Chronic recurrent osteomyelitis: a surgeon's enigma

Abstract

Background

Chronic recurrent forms of osteomyelitis of the mandible with their morbid clinical course have long been considered a challenge to maxillofacial surgeons in terms of both diagnosis and treatment. Various classifications and treatments have been established through the ages to define and manage the inflammatory symptoms occurring in adults and children. This paper discusses two such entities occurring in an adult and a child, highlighting the diagnostic and treatment challenges of recurrent osteomyelitis.

Methods

A thorough work up which included clinical, radiographic, blood investigations was done, followed by administration of antibiotics and anti‐inflammatory with or without surgical debridement / adjuvant therapies. Correlation of our findings and treatment plan was done with evidence based literature and practice.

Results

Complete resolution of symptoms with radiographic evidence were achieved in both the cases. In the recurrence period, long term steroids, NSAIDs, antibiotics resulted in better outcomes.

Conclusion

The evidence based protocol for osteomyelitis stresses on short inpatient stays predicated on efficient literature. Thorough clinical and radiographic evaluation with aggressive medical management and surgical intervention when necessary can result in longer symptom free periods. Thus understanding the disease, recurrence pattern and response to therapy is essential.

This article is protected by copyright. All rights reserved.

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Unilateral Sudden Sensorineural Hearing Loss: A Rare Presentation of Cerebral Venous Thrombosis

Abstract

Sudden sensorineural hearing loss (SNHL) is postulated to be caused due to a multitude of factors, but a definitive cause is seldom found despite extensive investigations. We present a rare case of sudden SNHL in which central venous thrombosis was found on magnetic resonance imaging. The case highlights the importance of neuroimaging in all cases of sudden SNHL before being labelled as "idiopathic" so that targeted therapy can be given.

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Impact of Classroom Determinants on Psychosocial Aspects of Voice Among School Teachers of Indore, India: A Preliminary Survey

Abstract

Teaching voice is the professional voice; often different in quality from our day-to-day speaking voice, and is supposed to be subjected to vocal abuse, misuse and overuse. This paper aims towards highlighting  the various classroom determinants that may impact teacher's voice and how these impacts can affect the daily activities in terms of functional emotional and psychosocial aspects. To understand the same, a cross sectional prospective study was conducted across eight English medium institutions of Indore (a city in central India) region. The study was carried out in three phases: formulation of a questionnaire, data collection (through administration of the questionnaire and VHI among sixty school teachers) followed by data analysis, to determine whether any association exists between the various classroom determinants and voice impairment. Significant association was found between determinants like teaching experience; number of classes, duration of breaks, use of any alternate method of teaching and alternate use of any amplification device with physical, emotional and functional aspects of life. The findings holistically indicate that various factors within the classroom environment only has a significant bearing on the voice disturbances of a school teacher's life thus deteriorating their quality of life. Thus it is substantial to begin a training programme by speech language pathologists in order to heighten awareness among teachers. After all voice disturbances are a real and treatable condition and with the right amount of training can be avoided.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Bxp2j0

Chronic recurrent osteomyelitis: a surgeon's enigma

Abstract

Background

Chronic recurrent forms of osteomyelitis of the mandible with their morbid clinical course have long been considered a challenge to maxillofacial surgeons in terms of both diagnosis and treatment. Various classifications and treatments have been established through the ages to define and manage the inflammatory symptoms occurring in adults and children. This paper discusses two such entities occurring in an adult and a child, highlighting the diagnostic and treatment challenges of recurrent osteomyelitis.

Methods

A thorough work up which included clinical, radiographic, blood investigations was done, followed by administration of antibiotics and anti‐inflammatory with or without surgical debridement / adjuvant therapies. Correlation of our findings and treatment plan was done with evidence based literature and practice.

Results

Complete resolution of symptoms with radiographic evidence were achieved in both the cases. In the recurrence period, long term steroids, NSAIDs, antibiotics resulted in better outcomes.

Conclusion

The evidence based protocol for osteomyelitis stresses on short inpatient stays predicated on efficient literature. Thorough clinical and radiographic evaluation with aggressive medical management and surgical intervention when necessary can result in longer symptom free periods. Thus understanding the disease, recurrence pattern and response to therapy is essential.

This article is protected by copyright. All rights reserved.

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Immunohistochemical Assessment of BAP1 Protein in Mucoepidermoid Carcinomas

Abstract

Mucoepidermoid carcinomas are common malignant salivary gland tumors. Despite recent advances in diagnosis and treatment, there has not been much improvement in outcome of these patients, necessitating identification of novel targeted therapeutic agents. Genomic profiling of mucoepidermoid carcinomas has recently revealed aberrations in BAP1 gene. Therefore, we conducted this study to identify BAP1 loss by immunohistochemistry in these tumors. Mucoepidermoid carcinoma cases were retrieved; hematoxylin-and-eosin stained sections were reviewed. Immunohistochemistry for BAP1 was performed. Forty cases were assessed, including 25 salivary gland and 15 pulmonary mucoepidermoid carcinomas. There were 19 cases in the parotid (76%), two in submandibular gland (8%), and remaining 16% from minor salivary gland locations. Ten (40%) were low grade, nine (36%) were intermediate grade, and six (24%) were high grade mucoepidermoid carcinomas. Thirteen (86.7%) pulmonary mucoepidermoid carcinomas were tracheobronchial, while two (13.3%) were intraparenchymal; all were low grade mucoepidermoid carcinomas. On immunohistochemistry, BAP1 nuclear staining was retained in all cases (100%), irrespective of tumor location or grade. Therapeutic connotations necessitate the identification of readily applicable techniques to detect BAP1 loss in mucoepidermoid carcinomas. Using immunohistochemistry, loss of BAP1 staining was not seen in any of our cases, suggesting insensitivity of BAP1 IHC to detect aberrations at genomic level in these tumors. Analysis of BAP1 alterations by targeted sequencing may therefore be performed prior to excluding the possibility of response to BAP1-targeted therapeutics based on immunohistochemistry alone.

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Unilateral Sudden Sensorineural Hearing Loss: A Rare Presentation of Cerebral Venous Thrombosis

Abstract

Sudden sensorineural hearing loss (SNHL) is postulated to be caused due to a multitude of factors, but a definitive cause is seldom found despite extensive investigations. We present a rare case of sudden SNHL in which central venous thrombosis was found on magnetic resonance imaging. The case highlights the importance of neuroimaging in all cases of sudden SNHL before being labelled as "idiopathic" so that targeted therapy can be given.

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

Impact of Classroom Determinants on Psychosocial Aspects of Voice Among School Teachers of Indore, India: A Preliminary Survey

Abstract

Teaching voice is the professional voice; often different in quality from our day-to-day speaking voice, and is supposed to be subjected to vocal abuse, misuse and overuse. This paper aims towards highlighting  the various classroom determinants that may impact teacher's voice and how these impacts can affect the daily activities in terms of functional emotional and psychosocial aspects. To understand the same, a cross sectional prospective study was conducted across eight English medium institutions of Indore (a city in central India) region. The study was carried out in three phases: formulation of a questionnaire, data collection (through administration of the questionnaire and VHI among sixty school teachers) followed by data analysis, to determine whether any association exists between the various classroom determinants and voice impairment. Significant association was found between determinants like teaching experience; number of classes, duration of breaks, use of any alternate method of teaching and alternate use of any amplification device with physical, emotional and functional aspects of life. The findings holistically indicate that various factors within the classroom environment only has a significant bearing on the voice disturbances of a school teacher's life thus deteriorating their quality of life. Thus it is substantial to begin a training programme by speech language pathologists in order to heighten awareness among teachers. After all voice disturbances are a real and treatable condition and with the right amount of training can be avoided.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Bxp2j0

Ocular Posterior Segment Involvement in Patients with Antiphospholipid Syndrome and Systemic Lupus Erythematosus.

CONCLUSION: Venous tortuosity was significantly more in patients with APS. There was no significant difference for other ocular findings between the groups. Ocular complication rate was lower compared to earlier reports, probably due to better management of disease activity with current treatment protocols. PMID: 30556792 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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Comparison of Spectral Domain Optical Coherence Tomography (SD OCT) Findings with Laser Flare Photometry (LFP) Measurements in Beh çet's Uveitis.

CONCLUSION: Flare is a reliable indicator of the inflammation in Behçet's uveitis. Its concurrent use with OCT to evaluate choroid and macula enables the assessment of inflammation. PMID: 30556759 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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Modified No-Touch Technique for Removal of a Dexamethasone Implant that has Migrated to the Anterior Chamber.

Authors: Stewart JM Abstract The dexamethasone intravitreal implant poses a risk to the cornea if it migrates into the anterior chamber. Because it tends to fracture if grasped with surgical instruments, no-touch techniques represent the most successful means of removing the device from the eye. The present report describes a new approach in which the implant is aspirated into the lumen of a needle, providing the surgeon with greater control in accessing the device within the anterior chamber. PMID: 30556778 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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Measuring disease activity and response to treatment in rheumatoid arthritis.

