intercostal vessels, potential role of transcutaneous near-infrared spectroscopy for monitoring of spinal cord perfusion and positive impact of implementing multimodal spinal cord protection strategies on reducing the risk of SCI. Summary SCI leading to paraplegia is a multifactorial complication that remains a major concern in complex aortic surgeries. Although there are no sufficient data to document the efficacy of spinal cord protection techniques individually, their effect on lowering the risk of SCI is most evident when used concomitantly using a multimodal approach that encompasses the perioperative and early postoperative period. Correspondence to Lovkesh Arora, MD, 200 Hawkins drive, 6JCP, Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IA 52242-1079, USA. Tel: +1 319 384 6079; e-mail: Lovkesh-arora@uiowa.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Prehabilitation is better than cure
Purpose of review With a continuously growing number of older patients undergoing major surgical procedures, reliable parameters practicable in perioperative routine revealing those patients at risk are urgently needed. Recently, the concept of 'prehabilitation' with its key elements exercise, nutrition and psychological stress reduction especially in frail patients is attracting increasing attention. Recent findings Literature search revealed a huge amount of publications in particular within the last 12 months. Although a single definition of both frailty and prehabilitation is still to be made, various players in the perioperative setting obviously are becoming increasingly convinced about a possible benefit of the program – referring to different components and measures performed. Although physiologically advantages seem obvious, there is hardly any reliable data on clinical outcomes resulting from properly performed studies. This applies especially to octogenarians; thus those at risk for adverse events the concept originally addresses. Summary Identifying high-risk patients at the earliest possible stage and increasing their physiological reserve prior to surgery is a promising approach that seems to result in remarkable improvements for older patients. However, further studies on effectiveness in a highly heterogeneous population and agreement on a common concept are mandatory before a final judgement can be given. Correspondence to Simone Gurlit, MD, Department of Anesthesiology and operative Intensive Care, St. Franziskus-Hospital Muenster, Hohenzollernring 70, 48145 Muenster, Germany. Tel: +49 251 935 3936; fax: +49 251 935 4077; e-mails: simonegurlit@aol.com, simone.gurlit@sfh-muenster.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Biomarkers and postoperative cognitive function: could it be that easy?
Purpose of review Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD. Recent findings Markers for delirium have been searched for in the cerebrospinal fluid to examine the pathologic cascade. However, cerebrospinal fluid cannot be easily obtained in the perioperative setting. Thus, attention shifts toward prediction markers from patients' blood to determine the individual risk. In this regard, three major groups of peripheral blood markers could be distinguished: first, global, but unspecific markers associated with POD/POCD; second, specific and established markers related to neurocognitive function; and third, upcoming or newly described markers with less evidence. Solely neuron-specific enolase is an adequate biomarker based on recent literature. Summary Single markers for postoperative cognitive impairment cannot predict POD/POCD in geriatric patients. However, a wisely arranged battery of promising biomarkers might achieve a satisfying sensitivity and specificity for the preoperative assessment of subsequent cognitive decline. Adequately powered studies to prove this hypothesis are required. Correspondence to Simon T. Schaefer, Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany. Tel: +49 89 440 013 181 142; fax: +49 89 440 078 886; e-mail: simon.schaefer@med.uni-muenchen.de Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/1qR4umk). Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Delayed recovery following thoracic surgery: persistent issues and potential interventions
Purpose of review Lung and esophageal surgery remain a curative option for resectable cancers. However, despite advances in surgical and anesthesia practices, the inclusion of patients with comorbidities that would have previously not been offered curative resection presents additional concerns and challenges. Recent findings Perioperative complication rates remain high and prolonged and/or painful recovery are common. Further, many patients face a permanent decline in their functional status, which negatively affects their quality of life. Examination of the variables associated with high complications following thoracic surgery reveals patient, physician, and institutional factors in the forefront. Anesthesiologist training, Enhanced Recovery After Surgery protocols, and preparations to minimize "failure to rescue" when a complication does arise are key strategies to address adverse outcomes. Summary Delayed and complicated recovery after thoracic noncardiac surgery persist in current practice. This review analyzes the diverse factors that can impact complications and quality of life after lung surgery and the interventions that can help decrease length of stay and improve return to baseline conditions. Correspondence to Alessia Pedoto, MD FASA, Department of Anesthesiology and Critical Care Medicine, 1275 York Ave. Room M301, New York, NY 10065, USA. Tel: +1 212 639 6840; e-mail: pedotoa@mskcc.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Examination of the enhanced recovery guidelines in thoracic surgery
Purpose of review Enhanced Recovery After Thoracic Surgery (ERATS) has gained momentum over the past few years, although the evidence base and expert recommendations lag behind other specialties. This review will present and examine key points from the first guidelines for enhanced recovery after lung surgery, released in 2018, jointly sponsored by the European Society of Thoracic Surgeons and the Enhanced Recovery After Surgery Society. Recent findings The recently released guidelines present core components of enhanced recovery as they pertain to lung resection surgery. Although evidence is still sparse in some areas, the guidelines summarize the available literature and incorporate levels of recommendation based upon the strength of available data as well as expert consensus. As of yet, the relative contribution of individual ERATS components to improvement in outcomes is unclear, but overall compliance does seem to be linked to positive results. Since the creation of the guidelines, additional literature related to ERATS has been released, and it will be incorporated and discussed into our review. Summary The creation of guidelines for enhanced recovery after lung resection will provide the thoracic anesthesiologist a framework upon which to build a comprehensive perioperative anesthetic plan. Correspondence to Emily G. Teeter, MD, FASE, Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, CB #7010, Chapel Hill, NC 27599-7010, USA. Tel: 1 (919) 966 5136; E-mail: Emily_Teeter@med.unc.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Extravascular lung water monitoring for thoracic and lung transplant surgeries
Purpose of review Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates. In this review, we focus on the emergence of transpulmonary thermodilution (TPTD) and lung ultrasound with a focus on the clinical integration of these modalities into current intraoperative and critical care practices. Recent findings Recent studies demonstrate transpulmonary thermodilution and lung ultrasound provide greater sensitivity and earlier detection of lung water accumulation and are useful to guide clinical management. Assessments from these techniques have predictive value of postoperative outcome. Further, EVLW assessment shows promise as a preoperative screening tool in lung transplant patients. Summary Monitoring EVLW in the perioperative period offers clinicians a powerful tool to guide fluid therapy and manage pulmonary edema. Both TPTD and lung ultrasound have unique attributes in the care of thoracic surgery and lung transplant patients. Correspondence to Sherif Assaad, MD, Department of Anesthesiology, Yale University School of Medicine, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA. Tel: +1 203 932 5711; fax: +1 203 937 4803; e-mail: sherif.assaad@yale.ed Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Neuromonitoring in the elderly
Purpose of review To summarize recent recommendations on intraoperative electroencephalogram (EEG) neuromonitoring in the elderly aimed at the prevention of postoperative delirium and long-term neurocognitive decline. We discuss recent perioperative EEG investigations relating to aging and cognitive dysfunction, and their implications on intraoperative EEG neuromonitoring in elderly patients. Recent findings The incidence of postoperative delirium in elderly can be reduced by monitoring depth of anesthesia, using an index number (0–100) derived from processed frontal EEG readings. The recently published European Society of Anaesthesiology guideline on postoperative delirium in elderly now recommends guiding general anesthesia with such indices (Level A). However, intraoperative EEG signatures are heavily influenced by age, cognitive function, and choice of anesthetic agents. Detailed spectral EEG analysis and research on EEG-based functional connectivity provide new insights into the pathophysiology of neuronal excitability, which is seen in elderly patients with postoperative delirium. Summary Anesthesiologists should become acquainted with intraoperative EEG signatures and their relation to age, anesthetic agents, and the risk of postoperative cognitive complications. A working knowledge would allow an optimized and individualized provision of general anesthesia for the elderly. Correspondence to Claudia Spies, Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel: +49 30 450 651 001; e-mail: claudia.spies@charite.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Incremental value of noncerebral somatic tissue oxygenation monitoring for patients undergoing surgery
Purpose of the review There is increasing interest in the use of noncerebral somatic tissue oxygen saturation (SstO2) monitoring on the basis of near-infrared spectroscopy in patients undergoing surgery or residing in intensive care unit. The relevant question is whether SstO2 monitoring can improve the quality of care. In this article, we reviewed the clinical application of SstO2 monitoring in acute care, focusing on its use in patients undergoing surgery. Recent findings Multiple small cohort studies conducted on pediatric patients reported close associations of SstO2 measurements over different regions such as the splanchnic and renal tissue beds with systemic oxygenation, transfusion, hemodynamic indices, morbidity, and mortality. Conversely, there is paucity of literature on SstO2 monitoring in adult patients. The limited number of reports suggests that SstO2 levels over bulk muscles such as the thenar eminence, forearm, and lower leg during surgery are correlated with postoperative outcomes including postoperative nausea and vomiting and the length of hospital stay in adult patients undergoing surgery. The only pilot, randomized interventional study based on 50 patients undergoing surgery did not find a difference in outcomes on the basis of the use of SstO2 monitoring. Summary Somatic tissue oxygenation may represent an essential aspect of human physiology in acute care, and it is likely outcome-relevant based on observational cohort studies. Future research should examine whether SstO2-guided care can further improve patient outcomes using randomized controlled trials. Correspondence to Lingzhong Meng, MD, Professor and Division Chief, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520, USA. Tel: +1 203 785 2802; e-mail: lingzhong.meng@yale.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Prehabilitation is better than cure
Purpose of review With a continuously growing number of older patients undergoing major surgical procedures, reliable parameters practicable in perioperative routine revealing those patients at risk are urgently needed. Recently, the concept of 'prehabilitation' with its key elements exercise, nutrition and psychological stress reduction especially in frail patients is attracting increasing attention. Recent findings Literature search revealed a huge amount of publications in particular within the last 12 months. Although a single definition of both frailty and prehabilitation is still to be made, various players in the perioperative setting obviously are becoming increasingly convinced about a possible benefit of the program – referring to different components and measures performed. Although physiologically advantages seem obvious, there is hardly any reliable data on clinical outcomes resulting from properly performed studies. This applies especially to octogenarians; thus those at risk for adverse events the concept originally addresses. Summary Identifying high-risk patients at the earliest possible stage and increasing their physiological reserve prior to surgery is a promising approach that seems to result in remarkable improvements for older patients. However, further studies on effectiveness in a highly heterogeneous population and agreement on a common concept are mandatory before a final judgement can be given. Correspondence to Simone Gurlit, MD, Department of Anesthesiology and operative Intensive Care, St. Franziskus-Hospital Muenster, Hohenzollernring 70, 48145 Muenster, Germany. Tel: +49 251 935 3936; fax: +49 251 935 4077; e-mails: simonegurlit@aol.com, simone.gurlit@sfh-muenster.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Biomarkers and postoperative cognitive function: could it be that easy?
Purpose of review Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD. Recent findings Markers for delirium have been searched for in the cerebrospinal fluid to examine the pathologic cascade. However, cerebrospinal fluid cannot be easily obtained in the perioperative setting. Thus, attention shifts toward prediction markers from patients' blood to determine the individual risk. In this regard, three major groups of peripheral blood markers could be distinguished: first, global, but unspecific markers associated with POD/POCD; second, specific and established markers related to neurocognitive function; and third, upcoming or newly described markers with less evidence. Solely neuron-specific enolase is an adequate biomarker based on recent literature. Summary Single markers for postoperative cognitive impairment cannot predict POD/POCD in geriatric patients. However, a wisely arranged battery of promising biomarkers might achieve a satisfying sensitivity and specificity for the preoperative assessment of subsequent cognitive decline. Adequately powered studies to prove this hypothesis are required. Correspondence to Simon T. Schaefer, Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany. Tel: +49 89 440 013 181 142; fax: +49 89 440 078 886; e-mail: simon.schaefer@med.uni-muenchen.de Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/1qR4umk). Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Delayed recovery following thoracic surgery: persistent issues and potential interventions
Purpose of review Lung and esophageal surgery remain a curative option for resectable cancers. However, despite advances in surgical and anesthesia practices, the inclusion of patients with comorbidities that would have previously not been offered curative resection presents additional concerns and challenges. Recent findings Perioperative complication rates remain high and prolonged and/or painful recovery are common. Further, many patients face a permanent decline in their functional status, which negatively affects their quality of life. Examination of the variables associated with high complications following thoracic surgery reveals patient, physician, and institutional factors in the forefront. Anesthesiologist training, Enhanced Recovery After Surgery protocols, and preparations to minimize "failure to rescue" when a complication does arise are key strategies to address adverse outcomes. Summary Delayed and complicated recovery after thoracic noncardiac surgery persist in current practice. This review analyzes the diverse factors that can impact complications and quality of life after lung surgery and the interventions that can help decrease length of stay and improve return to baseline conditions. Correspondence to Alessia Pedoto, MD FASA, Department of Anesthesiology and Critical Care Medicine, 1275 York Ave. Room M301, New York, NY 10065, USA. Tel: +1 212 639 6840; e-mail: pedotoa@mskcc.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Cochlear Promontory Stimulation for Treatment of Tinnitus
Condition: Tinnitus Intervention: Device: Cochlear promontory stimulation Sponsor: Mayo Clinic Active, not recruiting (Source: ClinicalTrials.gov)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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Cochlear Promontory Stimulation for Treatment of Tinnitus
Condition: Tinnitus Intervention: Device: Cochlear promontory stimulation Sponsor: Mayo Clinic Active, not recruiting (Source: ClinicalTrials.gov)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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Improving CarE for Community Acquired Pneumonia
Condition: Pneumonia Childhood Intervention: Behavioral: Decision Support Sponsors: Vanderbilt University Medical Center; National Institute of Allergy and Infectious Diseases (NIAID); University of Utah; Intermountain Health Care, Inc. Not yet recruiting (Source: ClinicalTrials.gov)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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The Pharmacokinetics, Safety, and Tolerability of Abacavir/Dolutegravir/Lamivudine Dispersible and Immediate Release Tablets in HIV-1-Infected Children Less Than 12 Years of Age
Condition: HIV Infections Interventions: Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Dispersible Tablets; Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Immediate Release Tablets (Immediate release) Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); International Maternal Pediatric Adolescent AIDS Clinical Trials Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); ViiV Hea lthcare Ltd. Not yet recruiting (Source: ClinicalTrials.gov)
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The Pharmacokinetics, Safety, and Tolerability of Abacavir/Dolutegravir/Lamivudine Dispersible and Immediate Release Tablets in HIV-1-Infected Children Less Than 12 Years of Age
Condition: HIV Infections Interventions: Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Dispersible Tablets; Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Immediate Release Tablets (Immediate release) Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); International Maternal Pediatric Adolescent AIDS Clinical Trials Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); ViiV Hea lthcare Ltd. 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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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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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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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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Improving CarE for Community Acquired Pneumonia
Condition: Pneumonia Childhood Intervention: Behavioral: Decision Support Sponsors: Vanderbilt University Medical Center; National Institute of Allergy and Infectious Diseases (NIAID); University of Utah; Intermountain Health Care, Inc. Not yet recruiting (Source: ClinicalTrials.gov)