Authors: Buzatu C, Moots RJ Abstract INTRODUCTION: Effective treatment of rheumatoid arthritis (RA) requires suppression of the underlying inflammation. Measurement of such inflammation, the disease activity, is mandatory to target treatment and maximize outcomes. However, this is not as straightforward as it may seem. Areas covered: The many tools developed to measure disease activity in RA, from composite scores and patient reported outcomes, to laboratory markers and imaging are discussed, with a focus on their utility in guiding therapy and assessing response. The complex issues in measuring disease activity in RA, whether in clinical trials or normal clinical practice, and in the context of national guidelines and recommendations, available time and resources are considered. E...

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

Ocular Posterior Segment Involvement in Patients with Antiphospholipid Syndrome and Systemic Lupus Erythematosus.

CONCLUSION: Venous tortuosity was significantly more in patients with APS. There was no significant difference for other ocular findings between the groups. Ocular complication rate was lower compared to earlier reports, probably due to better management of disease activity with current treatment protocols. PMID: 30556792 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2LnUIM0

Comparison of Spectral Domain Optical Coherence Tomography (SD OCT) Findings with Laser Flare Photometry (LFP) Measurements in Beh çet's Uveitis.

CONCLUSION: Flare is a reliable indicator of the inflammation in Behçet's uveitis. Its concurrent use with OCT to evaluate choroid and macula enables the assessment of inflammation. PMID: 30556759 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rK5mnp

Familial Nanophthalmos Presenting with Spontaneous Uveal Effusion Syndrome.

CONCLUSION: This is the first report of familial nanophthalmos presenting with spontaneous UES. PMID: 30556758 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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Modified No-Touch Technique for Removal of a Dexamethasone Implant that has Migrated to the Anterior Chamber.

Authors: Stewart JM Abstract The dexamethasone intravitreal implant poses a risk to the cornea if it migrates into the anterior chamber. Because it tends to fracture if grasped with surgical instruments, no-touch techniques represent the most successful means of removing the device from the eye. The present report describes a new approach in which the implant is aspirated into the lumen of a needle, providing the surgeon with greater control in accessing the device within the anterior chamber. PMID: 30556778 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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

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

Ocular Involvement in Muckle-Wells Syndrome.

CONCLUSION: MWS is a rare systemic autoinflammatory disorder that presents with a variety of ocular findings. Exacerbation of systemic and ocular findings with cold is a hallmark of the disease. PMID: 30556770 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

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Feasibility of MR-only radiation planning for hypofractionated stereotactic radiotherapy of schwannomas using non-coplanar volumetric modulated arc therapy

Abstract

Purpose

To compare the dose calculation accuracy of plans done on a CT density-assigned MR image set for hypofractionated stereotactic radiotherapy (HSRT) using volumetric modulated radiation therapy containing non-coplanar beams.

Methods

Eighteen patients diagnosed with schwannoma treated with HSRT were selected retrospectively. These patients underwent planning CT (pCT) for radiation therapy (RT) and contrast-enhanced three-dimensional fast-spoiled gradient-echo image (3D FSPGR) to assist tumor delineation. CT_plan is plan done on pCT. The structures body, bone, and air are contoured exclusively on MR image and assigned Hounsfield units of 25, + 1000, and − 1000, respectively. This is termed as MRCT. After registration, original plans from pCT are pasted on the MRCT. Dose calculation is done in two ways: (1) with preset MU values (DDC) and (2) with optimization (OPT_DC). Conformity indices and D_max and D_0.5cc of brainstem, gamma agreement index and correlation coefficient are analyzed. ANOVA test is carried out to find the significance of difference between plans.

Results

The mean deviations of D_max and D_0.5cc of brainstem for CT_plan versus DDC are 2.49% and 1.45% respectively. The mean deviations of D_max and D_0.5cc of brainstem for CT_plan versus OPT_DC are − 1.56% and − 1.97%, respectively. Mean deviations of conformity index for DDC and OPT_DC are 0.84% and 0.89%, respectively. No significant difference was found with ANOVA test.

Conclusion

Results show that there is no difference between plans generated with actual CT data and MRCT data. Thus MR scans could be employed for radiation planning provided the verification image is available. This gives us confidence to reduce treatment margins where image registration process is avoided.

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Natural language processing yields rad-path correlation - AuntMinnie

Natural language processing yields rad-path correlation  AuntMinnie

December 19, 2018 -- The combination of open-source natural language processing (NLP) technology and commonly used radiology structured reporting ...

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Pharma Stock Roundup: AZN, RHHBY Cancer Drugs, LLY, BMY New Deals in Focus - Zacks.com

Pharma Stock Roundup: AZN, RHHBY Cancer Drugs, LLY, BMY New Deals in Focus  Zacks.com

AstraZeneca's (AZN) Imfinzi misses endpoint in study. Roche's (RHHBY) cancer drug combo gets FDA nod for first-line lung cancer. Lilly (LLY) & Bristol Myers ...

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Natural language processing yields rad-path correlation - AuntMinnie

Natural language processing yields rad-path correlation  AuntMinnie

December 19, 2018 -- The combination of open-source natural language processing (NLP) technology and commonly used radiology structured reporting ...

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Pharma Stock Roundup: AZN, RHHBY Cancer Drugs, LLY, BMY New Deals in Focus - Zacks.com

Pharma Stock Roundup: AZN, RHHBY Cancer Drugs, LLY, BMY New Deals in Focus  Zacks.com

AstraZeneca's (AZN) Imfinzi misses endpoint in study. Roche's (RHHBY) cancer drug combo gets FDA nod for first-line lung cancer. Lilly (LLY) & Bristol Myers ...

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Obesity at fault for 4 percent of cancers worldwide, study says - UPI.com

Obesity at fault for 4 percent of cancers worldwide, study says  UPI.com

Overweight and obesity accounted for nearly 4 percent of all cancers globally in 2012, and that rate is likely to rise in coming decades, a new study suggests.

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Obesity at fault for 4 percent of cancers worldwide, study says - UPI.com

Obesity at fault for 4 percent of cancers worldwide, study says  UPI.com

Overweight and obesity accounted for nearly 4 percent of all cancers globally in 2012, and that rate is likely to rise in coming decades, a new study suggests.

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Congenital Hypothyroidism due to Oligogenic Mutations in Two Sudanese Families

Thyroid, Ahead of Print.


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National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


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Incidence of Neonatal Hyperthyroidism Among Newborns of Graves' Disease Patients Treated with Radioiodine Therapy

Thyroid, Ahead of Print.


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Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


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Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China

Thyroid, Volume 28, Issue 12, Page 1674-1681, December 2018.


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Future Meetings

Thyroid, Volume 28, Issue 12, Page 1729-1730, December 2018.


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Effects of noise exposure on auditory brainstem response and speech-in-noise tasks: a review of the literature

. (Source: International Journal of Audiology)

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Turning a blind eye and a deaf ear to traditional and complementary medicine practice does not make it go away: a qualitative study exploring perceptions and attitudes of stakeholders towards the integration of traditional and complementary medicine into medical school curriculum in Uganda

A substantial proportion of healthcare professionals have inadequate understanding of traditional and complementary medicine and often consider their use inappropriate. (Source: BMC Medical Education)

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Reported benefits of peer support group involvement by adults with hearing loss

. (Source: International Journal of Audiology)

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Effects of noise exposure on auditory brainstem response and speech-in-noise tasks: a review of the literature

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Gv2JQJ

Congenital Hypothyroidism due to Oligogenic Mutations in Two Sudanese Families

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Gr4ezf

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R8JS1C

Clinical Applicability of Low Levels of Thyroglobulin Autoantibodies as Cutoff Point for Thyroglobulin Autoantibody Positivity

Thyroid, Ahead of Print.


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

Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


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

Correction to: Cardiovascular Morbidity and Mortality After Treatment of Hyperthyroidism with Either Radioactive Iodine or Thyroidectomy by Ryödi E, Metso S, Huhtala H, Välimäki M, Auvinen A, and Jaatinen P. Thyroid 2018;28:1111–1120. DOI: 10.1089/thy.2017.0461

Thyroid, Volume 28, Issue 12, Page 1731-1731, December 2018.


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Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China

Thyroid, Volume 28, Issue 12, Page 1674-1681, December 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GoVxW2

Future Meetings

Thyroid, Volume 28, Issue 12, Page 1729-1730, December 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R6lf5V

Turning a blind eye and a deaf ear to traditional and complementary medicine practice does not make it go away: a qualitative study exploring perceptions and attitudes of stakeholders towards the integration of traditional and complementary medicine into medical school curriculum in Uganda

A substantial proportion of healthcare professionals have inadequate understanding of traditional and complementary medicine and often consider their use inappropriate. (Source: BMC Medical Education)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R1qOCJ

Reported benefits of peer support group involvement by adults with hearing loss

. (Source: International Journal of Audiology)

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Johnny K aiming for recall after cancer scare - FTBL Australia

Johnny K aiming for recall after cancer scare  FTBL Australia

After recovering from a cancer scare, Newcastle Jets youngster Johnny Koutroumbis is hoping to make his first start of the season. Jets rising star Johnny ...