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The Pharmacokinetics, Safety, and Tolerability of Abacavir/Dolutegravir/Lamivudine Dispersible and Immediate Release Tablets in HIV-1-Infected Children Less Than 12 Years of Age
Condition: HIV Infections Interventions: Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Dispersible Tablets; Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Immediate Release Tablets (Immediate release) Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); International Maternal Pediatric Adolescent AIDS Clinical Trials Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); ViiV Hea lthcare Ltd. Not yet recruiting (Source: ClinicalTrials.gov)
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The Pharmacokinetics, Safety, and Tolerability of Abacavir/Dolutegravir/Lamivudine Dispersible and Immediate Release Tablets in HIV-1-Infected Children Less Than 12 Years of Age
Condition: HIV Infections Interventions: Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Dispersible Tablets; Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Immediate Release Tablets (Immediate release) Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); International Maternal Pediatric Adolescent AIDS Clinical Trials Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); ViiV Hea lthcare Ltd. 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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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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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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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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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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Mayo Clinic Minute: Why allergies shouldn't prevent kids from having pets
Having a pet has been proven to improve overall health, but it can be problematic for children who suffer from pet allergies. Pet dander can cause a long list of allergy symptoms, but most of them are fairly easy to treat. Dr. Anupama Ravi, a Mayo Clinic pediatric allergy specialist, says she doesn't think the [...] (Source: News from Mayo Clinic)
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Mayo Clinic Minute: Why allergies shouldn't prevent kids from having pets
Having a pet has been proven to improve overall health, but it can be problematic for children who suffer from pet allergies. Pet dander can cause a long list of allergy symptoms, but most of them are fairly easy to treat. Dr. Anupama Ravi, a Mayo Clinic pediatric allergy specialist, says she doesn't think the [...] (Source: News from Mayo Clinic)
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Mayo Clinic Minute: Why allergies shouldn't prevent kids from having pets
Having a pet has been proven to improve overall health, but it can be problematic for children who suffer from pet allergies. Pet dander can cause a long list of allergy symptoms, but most of them are fairly easy to treat. Dr. Anupama Ravi, a Mayo Clinic pediatric allergy specialist, says she doesn't think the [...] (Source: News from Mayo Clinic)
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Mayo Clinic Minute: Why allergies shouldn't prevent kids from having pets
Having a pet has been proven to improve overall health, but it can be problematic for children who suffer from pet allergies. Pet dander can cause a long list of allergy symptoms, but most of them are fairly easy to treat. Dr. Anupama Ravi, a Mayo Clinic pediatric allergy specialist, says she doesn't think the [...] (Source: News from Mayo Clinic)
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The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.
The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.
Acta Otorhinolaryngol Ital. 2018 Nov 09;:
Authors: Re M, Gioacchini FM, Scarpa A, Cassandro C, Tulli M, Cassandro E
Abstract
The aim of this study was to systematically review publications that investigated the prognostic role of E-cadherin immunostaining in patients affected by laryngeal squamous cell carcinoma. An appropriate string was run on PubMed to retrieve articles dealing with this topic. A double cross-check was performed on citations and full-text articles by two authors independently to analyse all manuscripts and perform a comprehensive quality assessment. Among 89 abstracts identified, 13 articles were included. These studies reported on 1,121 patients with histologically confirmed diagnosis of laryngeal squamous cell carcinoma. Overall, there were 10 studies that showed a significant correlation between E-cadherin immunohistochemical expression and at least one of the clinical and histopathological parameters considered by the authors. In particular E-cadherin expression was significantly associated with N stage (five studies), grading (four studies) and disease-free survival/disease-specific survival (six studies). In conclusion, the findings of our review appear similar to the results published by other authors on the putative role of E-cadherin in progression of malignancy. In fact, for laryngeal squamous cell carcinoma it seems that lower levels of E-cadherin correlate with increased tumoural aggressiveness and worse prognosis. Nevertheless, further high-quality prospective studies should be carried out to clarify if E-cadherin expression may be considered as an independent prognostic factor for patients affected by laryngeal cancer.
PMID: 30499566 [PubMed - as supplied by publisher]
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Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.
| Related Articles |
Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):476-479
Authors: Testani E, De Corso E, Losurdo A, Fiorita A, Vollono C, Marca GD, Scarano E
Abstract
Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCO2, which decreased from 52.3 mmHg before surgery to 42.0 mmHg after surgery. It is conceivable that, due to long-lasting severe OSAS, our patient lowered his chemosensitivity to PCO2. Consequently, the resolution of obstructive apnoeas and the restoration of normal nocturnal values of PCO2 may have reduced the nocturnal PCO2 to the point of being inadequate to stimulate ventilation.
PMID: 30498277 [PubMed - in process]
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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.
| Related Articles |
Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):468-475
Authors: Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH
Abstract
Hearing preservation surgery constitutes a considerable branch of cochlear implantation surgery and is being steadily developed and perfected. The aim of the study was to verify if insertion of a cochlear implant electrode according to individually calculated linear insertion depth improves hearing preservation. We evaluated the relations between the size of a cochlea, insertion depth angle, linear insertion depth and hearing preservation rate (HP) according to Hearing Preservation Classification in a retrospective case review of 54 patients implanted with a slim straight electrode Nucleus CI422 in 2008-2011. Group HP was 0.75 at activation, 0.67 at 12 months (for 53 patients) and 0.60 at 24 months. In 53 cases, the mean insertion depth angle was 375° (SD 17°); mean calculated cochlear duct length 35.87 mm (SD 1.95); mean calculated linear insertion depth 23.14 mm (SD 1.68). There was no significantly relevant relation between HP values and angular insertion depth or insertion depth. Preoperative measurements of cochlea and specific parameters such as linear insertion depth have no effect on hearing preservation. Poor hearing preservation in some deep insertion cases cannot be explained entirely by the electrode position.
PMID: 30498276 [PubMed - in process]
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Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.
| Related Articles |
Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):460-467
Authors: Casani AP, Guidetti G, Schoenhuber R, Consensus Conference Group
Abstract
Ménière's disease is a disorder of the inner ear that causes vertigo, tinnitus, fullness and hearing loss. Although several treatments are available, the success rate is reported to be around 70%, similar to placebo. Betahistine, a weak H1 receptor agonist and an effective H3 receptor antagonist, is frequently prescribed for Ménière's disease, especially to reduce recurrent vertigo attacks. The effects of this drug on hearing and other audiological symptoms remains unclear. Given the inconclusive reports in the literature, we proposed a consensus conference on the use of betahistine in Ménière's disease. The aim was to define best practice criteria for therapy for Ménière's disease, improve clinical suitability and reduce heterogeneity of the therapeutic approach. The consensus conference on betahistine for Ménière's disease involved a group of Italian experts in vestibular disorders who were asked a series of questions prepared by opinion leaders. The Delphi method, an iterative investigation method, was used to increase consensus. Via a tele-voting system, each participant anonymously evaluated all statements using a Likert 5-point scale. Betahistine was considered useful for the treatment of dizziness and vertigo during the intercritical phase of the disease (87% agreeing answers). However, during the acute phase of the disease betahistine was considered less effective and useful only when associated with other drugs (71% agreement). Similarly, the efficacy of the drug was considered low when used to reduce progressive hearing loss, tinnitus, and ear fullness. The experts advocated the use of betahistine during the intercritical phase of Ménière's disease to reduce the number and severity of vertigo attacks. Its use seems to be at low risk of major side effects.