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Medullary Thyroid Cancer Market Analysis and Revenue Generation of Leading Plaeyers in the Market - Coherent Times

Medullary Thyroid Cancer Market Analysis and Revenue Generation of Leading Plaeyers in the Market  Coherent Times

"Medullary Thyroid Cancer Market Research Report 2018" provides information on Leading Key Players, Verticals, Countries, Technology, Application, and ...

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Johnny K aiming for recall after cancer scare - FTBL Australia

Johnny K aiming for recall after cancer scare  FTBL Australia

After recovering from a cancer scare, Newcastle Jets youngster Johnny Koutroumbis is hoping to make his first start of the season. Jets rising star Johnny ...

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Medullary Thyroid Cancer Market Analysis and Revenue Generation of Leading Plaeyers in the Market - Coherent Times

Medullary Thyroid Cancer Market Analysis and Revenue Generation of Leading Plaeyers in the Market  Coherent Times

"Medullary Thyroid Cancer Market Research Report 2018" provides information on Leading Key Players, Verticals, Countries, Technology, Application, and ...

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A New Model for Congenital Vestibular Disorders

AbstractMany developmental disorders of the inner ear are manifested clinically as delayed motor development and challenges in maintaining posture and balance, indicating involvement of central vestibular circuits. How the vestibular circuitry is rewired in pediatric cases is poorly understood due to lack of a suitable animal model. Based on this, our lab designed and validated a chick embryo model to study vestibular development in congenital vestibular disorders. The developing inner ear or "otocyst" on the right side of 2-day-old chick embryos (E2) was surgically rotated 180° in the anterior–posterior axis, forming the "anterior–posterior axis rotated otocyst chick" or ARO chick. The ARO chick has areproducible pathology of a sac with truncated or missing semicircular canal...

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A New Model for Congenital Vestibular Disorders

AbstractMany developmental disorders of the inner ear are manifested clinically as delayed motor development and challenges in maintaining posture and balance, indicating involvement of central vestibular circuits. How the vestibular circuitry is rewired in pediatric cases is poorly understood due to lack of a suitable animal model. Based on this, our lab designed and validated a chick embryo model to study vestibular development in congenital vestibular disorders. The developing inner ear or "otocyst" on the right side of 2-day-old chick embryos (E2) was surgically rotated 180° in the anterior–posterior axis, forming the "anterior–posterior axis rotated otocyst chick" or ARO chick. The ARO chick has areproducible pathology of a sac with truncated or missing semicircular canal...

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Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market (Edition: 2018)- Identify Opportunities, Current Pipeline Scenario, Drivers, Influence Factors with Regional Analysis and Future forecast 2020 - The Flatland Post

Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market (Edition: 2018)- Identify Opportunities, Current Pipeline Scenario, Drivers, Influence Factors with Regional Analysis and Future forecast 2020  The Flatland Post

Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market– Pipeline Insight, 2018r report offers comprehensive insights of the pipeline therapeutics ...

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Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market (Edition: 2018)- Identify Opportunities, Current Pipeline Scenario, Drivers, Influence Factors with Regional Analysis and Future forecast 2020 - The Flatland Post

Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market (Edition: 2018)- Identify Opportunities, Current Pipeline Scenario, Drivers, Influence Factors with Regional Analysis and Future forecast 2020  The Flatland Post

Recurrent Head And Neck Cancer Squamous Cell Carcinoma Market– Pipeline Insight, 2018r report offers comprehensive insights of the pipeline therapeutics ...

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Morbidity and mortality in patients undergoing fecal diversion as an adjunct to wound healing: a NSQIP comparison study

Abstract

Background

Fecal diversion for chronic, non-healing wounds improves quality of life, assists in wound healing, and helps to prepare for reconstructive surgery. While commonplace, little has been published regarding the safety of diversion in this patient subgroup. The purpose of this study is to elucidate the morbidity and mortality of fecal diversion for chronic wounds and to identify those patients with disproportionately high perioperative risk.

Methods

Retrospective analyses were performed using the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database and an institutional database. The primary outcome analyzed was 30-day mortality and secondary outcomes included 30-day morbidity and readmission rate.

Results

Eight hundred fifty-nine patients were identified in the NSQIP database who underwent diversion compared to 3990 who did not. In unmatched data, there were no significant differences in substantial 30-day morbidities. In matched data, diverted patients had a significantly lower perioperative mortality. Fifty-six patients were identified in the institutional review who were diverted for non-healing wounds. Fifty percent of patients with a preoperative ejection fraction of less than 30% died within 30 days of surgery (LR 6.58, p = 0.045).

Conclusions

The NSQIP review indicates that fecal diversion does not inherently increase 30-day perioperative morbidity or mortality. While 30-day morbidity remains high, the institutional review suggests that patients with cardiac dysfunction contribute to the majority of complications. As such, an ejection fraction less than 30% may be a relative contraindication to immediate diversion. Medical optimization and elective diversion should be considered whenever feasible.

Level of Evidence: Level III, risk / prognostic study.

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Morbidity and mortality in patients undergoing fecal diversion as an adjunct to wound healing: a NSQIP comparison study

Abstract

Background

Fecal diversion for chronic, non-healing wounds improves quality of life, assists in wound healing, and helps to prepare for reconstructive surgery. While commonplace, little has been published regarding the safety of diversion in this patient subgroup. The purpose of this study is to elucidate the morbidity and mortality of fecal diversion for chronic wounds and to identify those patients with disproportionately high perioperative risk.

Methods

Retrospective analyses were performed using the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database and an institutional database. The primary outcome analyzed was 30-day mortality and secondary outcomes included 30-day morbidity and readmission rate.

Results

Eight hundred fifty-nine patients were identified in the NSQIP database who underwent diversion compared to 3990 who did not. In unmatched data, there were no significant differences in substantial 30-day morbidities. In matched data, diverted patients had a significantly lower perioperative mortality. Fifty-six patients were identified in the institutional review who were diverted for non-healing wounds. Fifty percent of patients with a preoperative ejection fraction of less than 30% died within 30 days of surgery (LR 6.58, p = 0.045).

Conclusions

The NSQIP review indicates that fecal diversion does not inherently increase 30-day perioperative morbidity or mortality. While 30-day morbidity remains high, the institutional review suggests that patients with cardiac dysfunction contribute to the majority of complications. As such, an ejection fraction less than 30% may be a relative contraindication to immediate diversion. Medical optimization and elective diversion should be considered whenever feasible.

Level of Evidence: Level III, risk / prognostic study.

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US, Rwanda medical professionals prepare for opening of first radiation oncology center - U.S. Africa Command

US, Rwanda medical professionals prepare for opening of first radiation oncology center  U.S. Africa Command

U.S. medical personnel worked hand-in-hand with their corresponding Rwandan counterparts to give cancer patients and their families renewed hope of ...

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Water tests show elevated perchlorate at Lake Norman High School - Statesville Record & Landmark

Water tests show elevated perchlorate at Lake Norman High School  Statesville Record & Landmark

Results from water tests at all Iredell-Statesville Schools earlier this month found high levels of an unregulated contaminant in Lake Norman High School's ...

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Water tests show elevated perchlorate at Lake Norman High School - Statesville Record & Landmark

Water tests show elevated perchlorate at Lake Norman High School  Statesville Record & Landmark

Results from water tests at all Iredell-Statesville Schools earlier this month found high levels of an unregulated contaminant in Lake Norman High School's ...

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Lumenis India, TMH organise workshop for otolaryngologists - BSI bureau

Lumenis India, TMH organise workshop for otolaryngologists  BSI bureau

CO2 lasers are increasingly becoming a first line treatment of early stage airway cancers, especially in the larynx.

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The dominant nutrient foramen at the clavicular midshaft: an anatomical study

Abstract

Background

The aim of the present study was to describe the prevalence and topography of the dominant nutrient foramen at the clavicle.

Methods

317 macerated human clavicles (167 right and 150 left) were available for the study. After detecting the dominant nutrient foramen, the total distance from the sternal surface to the examined nutrient foramen was measured. A foramen index (FI) was used for further data processing.

Results

We detected a dominant foramen in 300/317 (94.64%) clavicles, which was located in the middle third in 287/300 (95.7%) clavicles. The average clavicular length was measured at 14.9 cm ± 1.0 cm (range 11.6–17.5 cm) with an average foraminal distance from the sternoclavicular joint surface of 7.9 cm ± 1.3 cm (range 0.9–12.6 cm) in total. The mean FI was 53.2% ± SD 7.4% (range 5.5–79.3%).

Conclusion

The present study provides a topographic mapping of the foraminal area (46–60% of the total clavicular length). The findings help to assess clavicular fracture patterns, which pass through the foraminal area.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R7gysC

The dominant nutrient foramen at the clavicular midshaft: an anatomical study

Abstract

Background

The aim of the present study was to describe the prevalence and topography of the dominant nutrient foramen at the clavicle.

Methods

317 macerated human clavicles (167 right and 150 left) were available for the study. After detecting the dominant nutrient foramen, the total distance from the sternal surface to the examined nutrient foramen was measured. A foramen index (FI) was used for further data processing.

Results

We detected a dominant foramen in 300/317 (94.64%) clavicles, which was located in the middle third in 287/300 (95.7%) clavicles. The average clavicular length was measured at 14.9 cm ± 1.0 cm (range 11.6–17.5 cm) with an average foraminal distance from the sternoclavicular joint surface of 7.9 cm ± 1.3 cm (range 0.9–12.6 cm) in total. The mean FI was 53.2% ± SD 7.4% (range 5.5–79.3%).

Conclusion

The present study provides a topographic mapping of the foraminal area (46–60% of the total clavicular length). The findings help to assess clavicular fracture patterns, which pass through the foraminal area.

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National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EuN3Kv

Clinical Applicability of Low Levels of Thyroglobulin Autoantibodies as Cutoff Point for Thyroglobulin Autoantibody Positivity

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECS3O8

Incidence of Neonatal Hyperthyroidism Among Newborns of Graves' Disease Patients Treated with Radioiodine Therapy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ew4das

Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECRZ0Q

Correction to: Cardiovascular Morbidity and Mortality After Treatment of Hyperthyroidism with Either Radioactive Iodine or Thyroidectomy by Ryödi E, Metso S, Huhtala H, Välimäki M, Auvinen A, and Jaatinen P. Thyroid 2018;28:1111–1120. DOI: 10.1089/thy.2017.0461

Thyroid, Volume 28, Issue 12, Page 1731-1731, December 2018.


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

Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China

Thyroid, Volume 28, Issue 12, Page 1674-1681, December 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EDHF8L

Future Meetings

Thyroid, Volume 28, Issue 12, Page 1729-1730, December 2018.


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

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EuN3Kv

Clinical Applicability of Low Levels of Thyroglobulin Autoantibodies as Cutoff Point for Thyroglobulin Autoantibody Positivity

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECS3O8

Incidence of Neonatal Hyperthyroidism Among Newborns of Graves' Disease Patients Treated with Radioiodine Therapy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ew4das

Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECRZ0Q

Correction to: Cardiovascular Morbidity and Mortality After Treatment of Hyperthyroidism with Either Radioactive Iodine or Thyroidectomy by Ryödi E, Metso S, Huhtala H, Välimäki M, Auvinen A, and Jaatinen P. Thyroid 2018;28:1111–1120. DOI: 10.1089/thy.2017.0461

Thyroid, Volume 28, Issue 12, Page 1731-1731, December 2018.


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

Future Meetings

Thyroid, Volume 28, Issue 12, Page 1729-1730, December 2018.


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

Congenital Hypothyroidism due to Oligogenic Mutations in Two Sudanese Families

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EEe2US

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EuN3Kv

Clinical Applicability of Low Levels of Thyroglobulin Autoantibodies as Cutoff Point for Thyroglobulin Autoantibody Positivity

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECS3O8

Incidence of Neonatal Hyperthyroidism Among Newborns of Graves' Disease Patients Treated with Radioiodine Therapy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ew4das

Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECRZ0Q

Correction to: Cardiovascular Morbidity and Mortality After Treatment of Hyperthyroidism with Either Radioactive Iodine or Thyroidectomy by Ryödi E, Metso S, Huhtala H, Välimäki M, Auvinen A, and Jaatinen P. Thyroid 2018;28:1111–1120. DOI: 10.1089/thy.2017.0461

Thyroid, Volume 28, Issue 12, Page 1731-1731, December 2018.


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

Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China

Thyroid, Volume 28, Issue 12, Page 1674-1681, December 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EDHF8L

Congenital Hypothyroidism due to Oligogenic Mutations in Two Sudanese Families

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EEe2US

National Trends in Incidence, Mortality, and Clinical Outcomes of Patients Hospitalized for Thyrotoxicosis With and Without Thyroid Storm in the United States, 2004–2013

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EuN3Kv

Clinical Applicability of Low Levels of Thyroglobulin Autoantibodies as Cutoff Point for Thyroglobulin Autoantibody Positivity

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECS3O8

Incidence of Neonatal Hyperthyroidism Among Newborns of Graves' Disease Patients Treated with Radioiodine Therapy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ew4das

Regeneration of a Bioengineered Thyroid Using Decellularized Thyroid Matrix

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2ECRZ0Q

Correction to: Cardiovascular Morbidity and Mortality After Treatment of Hyperthyroidism with Either Radioactive Iodine or Thyroidectomy by Ryödi E, Metso S, Huhtala H, Välimäki M, Auvinen A, and Jaatinen P. Thyroid 2018;28:1111–1120. DOI: 10.1089/thy.2017.0461

Thyroid, Volume 28, Issue 12, Page 1731-1731, December 2018.


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

Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China

Thyroid, Volume 28, Issue 12, Page 1674-1681, December 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EDHF8L

Future Meetings

Thyroid, Volume 28, Issue 12, Page 1729-1730, December 2018.


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

Morbidity and mortality in patients undergoing fecal diversion as an adjunct to wound healing: a NSQIP comparison study

Abstract

Background

Fecal diversion for chronic, non-healing wounds improves quality of life, assists in wound healing, and helps to prepare for reconstructive surgery. While commonplace, little has been published regarding the safety of diversion in this patient subgroup. The purpose of this study is to elucidate the morbidity and mortality of fecal diversion for chronic wounds and to identify those patients with disproportionately high perioperative risk.

Methods

Retrospective analyses were performed using the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database and an institutional database. The primary outcome analyzed was 30-day mortality and secondary outcomes included 30-day morbidity and readmission rate.

Results

Eight hundred fifty-nine patients were identified in the NSQIP database who underwent diversion compared to 3990 who did not. In unmatched data, there were no significant differences in substantial 30-day morbidities. In matched data, diverted patients had a significantly lower perioperative mortality. Fifty-six patients were identified in the institutional review who were diverted for non-healing wounds. Fifty percent of patients with a preoperative ejection fraction of less than 30% died within 30 days of surgery (LR 6.58, p = 0.045).

Conclusions

The NSQIP review indicates that fecal diversion does not inherently increase 30-day perioperative morbidity or mortality. While 30-day morbidity remains high, the institutional review suggests that patients with cardiac dysfunction contribute to the majority of complications. As such, an ejection fraction less than 30% may be a relative contraindication to immediate diversion. Medical optimization and elective diversion should be considered whenever feasible.

Level of Evidence: Level III, risk / prognostic study.

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

Morbidity and mortality in patients undergoing fecal diversion as an adjunct to wound healing: a NSQIP comparison study

Abstract

Background

Fecal diversion for chronic, non-healing wounds improves quality of life, assists in wound healing, and helps to prepare for reconstructive surgery. While commonplace, little has been published regarding the safety of diversion in this patient subgroup. The purpose of this study is to elucidate the morbidity and mortality of fecal diversion for chronic wounds and to identify those patients with disproportionately high perioperative risk.

Methods

Retrospective analyses were performed using the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database and an institutional database. The primary outcome analyzed was 30-day mortality and secondary outcomes included 30-day morbidity and readmission rate.

Results

Eight hundred fifty-nine patients were identified in the NSQIP database who underwent diversion compared to 3990 who did not. In unmatched data, there were no significant differences in substantial 30-day morbidities. In matched data, diverted patients had a significantly lower perioperative mortality. Fifty-six patients were identified in the institutional review who were diverted for non-healing wounds. Fifty percent of patients with a preoperative ejection fraction of less than 30% died within 30 days of surgery (LR 6.58, p = 0.045).

Conclusions

The NSQIP review indicates that fecal diversion does not inherently increase 30-day perioperative morbidity or mortality. While 30-day morbidity remains high, the institutional review suggests that patients with cardiac dysfunction contribute to the majority of complications. As such, an ejection fraction less than 30% may be a relative contraindication to immediate diversion. Medical optimization and elective diversion should be considered whenever feasible.

Level of Evidence: Level III, risk / prognostic study.