PMID: 30498275 [PubMed - in process]
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Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.
| Related Articles |
Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):453-459
Authors: Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M
Abstract
The present study aims to obtain a probability model allowing prediction of auditory recovery in patients affected by sudden sensorineural hearing loss treated exclusively with intratympanic steroids. A monocentric retrospective chart review of 381 patients has been performed. A Probit model was used to investigate the correlation between the success of treatment (marked or total recovery according to Furuashi's criteria) and the delay between onset of disease and beginning of therapy. The age of patients and audiometric curve shapes were included in the analysis. The results show that delay is negatively correlated with variable success. Considering the entire sample, each day of delay decreases the probability of success by 3%. The prediction model shows that for each day that passes from the onset of the disease the probability of success declines in absence of the medical treatment, hence we conclude that early treatment is strongly recommended.
PMID: 30498274 [PubMed - in process]
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Cochlear implantation in far-advanced otosclerosis: hearing results and complications.
| Related Articles |
Cochlear implantation in far-advanced otosclerosis: hearing results and complications.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):445-452
Authors: Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D
Abstract
Severe forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, complications and hearing outcomes. FAO patients were diagnosed based on medical history, examination and CT scan. Thirty-five ears from FAO patients were compared to 38 control ears. Audiometric results were assessed at least 12 months after implantation by pure tone average, speech reception threshold, monosyllabic and disyllabic word recognition score (WRS) and Central Institute for the Deaf (CID) sentences test. Complications and surgical difficulties were compiled. CT scan findings were categorised within 3 grades of otosclerotic extension. No significant difference was found between FAO and non-FAO hearing outcomes, except that monosyllabic WRS were lower for FAO patients, especially those who underwent previous stapedotomy. Facial nerve symptomatology occurred in 8.6% of FAO patients; among these, one required explantation-reimplantation surgery. 86% of FAO implanted patients had retrofenestral extension on CT. These were associated with poorer disyllabic WRS (51% vs 68%, p < 0.05) than those with only fenestral involvement. Although not significant, high grade of severity on CT tended to be associated with surgical difficulties and complications. Cochlear implantation in FAO patients is an effective treatment technique. Though the overall complication rate is low, it tends to be higher in cases of severe extension on CT. Patient counselling should be adjusted accordingly.
PMID: 30498273 [PubMed - in process]
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Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.
| Related Articles |
Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):439-444
Authors: Procacci P, Lanaro L, Molteni G, Marchioni D, Lonardi F, Fusetti S, Nocini PF, Albanese M
Abstract
Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option.
PMID: 30498272 [PubMed - in process]
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The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.
| Related Articles |
The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):431-438
Authors: Bugova G, Janickova M, Uhliarova B, Babela R, Jesenak M
Abstract
Exposure to tobacco smoke is associated with a higher risk of respiratory tract diseases. The aim of this study was to determine the influence of passive smoking on selected characteristics of children with adenoid hypertrophy. Sixty-one children with adenoid hypertrophy were enrolled in the prospective study. Differences in bacterial colonisation of middle nasal meatus and nasopharynx and changes in selected laboratory immune and inflammatory markers according to the tobacco smoke exposure were analysed. Exposure to tobacco smoke was associated with significantly higher colonisation of pathogenic bacteria and polymicrobial growth of pathogenic bacteria (≥ 2 bacteria) in middle nasal meatus compared to non-exposed children (P = 0.045, P = 0.032, respectively). Identification of pathogenic bacteria in the middle nasal meatus did not correlate with isolation of pathogenic bacteria in the nasopharynx in either group of children. Parameters of humoral immunity in serum, IgA and IgG, were detected at higher concentrations in children exposed to tobacco smoke (P = 0.047, P = 0.031, respectively). Differences in selected parameters of cellular immunity in peripheral blood according to passive smoking were not observed. Tobacco smoke exposure is related to increased colonisation by pathogenic bacteria in middle nasal meatus and elevation of IgA and IgG in peripheral blood, but does not seem to influence markers of cellular immunity parameters in children with adenoid hypertrophy. Avoidance of passive smoking could be recommended as a universal preventive strategy against microbial colonisation of the upper airways and development of various inflammatory diseases in children, e.g. adenoid hypertrophy.
PMID: 30498271 [PubMed - in process]
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Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.
| Related Articles |
Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):424-430
Authors: Milovanovic J, Vukasinovic M, Jotic A, Vlajinac H, Milovanovic A, Pavlovic B, Banko B, Maksimovic J
Abstract
The aim of our study was to compare socio-demographic characteristics of vocal fold nodules, polyps and oedema. The study included patients diagnosed for the first time with vocal fold nodules, polyps and oedema at the Communication Disorders Care Center of Clinic for Otorhinolaryngology and Maxillofacial Surgery in Clinical Center of Serbia, Belgrade. Diagnosis was made on the basis of symptoms, clinical otorhinolaryngological and phoniatric examination and endovideolaryngostroboscopic findings. A self-administered questionnaire was used to collect the following data: socio-demographic status, exposure to occupational noise and air pollution, occupational voice demands, health habits, symptoms of the present voice problems and voice problems in the family. By multivariate logistic regression analyses, nodules and oedema were more frequent in women than men in comparison with polyps (p < 0.001). Patients with nodules and polyps were younger than those with oedema (p < 0.001). Patients with nodules were more frequently lecturers, singers and actors compared with polyp patients (p = 0.006), had occupational voice demands more frequently than patients with oedema (p = 0.037) and were less frequently smokers than patients with polyps (p = 0.043) and those with oedema (p < 0.001). Patients with oedema were more frequently current smokers than patients with nodules and those with polyps (p < 0.001). Hoarseness as the main symptom was more frequent among patients with nodules than among patients with polyps (p = 0.040) and those with oedema (p = 0.001).Voice problems in the family was more frequently reported by oedema patients than by patients with polyps (p = 0.005). These findings are in agreement with majority of previous studies and may be of help in investigations on the aetiology of the disease.
PMID: 30498270 [PubMed - in process]
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Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.
| Related Articles |
Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):417-423
Authors: Fiz I, Koelmel JC, Piazza C, Fiz F, Di Dio D, Bittar Z, Peretti G, Sittel C
Abstract
Idiopathic progressive subglottic stenosis is a rare cause of tracheal narrowing. Partial cricotracheal resection and anastomosis can cure idiopathic stenosis, even if some patients may require multiple interventions and experience voice and swallowing deterioration. We investigated risk factors for retreatment and assessed the impact of crico-tracheal resection on functional parameters. We conducted a retrospective multicentric study on 44 female patients (mean age 52.6 ± 13.1 years) affected by idiopathic stenosis and treated by crico-tracheal resection between 2002 and 2016. Functional outcomes after crico-tracheal resection were assessed by the airway-dyspnoea-voice-swallowing score (range 1-5, with "1" expressing normal and "5" completely altered function). Previous treatments, grade of stenosis, site, airway comorbidities, age and resection length were tested as predictors of postoperative complications and number of additional treatments, using bivariate and multivariate analysis. The overall decannulation rate was 97.3%. The dyspnoea score improved (mean variation 1.4 ± 1.0; p < 0.001), while voice and swallowing were negatively affected (mean variation 1.6 ± 0.9 and 0.5 ± 0.7, respectively; p < 0.001). Airway comorbidities were associated with a higher rate of complications (p < 0.05). Retreatments were more frequent in patients with postoperative complications (p < 0.05). The length of resection correlated with the number of subsequent treatments (R = 0.52; p < 0.01). At multivariate analysis, post-operative complications were predicted by comorbidities and disease stage (p < 0.05); number of retreatments was linked to the length of resection (p < 0.05) as well as with the application of mitomycin C (p < 0.001). Crico-tracheal resection for idiopathic progressive subglottic stenosis offers good functional results in terms of airway patency. These data suggest that a higher complication rate can be expected in patients affected by comorbidities. Moreover, more extensive surgical resection seems to be associated with the occurrence and number of subsequent retreatments. On the contrary, the local application of an anti-proliferative drug does not seem to be of use in preventing recurrences.