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

Interpace Diagnostics Group (IDXG) Trading Down 3.1% - PressOracle

Interpace Diagnostics Group (IDXG) Trading Down 3.1%  PressOracle

Shares of Interpace Diagnostics Group Inc (NASDAQ:IDXG) fell 3.1% during trading on Tuesday . The company traded as low as $0.92 and last traded at $0.93.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2A7NwPN

Differentiated Thyroid Cancer Therapeutics Market to generate huge revenue during 2016-2024 - Industry Daily News

Differentiated Thyroid Cancer Therapeutics Market to generate huge revenue during 2016-2024  Industry Daily News

The Differentiated Thyroid Cancer Therapeutics Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecasts 2016–2024 report that highlights ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2S9ZlMv

Anaplastic Thyroid Cancer Market 2018 Global Share, Trends, Demand, Challenges and Opportunities Research Report and Forecast to 2026 - The Industry Chronicle

Anaplastic Thyroid Cancer Market 2018 Global Share, Trends, Demand, Challenges and Opportunities Research Report and Forecast to 2026  The Industry Chronicle

According to the new market research report on "Global Anaplastic Thyroid Cancer Market Report 2018 – 2026" covers there Product Type, Region Coverage,

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Interpace Diagnostics Group (IDXG) Trading Down 3.1% - PressOracle

Interpace Diagnostics Group (IDXG) Trading Down 3.1%  PressOracle

Shares of Interpace Diagnostics Group Inc (NASDAQ:IDXG) fell 3.1% during trading on Tuesday . The company traded as low as $0.92 and last traded at $0.93.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2A7NwPN

Differentiated Thyroid Cancer Therapeutics Market to generate huge revenue during 2016-2024 - Industry Daily News

Differentiated Thyroid Cancer Therapeutics Market to generate huge revenue during 2016-2024  Industry Daily News

The Differentiated Thyroid Cancer Therapeutics Market: Global Industry Analysis, Size, Share, Growth, Trends, and Forecasts 2016–2024 report that highlights ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2S9ZlMv

Anaplastic Thyroid Cancer Market 2018 Global Share, Trends, Demand, Challenges and Opportunities Research Report and Forecast to 2026 - The Industry Chronicle

Anaplastic Thyroid Cancer Market 2018 Global Share, Trends, Demand, Challenges and Opportunities Research Report and Forecast to 2026  The Industry Chronicle

According to the new market research report on "Global Anaplastic Thyroid Cancer Market Report 2018 – 2026" covers there Product Type, Region Coverage,

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

Rallying call for fellows and members to work with The British Association of Oral and Maxillofacial Surgeons to educate and promote oral and maxillofacial surgery to medics and dentists

As the President, Chair, and member of Council with the "Youth Policy" portfolio, respectively, for the British Association of Oral and Maxillofacial Surgeons (BAOMS) we welcome the recent paper by Payne et al,1 which highlighted the work needed to improve students' knowledge of oral and maxillofacial surgery (OMFS) and to raise their awareness of the specialty as a great choice of career. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Lom4lk

Rallying call for fellows and members to work with The British Association of Oral and Maxillofacial Surgeons to educate and promote oral and maxillofacial surgery to medics and dentists

As the President, Chair, and member of Council with the "Youth Policy" portfolio, respectively, for the British Association of Oral and Maxillofacial Surgeons (BAOMS) we welcome the recent paper by Payne et al,1 which highlighted the work needed to improve students' knowledge of oral and maxillofacial surgery (OMFS) and to raise their awareness of the specialty as a great choice of career. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Lom4lk

Expanding the phenotypic spectrum of CACNA1H mutations

The CACNA1H gene mutations encoding the α1H subunit of Cav3.2 T-type calcium channels have been associated with generalized epilepsy. Focal or multifocal epilepsy and systemic (immunologic, gastrointestinal) involvement associated with these mutations have not been described previously. We detail clinical characteristics of five patients with CACNA1H mutations and expand its phenotypic spectrum. (Source: Pediatric Neurology)

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Expanding the phenotypic spectrum of CACNA1H mutations

The CACNA1H gene mutations encoding the α1H subunit of Cav3.2 T-type calcium channels have been associated with generalized epilepsy. Focal or multifocal epilepsy and systemic (immunologic, gastrointestinal) involvement associated with these mutations have not been described previously. We detail clinical characteristics of five patients with CACNA1H mutations and expand its phenotypic spectrum. (Source: Pediatric Neurology)

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Salt Accumulation May Be a Factor in Atopic Dermatitis

(MedPage Today) -- But hypothesis regarding sodium chloride levels in skin needs more work, expert says (Source: MedPage Today Allergy)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rEmw5F

Salt Accumulation May Be a Factor in Atopic Dermatitis

(MedPage Today) -- But hypothesis regarding sodium chloride levels in skin needs more work, expert says (Source: MedPage Today Allergy)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rEmw5F

ALLERGY TIME (Chlorpheniramine Maleate) Tablet [Time Cap Labs Inc]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Loh68a

ALL DAY ALLERGY (Cetirizine Hcl) Capsule [Cardinal Health (Leader) 37205]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

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

ALLERGY ANTIHISTAMINE (Diphenhydramine Hydrochloride) Tablet [Cardinal Health (Leader) 37205]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Lpgv62

ALLERGY (Allium Sat, Anacardium, Apis Mel, Gambogia, Merc Solub, Nat Carb, Nitricum Ac, Nux Vom, Phosphorus, Pulsatilla, Sulphur) Liquid [Net Remedies]

Updated Date: Dec 14, 2018 EST (Source: DailyMed Drug Label Updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rJeB79

ALLERGY TIME (Chlorpheniramine Maleate) Tablet [Time Cap Labs Inc]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Loh68a

ALL DAY ALLERGY (Cetirizine Hcl) Capsule [Cardinal Health (Leader) 37205]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

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

ALLERGY ANTIHISTAMINE (Diphenhydramine Hydrochloride) Tablet [Cardinal Health (Leader) 37205]

Updated Date: Dec 18, 2018 EST (Source: DailyMed Drug Label Updates)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Lpgv62

ALLERGY (Allium Sat, Anacardium, Apis Mel, Gambogia, Merc Solub, Nat Carb, Nitricum Ac, Nux Vom, Phosphorus, Pulsatilla, Sulphur) Liquid [Net Remedies]

Updated Date: Dec 14, 2018 EST (Source: DailyMed Drug Label Updates)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rJeB79

VISINE A MULTI-ACTION EYE ALLERGY RELIEF (Naphazoline Hydrochloride And Pheniramine Maleate) Solution/ Drops [REMEDYREPACK INC.]

Updated Date: Dec 14, 2018 EST (Source: DailyMed Drug Label Updates)

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ALLERGY MULTI-SYMPTOM (Acetaminophen, Chlorpheniramine Maleate, And Phenylephrine Hydrochloride) Tablet, Coated [Marc Glassman, Inc.]

Updated Date: Dec 14, 2018 EST (Source: DailyMed Drug Label Updates)

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

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Radiation therapy for newly diagnosed metastatic HNSCC patients | Head & Neck - MD Linx

Radiation therapy for newly diagnosed metastatic HNSCC patients | Head & Neck  MD Linx

Internal Medicine Article: Radiation therapy for patients with newly diagnosed metastatic head and neck squamous cell carcinoma.

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Controversies in drug allergy: Testing for delayed reactions

Controversies exist with regard to in  vivo approaches to delayed immunologically mediated adverse drug reactions, such as exanthem (maculopapular eruption), drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and fixed drug eruptions. I n particular, widespread differences exist between regions and practice on the availability and use of intradermal and patch testing, the standard drug concentrations used, the use of additional drugs in intradermal and patch testing to help determine cross-reactivity, the timing of testing in relat ion to the occurrence of the adverse drug reaction, the use of testing in specific phenotypes, and the use of oral challenge in conjunction with delayed intrade...

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Controversies in drug allergy: In vitro testing

Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions and should identify the culprit drug or drugs and safe alternatives. However, making the diagnosis can be complex and challenging. Reliable in  vitro tests can offer the potential to improve a diagnosis of DHR and influence medical decision making. Importantly, in vitro testing is frequently not performed as a test in isolation but rather as a component of a diagnostic algorithm along with additional tests. (Source: Journal of Allergy and Clinical Immunology)

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Return to contact sport post ORIF facial fractures

Aims: Contact sports, such as rugby, are responsible for many maxillofacial injuries. To our knowledge there are no guidelines in the medical literature on time to return to contact sports following surgical repair of facial fractures. We describe current practice amongst the oral and maxillofacial community in the UK. We formulate guidelines to inform the clinician on appropriate timing for return to contact sports post fixation of facial fractures.

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Two new surgical techniques to refine surgery around the ear

Numerous incisions around the ear have been described and many are used in oral and maxillofacial surgery for procedures involving the TMJ and the parotid, as well as for rhytidectomy. The traditional pre-auricular and endaural incisions often result in a visible scar. Additionally, surgical procedures around the ear often result in the collection of blood in the ear canal. Although the blood represents minimal risk it is unpleasant, inconvenient and often difficult to remove.

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Postoperative observations for orbital and zygomatic repairs – A 5 year review

Retrobulbar haemorrhage is a rare complication of peri-orbital or zygomatic complex surgery, with an incidence of 0.3%.(1) However it carries a serious risk of blindness if not detected and managed immediately. Thus, most maxillofacial surgeons advocate post-operative eye observations.

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Radiation therapy for newly diagnosed metastatic HNSCC patients | Head & Neck - MD Linx

Radiation therapy for newly diagnosed metastatic HNSCC patients | Head & Neck  MD Linx

Internal Medicine Article: Radiation therapy for patients with newly diagnosed metastatic head and neck squamous cell carcinoma.

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Controversies in drug allergy: Testing for delayed reactions

Controversies exist with regard to in  vivo approaches to delayed immunologically mediated adverse drug reactions, such as exanthem (maculopapular eruption), drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and fixed drug eruptions. I n particular, widespread differences exist between regions and practice on the availability and use of intradermal and patch testing, the standard drug concentrations used, the use of additional drugs in intradermal and patch testing to help determine cross-reactivity, the timing of testing in relat ion to the occurrence of the adverse drug reaction, the use of testing in specific phenotypes, and the use of oral challenge in conjunction with delayed intrade...

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Controversies in drug allergy: In vitro testing

Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions and should identify the culprit drug or drugs and safe alternatives. However, making the diagnosis can be complex and challenging. Reliable in  vitro tests can offer the potential to improve a diagnosis of DHR and influence medical decision making. Importantly, in vitro testing is frequently not performed as a test in isolation but rather as a component of a diagnostic algorithm along with additional tests. (Source: Journal of Allergy and Clinical Immunology)

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Return to contact sport post ORIF facial fractures

Aims: Contact sports, such as rugby, are responsible for many maxillofacial injuries. To our knowledge there are no guidelines in the medical literature on time to return to contact sports following surgical repair of facial fractures. We describe current practice amongst the oral and maxillofacial community in the UK. We formulate guidelines to inform the clinician on appropriate timing for return to contact sports post fixation of facial fractures.

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Oral & Maxillofacial Surgery (OMFS) trainees and consultants resume the trend of letting their dental registration lapse

Introduction: Although the GDC doubled their Annual Retention Fee (ARF) in 2015, it has been almost unchanged in 2016 to 2018.

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Managing the complications of injectable dermal fillers – who is picking up the tab?

Introduction: Injectable cosmetic products are being used more frequently year on year and account for up to 75% of cosmetic surgical procedures carried out in the UK each year. With an increasing caseload, complications, whilst rare, are on the increase. The authors present 4 recent cases of complications associated with injectable dermal fillers managed in NHS OMFS clinics, and discuss the literature supporting the management of these complications.

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Frequency of Level IIb Neck Dissections for OSCC

Introduction: Selective neck dissection (SND) is the gold standard in oncological management of the neck, it enables us to reduce the morbidity of neck dissection while maintaining the same oncological results. Spinal accessory nerve dysfunction and related shoulder disability is the commonest morbidity associated with dissection of Level IIb. This study was undertaken to ascertain the frequency of undertaking Level IIb dissection and the rate of Nodal metastasis to this level.

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Audit of Deranged Liver Enzymes In Post-operative Major Head & Neck Reconstructive Surgery - Are our patients coming to harm?

Introduction/Aims: Over the last 18 months, increasing numbers of our post head & neck reconstructive surgery patients have been observed to have deranged liver enzymes that can manifest up to one week post-operatively. NICE guidelines recommend investigation of patients with persistent deranged liver enzymes or more than twice upper border of normal.

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Did not attend

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An audit of the orthognathic treatment pathway in a Regional Maxillofacial Unit

Background and objectives: Orthognathic surgery has become increasingly common to correct malocclusions with a substantial skeletal component.

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Advertising and marketing breaches by non-surgical aesthetic trainers

The practice of non-surgical aesthetics is a booming industry, and discussion is being had about how this area of practice requires regulation in order to protect patients from undue harm. Whilst GMC guidance is available and often adhered to by clinicians advertising clinical services, there is guidance available from the Advertising Standards Authority (ASA) regarding medical services provision and the methods used to promote such practice. Having reviewed these ASA guidelines, we wanted to establish how many providers were in fact in breach of the ASA and GMC guidance.

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Audit on the non-diagnostic rate of fine needle aspirations and the subsequent management in a maxillofacial unit over a 1-year period

Introduction: Fine-needle aspiration (FNA) is a simple technique used in the preoperative diagnosis of head and neck lumps. It has limitations as cellular aspirates may be inadequate or equivocal for diagnosis. FNA performance can be optimised through image guidance, availability of on-site pathologists or ancillary techniques – though it is operator-experience dependent. There is little in the literature to inform on the optimal follow up management of non-diagnostic samples.

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Emergency management of the neck breather A closed loop, multi-centre audit

Aims: A multi centre completed audit cycle to ascertain improvements in knowledge of emergency tracheostomy and laryngectomy management following implementation of a teaching programme. Results were compared with The Global Tracheostomy Safety Project emergency management algorithm with a standard of 100% compliance.

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COPD Ups Death Risk in Heart Failure Patients (CME/CE)

(MedPage Today) -- But increased risk was specific to patients who received most intense COPD medication regimens (Source: MedPage Today Allergy)

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COPD Ups Death Risk in Heart Failure Patients (CME/CE)

(MedPage Today) -- But increased risk was specific to patients who received most intense COPD medication regimens (Source: MedPage Today Allergy)

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Cetuximab continues to play vital role in head and neck cancer treatment | News for Doctor, Nurse, Pharmacist | Multidisciplinary - MIMS General News (Hong Kong)

Cetuximab continues to play vital role in head and neck cancer treatment | News for Doctor, Nurse, Pharmacist | Multidisciplinary  MIMS General News (Hong Kong)

The concurrent use of cetuximab, an EGFR monoclonal antibody, with radiotherapy (RT) has been a recommended treatment option for patients with ...

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Cetuximab continues to play vital role in head and neck cancer treatment | News for Doctor, Nurse, Pharmacist | Multidisciplinary - MIMS General News (Hong Kong)

Cetuximab continues to play vital role in head and neck cancer treatment | News for Doctor, Nurse, Pharmacist | Multidisciplinary  MIMS General News (Hong Kong)

The concurrent use of cetuximab, an EGFR monoclonal antibody, with radiotherapy (RT) has been a recommended treatment option for patients with ...

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COPD Ups Death Risk in Heart Failure Patients (CME/CE)

(MedPage Today) -- But increased risk was specific to patients who received most intense COPD medication regimens (Source: MedPage Today Allergy)

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New continuum of care for recurrent and/or metastatic squamous cell carcinoma of the head and neck | News for Doctor, Nurse, Pharmacist | Multidisciplinary - MIMS General News (Hong Kong)

New continuum of care for recurrent and/or metastatic squamous cell carcinoma of the head and neck | News for Doctor, Nurse, Pharmacist | Multidisciplinary  MIMS General News (Hong Kong)

The introduction of cetuximab in combination with platinum plus 5-fluorouracil (5-FU) chemotherapy, followed by maintenance therapy (EXTREME regimen), ...

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COPD Ups Death Risk in Heart Failure Patients (CME/CE)

(MedPage Today) -- But increased risk was specific to patients who received most intense COPD medication regimens (Source: MedPage Today Allergy)

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New continuum of care for recurrent and/or metastatic squamous cell carcinoma of the head and neck | News for Doctor, Nurse, Pharmacist | Multidisciplinary - MIMS General News (Hong Kong)

New continuum of care for recurrent and/or metastatic squamous cell carcinoma of the head and neck | News for Doctor, Nurse, Pharmacist | Multidisciplinary  MIMS General News (Hong Kong)

The introduction of cetuximab in combination with platinum plus 5-fluorouracil (5-FU) chemotherapy, followed by maintenance therapy (EXTREME regimen), ...

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Europe Thyroid Cancer Market and Competitive Landscape - 2018 - ResearchAndMarkets.com - Odessa American

Europe Thyroid Cancer Market and Competitive Landscape - 2018 - ResearchAndMarkets.com  Odessa American

DUBLIN--(BUSINESS WIRE)--Dec 11, 2018--The "Europe Thyroid Cancer Market and Competitive Landscape - 2018" report has been added to ...