PMID: 30498269 [PubMed - in process]
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Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.
| Related Articles |
Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):399-408
Authors: Staderini E, Patini R, De Luca M, Gallenzi P
Abstract
The aim of this systematic review is to analyse the quality and clinical evidence in the literature analysing, through 3D stereophotogrammetry, the nasolabial soft tissue modifications that may occur after rapid maxillary expansion (RME). This systematic literature review was based on the PRISMA-P statement and was registered in the PROSPERO database with the following protocol ID: CRD42017079875. Pubmed, Cochrane, EBSCO, Scopus, Web of Science databases were searched with no restriction of year or publication status. Selection criteria were: randomised clinical trials, controlled clinical trials, cohort studies, cross-sectional studies, case-control studies on patients with unilateral/bilateral crossbite, transverse maxillary deficiency and crowding, treated with RME and monitored by 3D stereophotogrammetry. 652 articles were retrieved in the initial search. After the review process, 11 full-text articles met inclusion criteria. After the evaluation process, 4 publications were included for the present literature review. Due to the heterogeneous methodology meta-analysis was not possible; consequently, a systematic assessment of the studies and summary of the findings from the available evidence were used to answer the research question. The maximum widening of the alar cartilage is 1.41 ± 0.95 mm, whose clinical significance is open to question. The effect of RME on the mouth width remains controversial. In Altindis et al., the difference between pre-treatment and post-treatment mouth width (1.80 mm increment in the banded RME group) was statistically significant, while in Baysal 1.86 mm was considered a non-significant value. Inconsistencies and limitations in the study population and measurement protocols were detected between studies. These data underline the necessity for updated guidelines that allow to standardise, for this type of study, sample selection, measurement methods and collection of results.
PMID: 30498268 [PubMed - in process]
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The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.
The prognostic significance of E-cadherin expression in laryngeal squamous-cell carcinoma: a systematic review.
Acta Otorhinolaryngol Ital. 2018 Nov 09;:
Authors: Re M, Gioacchini FM, Scarpa A, Cassandro C, Tulli M, Cassandro E
Abstract
The aim of this study was to systematically review publications that investigated the prognostic role of E-cadherin immunostaining in patients affected by laryngeal squamous cell carcinoma. An appropriate string was run on PubMed to retrieve articles dealing with this topic. A double cross-check was performed on citations and full-text articles by two authors independently to analyse all manuscripts and perform a comprehensive quality assessment. Among 89 abstracts identified, 13 articles were included. These studies reported on 1,121 patients with histologically confirmed diagnosis of laryngeal squamous cell carcinoma. Overall, there were 10 studies that showed a significant correlation between E-cadherin immunohistochemical expression and at least one of the clinical and histopathological parameters considered by the authors. In particular E-cadherin expression was significantly associated with N stage (five studies), grading (four studies) and disease-free survival/disease-specific survival (six studies). In conclusion, the findings of our review appear similar to the results published by other authors on the putative role of E-cadherin in progression of malignancy. In fact, for laryngeal squamous cell carcinoma it seems that lower levels of E-cadherin correlate with increased tumoural aggressiveness and worse prognosis. Nevertheless, further high-quality prospective studies should be carried out to clarify if E-cadherin expression may be considered as an independent prognostic factor for patients affected by laryngeal cancer.
PMID: 30499566 [PubMed - as supplied by publisher]
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Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.
| Related Articles |
Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):476-479
Authors: Testani E, De Corso E, Losurdo A, Fiorita A, Vollono C, Marca GD, Scarano E
Abstract
Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCO2, which decreased from 52.3 mmHg before surgery to 42.0 mmHg after surgery. It is conceivable that, due to long-lasting severe OSAS, our patient lowered his chemosensitivity to PCO2. Consequently, the resolution of obstructive apnoeas and the restoration of normal nocturnal values of PCO2 may have reduced the nocturnal PCO2 to the point of being inadequate to stimulate ventilation.
PMID: 30498277 [PubMed - in process]
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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.
| Related Articles |
Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):468-475
Authors: Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH
Abstract
Hearing preservation surgery constitutes a considerable branch of cochlear implantation surgery and is being steadily developed and perfected. The aim of the study was to verify if insertion of a cochlear implant electrode according to individually calculated linear insertion depth improves hearing preservation. We evaluated the relations between the size of a cochlea, insertion depth angle, linear insertion depth and hearing preservation rate (HP) according to Hearing Preservation Classification in a retrospective case review of 54 patients implanted with a slim straight electrode Nucleus CI422 in 2008-2011. Group HP was 0.75 at activation, 0.67 at 12 months (for 53 patients) and 0.60 at 24 months. In 53 cases, the mean insertion depth angle was 375° (SD 17°); mean calculated cochlear duct length 35.87 mm (SD 1.95); mean calculated linear insertion depth 23.14 mm (SD 1.68). There was no significantly relevant relation between HP values and angular insertion depth or insertion depth. Preoperative measurements of cochlea and specific parameters such as linear insertion depth have no effect on hearing preservation. Poor hearing preservation in some deep insertion cases cannot be explained entirely by the electrode position.
PMID: 30498276 [PubMed - in process]
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Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.
| Related Articles |
Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):460-467
Authors: Casani AP, Guidetti G, Schoenhuber R, Consensus Conference Group
Abstract
Ménière's disease is a disorder of the inner ear that causes vertigo, tinnitus, fullness and hearing loss. Although several treatments are available, the success rate is reported to be around 70%, similar to placebo. Betahistine, a weak H1 receptor agonist and an effective H3 receptor antagonist, is frequently prescribed for Ménière's disease, especially to reduce recurrent vertigo attacks. The effects of this drug on hearing and other audiological symptoms remains unclear. Given the inconclusive reports in the literature, we proposed a consensus conference on the use of betahistine in Ménière's disease. The aim was to define best practice criteria for therapy for Ménière's disease, improve clinical suitability and reduce heterogeneity of the therapeutic approach. The consensus conference on betahistine for Ménière's disease involved a group of Italian experts in vestibular disorders who were asked a series of questions prepared by opinion leaders. The Delphi method, an iterative investigation method, was used to increase consensus. Via a tele-voting system, each participant anonymously evaluated all statements using a Likert 5-point scale. Betahistine was considered useful for the treatment of dizziness and vertigo during the intercritical phase of the disease (87% agreeing answers). However, during the acute phase of the disease betahistine was considered less effective and useful only when associated with other drugs (71% agreement). Similarly, the efficacy of the drug was considered low when used to reduce progressive hearing loss, tinnitus, and ear fullness. The experts advocated the use of betahistine during the intercritical phase of Ménière's disease to reduce the number and severity of vertigo attacks. Its use seems to be at low risk of major side effects.
PMID: 30498275 [PubMed - in process]
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Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.
| Related Articles |
Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):453-459
Authors: Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M
Abstract
The present study aims to obtain a probability model allowing prediction of auditory recovery in patients affected by sudden sensorineural hearing loss treated exclusively with intratympanic steroids. A monocentric retrospective chart review of 381 patients has been performed. A Probit model was used to investigate the correlation between the success of treatment (marked or total recovery according to Furuashi's criteria) and the delay between onset of disease and beginning of therapy. The age of patients and audiometric curve shapes were included in the analysis. The results show that delay is negatively correlated with variable success. Considering the entire sample, each day of delay decreases the probability of success by 3%. The prediction model shows that for each day that passes from the onset of the disease the probability of success declines in absence of the medical treatment, hence we conclude that early treatment is strongly recommended.
PMID: 30498274 [PubMed - in process]
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Cochlear implantation in far-advanced otosclerosis: hearing results and complications.
| Related Articles |
Cochlear implantation in far-advanced otosclerosis: hearing results and complications.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):445-452
Authors: Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D
Abstract
Severe forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, complications and hearing outcomes. FAO patients were diagnosed based on medical history, examination and CT scan. Thirty-five ears from FAO patients were compared to 38 control ears. Audiometric results were assessed at least 12 months after implantation by pure tone average, speech reception threshold, monosyllabic and disyllabic word recognition score (WRS) and Central Institute for the Deaf (CID) sentences test. Complications and surgical difficulties were compiled. CT scan findings were categorised within 3 grades of otosclerotic extension. No significant difference was found between FAO and non-FAO hearing outcomes, except that monosyllabic WRS were lower for FAO patients, especially those who underwent previous stapedotomy. Facial nerve symptomatology occurred in 8.6% of FAO patients; among these, one required explantation-reimplantation surgery. 86% of FAO implanted patients had retrofenestral extension on CT. These were associated with poorer disyllabic WRS (51% vs 68%, p < 0.05) than those with only fenestral involvement. Although not significant, high grade of severity on CT tended to be associated with surgical difficulties and complications. Cochlear implantation in FAO patients is an effective treatment technique. Though the overall complication rate is low, it tends to be higher in cases of severe extension on CT. Patient counselling should be adjusted accordingly.
PMID: 30498273 [PubMed - in process]
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Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.
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Trans-nasal endoscopic and intra-oral combined approach for odontogenic cysts.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):439-444
Authors: Procacci P, Lanaro L, Molteni G, Marchioni D, Lonardi F, Fusetti S, Nocini PF, Albanese M
Abstract
Maxillary cysts are a common finding in maxillofacial surgery, dentistry and otolaryngology. Treatment is surgical; a traditional approach includes Caldwell-Luc and other intra-oral approaches. In this article, we analyse the outcomes of 9 patients operated on using a combined intra-oral and trans-nasal approach to the aforementioned disease. Although the number of patients is small, the good results of this study suggest that the combined approach might be a reliable treatment option.
PMID: 30498272 [PubMed - in process]
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The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.
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The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):431-438
Authors: Bugova G, Janickova M, Uhliarova B, Babela R, Jesenak M
Abstract
Exposure to tobacco smoke is associated with a higher risk of respiratory tract diseases. The aim of this study was to determine the influence of passive smoking on selected characteristics of children with adenoid hypertrophy. Sixty-one children with adenoid hypertrophy were enrolled in the prospective study. Differences in bacterial colonisation of middle nasal meatus and nasopharynx and changes in selected laboratory immune and inflammatory markers according to the tobacco smoke exposure were analysed. Exposure to tobacco smoke was associated with significantly higher colonisation of pathogenic bacteria and polymicrobial growth of pathogenic bacteria (≥ 2 bacteria) in middle nasal meatus compared to non-exposed children (P = 0.045, P = 0.032, respectively). Identification of pathogenic bacteria in the middle nasal meatus did not correlate with isolation of pathogenic bacteria in the nasopharynx in either group of children. Parameters of humoral immunity in serum, IgA and IgG, were detected at higher concentrations in children exposed to tobacco smoke (P = 0.047, P = 0.031, respectively). Differences in selected parameters of cellular immunity in peripheral blood according to passive smoking were not observed. Tobacco smoke exposure is related to increased colonisation by pathogenic bacteria in middle nasal meatus and elevation of IgA and IgG in peripheral blood, but does not seem to influence markers of cellular immunity parameters in children with adenoid hypertrophy. Avoidance of passive smoking could be recommended as a universal preventive strategy against microbial colonisation of the upper airways and development of various inflammatory diseases in children, e.g. adenoid hypertrophy.
PMID: 30498271 [PubMed - in process]
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Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.
| Related Articles |
Relationship between socio-demographic characteristics and vocal fold nodules, polyps and oedema.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):424-430
Authors: Milovanovic J, Vukasinovic M, Jotic A, Vlajinac H, Milovanovic A, Pavlovic B, Banko B, Maksimovic J
Abstract
The aim of our study was to compare socio-demographic characteristics of vocal fold nodules, polyps and oedema. The study included patients diagnosed for the first time with vocal fold nodules, polyps and oedema at the Communication Disorders Care Center of Clinic for Otorhinolaryngology and Maxillofacial Surgery in Clinical Center of Serbia, Belgrade. Diagnosis was made on the basis of symptoms, clinical otorhinolaryngological and phoniatric examination and endovideolaryngostroboscopic findings. A self-administered questionnaire was used to collect the following data: socio-demographic status, exposure to occupational noise and air pollution, occupational voice demands, health habits, symptoms of the present voice problems and voice problems in the family. By multivariate logistic regression analyses, nodules and oedema were more frequent in women than men in comparison with polyps (p < 0.001). Patients with nodules and polyps were younger than those with oedema (p < 0.001). Patients with nodules were more frequently lecturers, singers and actors compared with polyp patients (p = 0.006), had occupational voice demands more frequently than patients with oedema (p = 0.037) and were less frequently smokers than patients with polyps (p = 0.043) and those with oedema (p < 0.001). Patients with oedema were more frequently current smokers than patients with nodules and those with polyps (p < 0.001). Hoarseness as the main symptom was more frequent among patients with nodules than among patients with polyps (p = 0.040) and those with oedema (p = 0.001).Voice problems in the family was more frequently reported by oedema patients than by patients with polyps (p = 0.005). These findings are in agreement with majority of previous studies and may be of help in investigations on the aetiology of the disease.
PMID: 30498270 [PubMed - in process]
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Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.
| Related Articles |
Predictors of recurrence after surgical treatment of idiopathic progressive subglottic stenosis.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):417-423
Authors: Fiz I, Koelmel JC, Piazza C, Fiz F, Di Dio D, Bittar Z, Peretti G, Sittel C
Abstract
Idiopathic progressive subglottic stenosis is a rare cause of tracheal narrowing. Partial cricotracheal resection and anastomosis can cure idiopathic stenosis, even if some patients may require multiple interventions and experience voice and swallowing deterioration. We investigated risk factors for retreatment and assessed the impact of crico-tracheal resection on functional parameters. We conducted a retrospective multicentric study on 44 female patients (mean age 52.6 ± 13.1 years) affected by idiopathic stenosis and treated by crico-tracheal resection between 2002 and 2016. Functional outcomes after crico-tracheal resection were assessed by the airway-dyspnoea-voice-swallowing score (range 1-5, with "1" expressing normal and "5" completely altered function). Previous treatments, grade of stenosis, site, airway comorbidities, age and resection length were tested as predictors of postoperative complications and number of additional treatments, using bivariate and multivariate analysis. The overall decannulation rate was 97.3%. The dyspnoea score improved (mean variation 1.4 ± 1.0; p < 0.001), while voice and swallowing were negatively affected (mean variation 1.6 ± 0.9 and 0.5 ± 0.7, respectively; p < 0.001). Airway comorbidities were associated with a higher rate of complications (p < 0.05). Retreatments were more frequent in patients with postoperative complications (p < 0.05). The length of resection correlated with the number of subsequent treatments (R = 0.52; p < 0.01). At multivariate analysis, post-operative complications were predicted by comorbidities and disease stage (p < 0.05); number of retreatments was linked to the length of resection (p < 0.05) as well as with the application of mitomycin C (p < 0.001). Crico-tracheal resection for idiopathic progressive subglottic stenosis offers good functional results in terms of airway patency. These data suggest that a higher complication rate can be expected in patients affected by comorbidities. Moreover, more extensive surgical resection seems to be associated with the occurrence and number of subsequent retreatments. On the contrary, the local application of an anti-proliferative drug does not seem to be of use in preventing recurrences.