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Effects of Epithelial IL-13R α2 Expression in Inflammatory Bowel Disease

Bram Verstockt, Cl émentine Perrier, Gert De Hertogh, Jonathan Cremer, Brecht Creyns, Gert Van Assche, Marc Ferrante, Jan L. Ceuppens, Séverine Vermeire, Christine Breynaert (Source: Frontiers in Immunology)

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CD4+ T Cells Alter the Stromal Microenvironment and Repress Medullary Erythropoiesis in Murine Visceral Leishmaniasis

Olivier Preham, Flaviane A. Pinho, Ana Isabel Pinto, Gulab Fatima Rani, Najmeeyah Brown, Ian S. Hitchcock, Hiro Goto, Paul M. Kaye (Source: Frontiers in Immunology)

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Systemic Cytokine and Chemokine Profiles in Individuals With Schistosoma mansoni Infection and Low Parasite Burden

Vanessa N. Castro, Jailza L. Rodrigues, Diogo T. Cardoso, Samira D. Resende, Fernanda C. Magalh ães, Dayane C. Souza, Maira H. Requeijo, Deborah Negrão-Corrêa, Stefan M. Geiger (Source: Frontiers in Immunology)

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Recruitment of Antigen Presenting Cells to Skin Draining Lymph Node From HPV16E7-Expressing Skin Requires E7-Rb Interaction

Paula Kuo, Siok Min Teoh, Zewen K. Tuong, Graham R. Leggatt, Stephen R. Mattarollo, Ian H. Frazer (Source: Frontiers in Immunology)

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Controversies in Drug Allergy: Radiographic Contrast Media

Publication date: Available online 17 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Mario Sánchez-Borges, Werner Aberer, Knut Brockow, Gulfem E. Celik, Josefina Cernadas, Paul A. Greenberger, Marie-Soleil Masse, Rik Schrijvers, Axel TrautmannThe risk for developing immediate or delayed hypersensitivity reactions to radiocontrast media (RCM) interferes with the diagnosis and treatment of a number of patients requiring imaging diagnostic methods for many common diseases. A group of experts met in Orlando, Florida, in March 2018 to analyze the similarities and differences in the management of RCM reactions in different areas of the world. This paper presents a summary of the recommendations provided by this consensus group, highlighting controvers...

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Intravenous immunoglobulins for rheumatic disorders and thromboembolic events —a case series and review of the literature

AbstractTo report the temporal association between a series of thromboembolic events and intravenous immunoglobulin infusion in patients with rheumatic diseases, and to review the literature on the subject. The clinical presentation, course, and outcome of thromboembolic events occurring post-immunoglobulin infusion in nine patients is described. A web-based literature review using the PubMed database from 1996 to 2017 was performed, searching for the keywords: thrombosis, thromboembolism, intravenous immunoglobulin, pulmonary embolism, deep vein thrombosis, cerebrovascular event, and acute myocardial infarction. Nine patients who had suffered a thromboembolic event within a week after receiving an intravenous immunoglobulin infusion (Omr-IgG-am ™, OMRIX) were identified among our joint ...

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Serum periostin levels in adults of Chinese descent: an observational study

Periostin has been shown to be a marker of Type 2 airway inflammation, associated with airway eosinophilia. It has a potential role in identifying asthmatics who may be responsive to treatment with monoclonal ... (Source: Allergy, Asthma and Clinical Immunology)

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Superior effect of MP-AzeFlu than azelastine or fluticasone propionate alone on reducing inflammatory markers

MP-AzeFlu, intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP), is superior to AZE or FP alone for treatment of allergic rhinitis (AR). However, the precise anti-inflammato... (Source: Allergy, Asthma and Clinical Immunology)

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STAT1 gain-of-function compromises skin host defense in the context of interferon- γ signaling

Gain-of-function mutations in STAT1 cause epidermal host defense deficiency in a Th1 context thereby contributing to chronic mucocutaneous candidiasis. (Source: Journal of Allergy and Clinical Immunology)

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Microbiota and Food Allergy

AbstractEmerging evidence suggests that the increasing prevalence of food allergies is associated with compositional and functional changes in our gut microbiota. Microbiota-host interactions play a key role in regulating the immune system. Development of a healthy gut microbiota and immune system occurs early in life and is largely shaped by exposure to maternal microbes through vaginal/natural delivery and breast milk, whereas use of antibiotics can disrupt gut homeostasis and significantly raise the risk of allergic diseases. Thus, changes in the quantity or diversity of gut microbes affect oral toleranace through interations of microbial molecules with pattern recognition receptors on immune cells and confer susceptibility to food allergies. On the other hand, short chain fatty acids w...

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Atopic eczema and major cardiovascular outcomes: a systematic review and meta-analysis of population-based studies

There was a significant and increased relative risk of 1.15 for the association between increasing atopic eczema severity and angina, myocardial infarction, heart failure, stroke, ischaemic stroke and cardiovascular death, demonstrating evidence of a dose response relationship. (Source: Journal of Allergy and Clinical Immunology)

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Blood endotyping distinguishes the profile of vitiligo from other inflammatory and autoimmune skin diseases

Vitiligo is distinguished from other inflammatory skin diseases by strong Th1 polarization, along with elevated Th2/Th9/Th17/Th22 and low Treg frequency in blood. Future targeted therapeutic studies are needed to define the relative contribution of each skewed cytokine axis. (Source: Journal of Allergy and Clinical Immunology)

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Omalizumab effectiveness in Asthma COPD overlap: post hoc analysis of PROSPERO study

Patients with asthma and COPD overlap (ACO) are poorly represented in asthma clinical trials. This post hoc analysis of a large, real-world study demonstrates that omalizumab may be beneficial in patients with ACO. (Source: Journal of Allergy and Clinical Immunology)

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Clinical Application of Radiation Dose Reduction at Abdominal CT

Publication date: Available online 17 December 2018

Source: European Journal of Radiology

Author(s): Toru Higaki, Yuko Nakamura, Wataru Fukumoto, Yukiko Honda, Fuminari Tatsugami, Kazuo Awai

Abstract

Report VII of the Board on Radiation Effects Research (BRER), in which the linear no-threshold hypothesis was applied, estimates the lifetime carcinogenesis risk from computed tomography (CT) as 0.34 to 1.30%. Other studies provided evidence for breaks in double-stranded lymphocyte DNA in human blood during CT examinations. Although it cannot be claimed that such DNA damage is a direct cause of carcinogenesis, it is important to reduce the radiation exposure of patients subjected to CT studies. Here we focus on techniques and clinical applications of abdominal reduced-dose CT. With automatic exposure control (AEC), the X-ray tube current can be optimized and the noise level maintained uniformly, regardless of the target size. Iterative reconstruction can reduce the image noise on scans acquired at reduced radiation doses. Use of these techniques helped to reduce radiation exposure at routine examinations by about 20 - 40%. We also discuss advanced imaging methods such as dynamic perfusion CT.

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CD4+ T Cells Alter the Stromal Microenvironment and Repress Medullary Erythropoiesis in Murine Visceral Leishmaniasis

Olivier Preham, Flaviane A. Pinho, Ana Isabel Pinto, Gulab Fatima Rani, Najmeeyah Brown, Ian S. Hitchcock, Hiro Goto, Paul M. Kaye (Source: Frontiers in Immunology)

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Systemic Cytokine and Chemokine Profiles in Individuals With Schistosoma mansoni Infection and Low Parasite Burden

Vanessa N. Castro, Jailza L. Rodrigues, Diogo T. Cardoso, Samira D. Resende, Fernanda C. Magalh ães, Dayane C. Souza, Maira H. Requeijo, Deborah Negrão-Corrêa, Stefan M. Geiger (Source: Frontiers in Immunology)

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Effects of moderate- versus high- intensity swimming training on inflammatory and CD4+ T cell subset profiles in experimental autoimmune encephalomyelitis mice

This study explored the impacts of different-intensity swimming training on EAE mice. Female mice were given access to swimming with predetermined weight (moderated-intensity (ME) group is 0% body weight; high-intensity (HE) group is 4% body weight) for 6  weeks, were immunized to induce EAE and then continued swimming until sacrificed. (Source: Journal of Neuroimmunology)

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Review of cold-induced urticaria characteristics, diagnosis and management in a Western Canadian allergy practice

Cold-induced urticaria is a significant condition, especially among young females. Despite the morbidity of this disease, studies that fully characterize the disease are limited. (Source: Allergy, Asthma and Clinical Immunology)

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Human NK cells adapt their immune response towards increasing multiplicities of infection of Aspergillus fumigatus

The saprophytic fungus Aspergillus fumigatus reproduces by generation of conidia, which are spread by airflow throughout nature. Since humans are inhaling certain amounts of spores every day, the (innate) immune ... (Source: BMC Immunology)

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STAT1 gain-of-function compromises skin host defense in the context of interferon- γ signaling

Gain-of-function mutations in STAT1 cause epidermal host defense deficiency in a Th1 context thereby contributing to chronic mucocutaneous candidiasis. (Source: Journal of Allergy and Clinical Immunology)

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Oncolytic herpes simplex virus and immunotherapy

Oncolytic viruses have been proposed to be employed as a potential treatment of cancer. Well targeted, they will serve the purpose of cracking tumor cells without causing damage to normal cells. In this catego... (Source: BMC Immunology)

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Microbiota and Food Allergy

AbstractEmerging evidence suggests that the increasing prevalence of food allergies is associated with compositional and functional changes in our gut microbiota. Microbiota-host interactions play a key role in regulating the immune system. Development of a healthy gut microbiota and immune system occurs early in life and is largely shaped by exposure to maternal microbes through vaginal/natural delivery and breast milk, whereas use of antibiotics can disrupt gut homeostasis and significantly raise the risk of allergic diseases. Thus, changes in the quantity or diversity of gut microbes affect oral toleranace through interations of microbial molecules with pattern recognition receptors on immune cells and confer susceptibility to food allergies. On the other hand, short chain fatty acids w...