PMID: 30498269 [PubMed - in process]
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Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.
| Related Articles |
Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: a systematic review of clinical trials.
Acta Otorhinolaryngol Ital. 2018 Oct;38(5):399-408
Authors: Staderini E, Patini R, De Luca M, Gallenzi P
Abstract
The aim of this systematic review is to analyse the quality and clinical evidence in the literature analysing, through 3D stereophotogrammetry, the nasolabial soft tissue modifications that may occur after rapid maxillary expansion (RME). This systematic literature review was based on the PRISMA-P statement and was registered in the PROSPERO database with the following protocol ID: CRD42017079875. Pubmed, Cochrane, EBSCO, Scopus, Web of Science databases were searched with no restriction of year or publication status. Selection criteria were: randomised clinical trials, controlled clinical trials, cohort studies, cross-sectional studies, case-control studies on patients with unilateral/bilateral crossbite, transverse maxillary deficiency and crowding, treated with RME and monitored by 3D stereophotogrammetry. 652 articles were retrieved in the initial search. After the review process, 11 full-text articles met inclusion criteria. After the evaluation process, 4 publications were included for the present literature review. Due to the heterogeneous methodology meta-analysis was not possible; consequently, a systematic assessment of the studies and summary of the findings from the available evidence were used to answer the research question. The maximum widening of the alar cartilage is 1.41 ± 0.95 mm, whose clinical significance is open to question. The effect of RME on the mouth width remains controversial. In Altindis et al., the difference between pre-treatment and post-treatment mouth width (1.80 mm increment in the banded RME group) was statistically significant, while in Baysal 1.86 mm was considered a non-significant value. Inconsistencies and limitations in the study population and measurement protocols were detected between studies. These data underline the necessity for updated guidelines that allow to standardise, for this type of study, sample selection, measurement methods and collection of results.
PMID: 30498268 [PubMed - in process]
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Subjective analysis of the application of enhancement filters on magnetic resonance imaging of the temporomandibular joint
The aim of this research was to study the effect of enhancement filters on the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ).
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EVALUATION OF MAXILLARY TRABECULAR MICROSTRUCTURE BY USING TWO CBCT SYSTEMS AND MICRO-CT
To assess trabecular microarchitecture of the maxilla by using Cone-beam computed tomography (CBCT) and microcomputed tomography (micro-CT) ex vivo.
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The value of the apparent diffusion coefficient calculated from diffusion-weighted magnetic resonance images in the differentiation of maxillary sinus inflammatory diseases
This study examined the value of the apparent diffusion coefficient (ADC) calculated in diffusion-weighted magnetic resonance images (DWI) in the differentiation of inflammatory lesions of the maxillary sinus.
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Subjective analysis of the application of enhancement filters on magnetic resonance imaging of the temporomandibular joint
The aim of this research was to study the effect of enhancement filters on the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ).
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EVALUATION OF MAXILLARY TRABECULAR MICROSTRUCTURE BY USING TWO CBCT SYSTEMS AND MICRO-CT
To assess trabecular microarchitecture of the maxilla by using Cone-beam computed tomography (CBCT) and microcomputed tomography (micro-CT) ex vivo.
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The value of the apparent diffusion coefficient calculated from diffusion-weighted magnetic resonance images in the differentiation of maxillary sinus inflammatory diseases
This study examined the value of the apparent diffusion coefficient (ADC) calculated in diffusion-weighted magnetic resonance images (DWI) in the differentiation of inflammatory lesions of the maxillary sinus.
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Effect of periodontal treatment on Aggregatibacter actinomycetemcomitans (Aa) colonization and serum IgG levels against Aa serotypes and Omp29 of aggressive periodontitis patients
Abstract
Objective
To evaluate the effect of the periodontal treatment on A. actinomycetemcomitans (Aa) JP2 clone, and the IgG serum levels against its outer membrane protein (Omp29) and Aa serotypes in aggressive periodontitis (AgP).
Subjects and Methods
Seventeen patients with generalized (GAgP), 10 with localized (LAgP) and 10 healthy controls were included. AgP participants were submitted to periodontal treatment – scaling and root planing plus antibiotics (SRP+A). Periodontal parameters, e.g. probing depth [PD] and clinical attachment loss [CAL]), were evaluated at baseline and at 1‐year. Serum IgG against Omp29 and serotypes a, b and c were determined by ELISA. The levels of Aa JP2 clone were determined in subgingival biofilm samples by qPCR.
Results
Periodontal treatment resulted in significant reductions of PD, CAL, and IgG levels against Omp29, serotypes b and c. After therapy, IgG levels against Aa serotypes, as well as the levels of the JP2 clone in AgP became similar to controls. The reduction in JP2 clone count was correlated with a reduction of PD and IgG response against Omp29.
Conclusion
SRP+A decreased IgG levels response against Omp29 and Aa serotypes involved in the disease (b and c), while the serum‐response increased against tne commensal serotype (a), similar to what occurs in periodontally healthy individuals.
This article is protected by copyright. All rights reserved.
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NTN1 gene was risk to NSCLO among Han Chinese Population
Abstract
Objective
Genome wide association studies (GWAS) found NTN1, NOG and the region between CREBBP and ADCY9 were risks to non‐syndromic cleft lip with or without cleft palate (NSCL/P). However, the association of single nucleotide polymorphisms (SNPs) in these genes with NSCL/P in Western China is unknown.
Subjects and Methods
We selected seven SNPs in NTN1, NOG and between CREBBP and ADCY9, then performed transmission disequilibrium test (TDT), parent‐of‐origin effect and sliding window haplotype analysis to test the associations among 302 NSCL/P case‐parent trios from Western Han Chinese.
Results
We found allele G at rs4791774 in NTN1 was significantly over‐transmitted among non‐syndromic cleft lip only (NSCLO) (P=0.0067, OR=1.79, 95%CI: 1.17‐2.74); rs4791774 and rs9915089 tightly linked with each other among NSCL/P (D'=0.87, r2=0.67) and haplotypes carrying the risk allele G at rs4791774 were always found to be over‐transmitted from parents to cases. Motif analysis indicated that allele G at rs4791774 could greatly alter the affinity of Myc_disc7, so allele G at rs4791774 in NTN1 might modulate C‐MYC transcription to participate in the etiology of NSCLO.
Conclusions
Our study suggested allele G at rs4791774 in NTN1 gene is risk for NSCLO, which could greatly increase the risk to have a baby with cleft.
This article is protected by copyright. All rights reserved.
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Effect of periodontal treatment on Aggregatibacter actinomycetemcomitans (Aa) colonization and serum IgG levels against Aa serotypes and Omp29 of aggressive periodontitis patients
Abstract
Objective
To evaluate the effect of the periodontal treatment on A. actinomycetemcomitans (Aa) JP2 clone, and the IgG serum levels against its outer membrane protein (Omp29) and Aa serotypes in aggressive periodontitis (AgP).
Subjects and Methods
Seventeen patients with generalized (GAgP), 10 with localized (LAgP) and 10 healthy controls were included. AgP participants were submitted to periodontal treatment – scaling and root planing plus antibiotics (SRP+A). Periodontal parameters, e.g. probing depth [PD] and clinical attachment loss [CAL]), were evaluated at baseline and at 1‐year. Serum IgG against Omp29 and serotypes a, b and c were determined by ELISA. The levels of Aa JP2 clone were determined in subgingival biofilm samples by qPCR.
Results
Periodontal treatment resulted in significant reductions of PD, CAL, and IgG levels against Omp29, serotypes b and c. After therapy, IgG levels against Aa serotypes, as well as the levels of the JP2 clone in AgP became similar to controls. The reduction in JP2 clone count was correlated with a reduction of PD and IgG response against Omp29.
Conclusion
SRP+A decreased IgG levels response against Omp29 and Aa serotypes involved in the disease (b and c), while the serum‐response increased against tne commensal serotype (a), similar to what occurs in periodontally healthy individuals.
This article is protected by copyright. All rights reserved.
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NTN1 gene was risk to NSCLO among Han Chinese Population
Abstract
Objective
Genome wide association studies (GWAS) found NTN1, NOG and the region between CREBBP and ADCY9 were risks to non‐syndromic cleft lip with or without cleft palate (NSCL/P). However, the association of single nucleotide polymorphisms (SNPs) in these genes with NSCL/P in Western China is unknown.
Subjects and Methods
We selected seven SNPs in NTN1, NOG and between CREBBP and ADCY9, then performed transmission disequilibrium test (TDT), parent‐of‐origin effect and sliding window haplotype analysis to test the associations among 302 NSCL/P case‐parent trios from Western Han Chinese.
Results
We found allele G at rs4791774 in NTN1 was significantly over‐transmitted among non‐syndromic cleft lip only (NSCLO) (P=0.0067, OR=1.79, 95%CI: 1.17‐2.74); rs4791774 and rs9915089 tightly linked with each other among NSCL/P (D'=0.87, r2=0.67) and haplotypes carrying the risk allele G at rs4791774 were always found to be over‐transmitted from parents to cases. Motif analysis indicated that allele G at rs4791774 could greatly alter the affinity of Myc_disc7, so allele G at rs4791774 in NTN1 might modulate C‐MYC transcription to participate in the etiology of NSCLO.
Conclusions
Our study suggested allele G at rs4791774 in NTN1 gene is risk for NSCLO, which could greatly increase the risk to have a baby with cleft.
This article is protected by copyright. All rights reserved.
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Issue Information
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Diagnostic and other challenges
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Developments in the field of allergy in 2017 through the eyes of Clinical and Experimental Allergy
Summary
In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2017. Experimental models of allergic disease, basic mechanisms, clinical mechanisms, allergens, asthma and rhinitis and clinical allergy are all covered.
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Best of the Other Journals
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Forthcoming Meetings
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Cover Image
The cover image is based on the Original Article Monocytes accumulate in the airways of children with fatal asthma by Ibon Eguíluz‐Gracia et al, DOI: https://doi.org/10.1111/cea.13265.
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Issue Information
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Diagnostic and other challenges
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Developments in the field of allergy in 2017 through the eyes of Clinical and Experimental Allergy
Summary
In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2017. Experimental models of allergic disease, basic mechanisms, clinical mechanisms, allergens, asthma and rhinitis and clinical allergy are all covered.
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Best of the Other Journals
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Forthcoming Meetings
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Cover Image
The cover image is based on the Original Article Monocytes accumulate in the airways of children with fatal asthma by Ibon Eguíluz‐Gracia et al, DOI: https://doi.org/10.1111/cea.13265.
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Inhibition of autophagy by chloroquine makes chemotherapy in nasopharyngeal carcinoma more efficient
A combination of platinum-based chemotherapy and radiotherapy is the standard treatment for nasopharyngeal carcinoma (NPC). However, the efficacy of chemotherapy has reached a plateau. Many autophagy studies suggest that autophagy can either promote or suppress to cancer progression. Thus, a role of autophagy in the acquisition of chemoradioresistance has recently been a notable event. Therefore, we examined the relationship between autophagy and chemotherapy in NPC.
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Inhibition of autophagy by chloroquine makes chemotherapy in nasopharyngeal carcinoma more efficient
A combination of platinum-based chemotherapy and radiotherapy is the standard treatment for nasopharyngeal carcinoma (NPC). However, the efficacy of chemotherapy has reached a plateau. Many autophagy studies suggest that autophagy can either promote or suppress to cancer progression. Thus, a role of autophagy in the acquisition of chemoradioresistance has recently been a notable event. Therefore, we examined the relationship between autophagy and chemotherapy in NPC.
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Cochlear implantation in far-advanced otosclerosis: hearing results and complications.
Authors: Dumas AR, Schwalje AT, Franco-Vidal V, Bébéar JP, Darrouzet V, Bonnard D Abstract Severe forms of otosclerosis known as far-advanced otosclerosis (FAO) can lead to severe to profound sensorineural hearing loss and can justify cochlear implantation. Because of the pathophysiology of otosclerosis, patients implanted for FAO may experience an increased rate of complications, such as facial nerve stimulation or electrode dislocation, and may have poorer hearing outcomes than expected. This retrospective study aimed to compare cochlear implantation hearing outcomes, surgical difficulties and complications in FAO patients versus non-FAO patients. Moreover, we evaluated whether high resolution computed tomography (CT scan) findings were predictive of perioperative problems, com...
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Report from a Consensus Conference on the treatment of M énière's disease with betahistine: rationale, methodology and results.
Report from a Consensus Conference on the treatment of Ménière's disease with betahistine: rationale, methodology and results. Acta Otorhinolaryngol Ital. 2018 Oct;38(5):460-467 Authors: Casani AP, Guidetti G, Schoenhuber R, Consensus Conference Group Abstract Ménière's disease is a disorder of the inner ear that causes vertigo, tinnitus, fullness and hearing loss. Although several treatments are available, the success rate is reported to be around 70%, similar to placebo. Betahistine, a weak H1 receptor agonist and an effective H3 receptor antagonist, is frequently prescribed for Ménière's disease, especially to reduce recurrent vertigo attacks. The effects of this drug on hearing and other audiological symptoms remains unclear. Given the inconclusive reports in...
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Radiologic measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach.
Authors: Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH Abstract Hearing preservation surgery constitutes a considerable branch of cochlear implantation surgery and is being steadily developed and perfected. The aim of the study was to verify if insertion of a cochlear implant electrode according to individually calculated linear insertion depth improves hearing preservation. We evaluated the relations between the size of a cochlea, insertion depth angle, linear insertion depth and hearing preservation rate (HP) according to Hearing Preservation Classification in a retrospective case review of 54 patients implanted with a slim straight electrode Nucleus CI422 in 2008-2011. Group HP was 0.75 at activation, 0.67 at 12 months (for 53 patients) and ...
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Prediction of hearing recovery in sudden deafness treated with intratympanic steroids.
Authors: Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M Abstract The present study aims to obtain a probability model allowing prediction of auditory recovery in patients affected by sudden sensorineural hearing loss treated exclusively with intratympanic steroids. A monocentric retrospective chart review of 381 patients has been performed. A Probit model was used to investigate the correlation between the success of treatment (marked or total recovery according to Furuashi's criteria) and the delay between onset of disease and beginning of therapy. The age of patients and audiometric curve shapes were included in the analysis. The results show that delay is negatively correlated with variable success. Considering the entire sample, each da...
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