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Blood endotyping distinguishes the profile of vitiligo from other inflammatory and autoimmune skin diseases

Vitiligo is distinguished from other inflammatory skin diseases by strong Th1 polarization, along with elevated Th2/Th9/Th17/Th22 and low Treg frequency in blood. Future targeted therapeutic studies are needed to define the relative contribution of each skewed cytokine axis. (Source: Journal of Allergy and Clinical Immunology)

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Omalizumab effectiveness in Asthma COPD overlap: post hoc analysis of PROSPERO study

Patients with asthma and COPD overlap (ACO) are poorly represented in asthma clinical trials. This post hoc analysis of a large, real-world study demonstrates that omalizumab may be beneficial in patients with ACO. (Source: Journal of Allergy and Clinical Immunology)

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Clinical Application of Radiation Dose Reduction at Abdominal CT

Publication date: Available online 17 December 2018

Source: European Journal of Radiology

Author(s): Toru Higaki, Yuko Nakamura, Wataru Fukumoto, Yukiko Honda, Fuminari Tatsugami, Kazuo Awai

Abstract

Report VII of the Board on Radiation Effects Research (BRER), in which the linear no-threshold hypothesis was applied, estimates the lifetime carcinogenesis risk from computed tomography (CT) as 0.34 to 1.30%. Other studies provided evidence for breaks in double-stranded lymphocyte DNA in human blood during CT examinations. Although it cannot be claimed that such DNA damage is a direct cause of carcinogenesis, it is important to reduce the radiation exposure of patients subjected to CT studies. Here we focus on techniques and clinical applications of abdominal reduced-dose CT. With automatic exposure control (AEC), the X-ray tube current can be optimized and the noise level maintained uniformly, regardless of the target size. Iterative reconstruction can reduce the image noise on scans acquired at reduced radiation doses. Use of these techniques helped to reduce radiation exposure at routine examinations by about 20 - 40%. We also discuss advanced imaging methods such as dynamic perfusion CT.

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Colonic phenotype of adenocarcinoma base of the tongue: An entity rarely reported and treated with definitive chemoradiation

Neelam Sharma, Abhishek Purkayastha, Chhavi Arora, Kavita Sahai

International Journal of Oral Health Sciences 2018 8(2):116-119

The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approximately 9 times more frequent when compared with other types. Adenocarcinoma common histopathology for digestive system is very rarely reported in this region. In literature, there are limited data about the clinical presentation, histopathology, and treatment modalities for the primary adenocarcinoma of the base of the tongue (BOT). To the best of our knowledge, five cases of adenocarcinoma of the BOT with colonic differentiation have been reported in the world literature till date, and this is the first case report from India. The challenge in these type of cases is to differentiate between the primary adenocarcinoma of BOT which is extremely rare, metastatic lesion to this site from any other site, or its origin from minor salivary glands which is a more common possibility because all these situations have different treatment implications.

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Secretarys message

Dhanyakumar Budihal

International Journal of Oral Health Sciences 2018 8(2):56-56



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Children and their gadgets: A pedodontist perspective

Saraswathi Vishnu Naik

International Journal of Oral Health Sciences 2018 8(2):57-58



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Management of flabby ridge case: An arduous task in undergraduate practice

Jnanashree Chiplunkar, Masrie Tumbil, MD Chethan, DB Nandeeshwar, Disha Patel

International Journal of Oral Health Sciences 2018 8(2):104-108

A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting the maxillary or mandibular alveolar ridges. It can develop when hyperplastic soft tissue replaces the alveolar bone and is a common finding particularly in the upper anterior region of long-term denture wearers. Masticatory forces can displace this mobile denture-bearing tissue, leading to altered denture positioning and loss of peripheral seal. Unless managed appropriately, such "flabby ridges" adversely affect the support, retention, and stability of complete dentures. Many impression techniques have been proposed to help overcome this difficulty. This paper presents case report for prosthodontic rehabilitation of a patient with flabby ridge with McCord and Ahmad impression technique.

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Editorial

GP Sujatha

International Journal of Oral Health Sciences 2018 8(2):59-59



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Hemorrhagic bulla on the lip: A diagnostic dilemma

Aravinda Konidena, Hena Shaw, Mansimran Kaur Uppal

International Journal of Oral Health Sciences 2018 8(2):124-128

Angina bullosa hemorrhagica (ABH) is a rare benign disorder characterized by the sudden onset of painless blood-filled blister in the oral cavity that rupture in 24–48 h. We recently encountered an interesting case of ABHon the lower lip of 68-year-old female patient referred back from the prosthodontic department following the procedure of impression making. This case will be presented along with a review of previous case summaries reporting four or more cases.

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Hollow complete denture for resorbed ridges

U Krishna Kumar, Sanjay Murgod

International Journal of Oral Health Sciences 2018 8(2):60-62

The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased inter-arch space provide decreased support, retention, and stability and pose a clinical challenge to the success of complete denture prostheses. The consequent weight of the processed complete denture only compromises them further. This article highlights a technique for the fabrication of a hollow maxillary complete denture in situation where there is excessive resorption of the maxillary residual alveolar ridge and thereby greatly reducing the weight of an exceptionally heavy maxillary denture. Weight of a denture may be a contributing factor to the successful resolution of a patient's problem; the hollow denture can be considered as one of the treatment modalities.

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Probiotics and periodontal disease

Anjhana Asok, Rahul Bhandary, Mamatha Shetty, Nina Shenoy

International Journal of Oral Health Sciences 2018 8(2):68-72

Probiotics are live microorganisms that when administered in adequate amounts confer health benefits to the host. Lactobacillus acidophilus was the first probiotic species. Elie Metchnikoff reported fermented dairy products to have beneficial properties. Probiotics have been used in combination with prebiotics to produce synbiotics. Probiotics have been widely used in the medical field to combat various diseases. Probiotics have been found to be helpful in periodontal tissue destruction by altering the host defense mechanism and inhibiting the secretion of proinflammatory cytokines that can mediate tissue destruction. Probiotics have been demonstrated to produce high ecological pH and have inhibitory effect on volatile sulfur compounds that help to control halitosis. The concept of guided tissue recolonization has emphasized the increased use of probiotics in periodontal management. Although probiotics also include side effects, further longitudinal studies are required to provide substantial data on the use of probiotics.

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Age estimation using tooth cementum annulations method by different types of microscope: A comparative study

HL Geetha, Venkat P Baghisath, Hari B Vinay, B Sudheer, Vijay J Kumar, CH Gayathri

International Journal of Oral Health Sciences 2018 8(2):73-80

Introduction: Age is an essential factor in establishing the identity of a person. Age estimation through dental parameters can be of valuable assistance in human identification as teeth can survive in most conditions encountered at death and during decomposition. Tooth cementum annulations are one of the many methods for determination of an individual's age. Incremental lines in cementum are counted in this method. Objective: The aim of this study was to examine the correlation between chronologic age and estimated age and to find the most accurate method of calculating cemental annulations using different types of microscopes (light microscope, phase contrast microscope, polarized, and stereomicroscope). Methodology: The extracted teeth were cleaned and polished. Block was prepared by embedding two third of each tooth root horizontally in self-cure acrylic. Using a hard tissue microtome (SP 1600) longitudinal sections of 100 μm thickness were made. The sections were cleaned in alcohol and were mounted on a glass slide. These sections were observed under different types of microscopes (light microscope, phase contrast microscope, polarized, and stereomicroscope) to count cemental annulations. Results: The relationship between chronological age and estimated age using light microscope, phase contrast and polarized microscope showed stronger correlation while stereo microscope showed a weaker correlation. Conclusion: The use of polarized microscope increases the accuracy and thus, can predict the near estimate of the age for all the age groups.

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A comparative study of cone-beam computed tomography and intrasurgical measurements of intrabony periodontal defects

Santosh R Patil, Ibrahim A Al-Zoubi, Ravi Gudipaneni, Kuraym Khalid Kuraym Alenazi, Nidhi Yadav

International Journal of Oral Health Sciences 2018 8(2):81-85

Objective: The objective of this study was to analyze the correlation between cone-beam computed tomography (CBCT) measurements and intrasurgical measurements of intrabony periodontal defects. Materials and Methods: Thirty-two patients with intrabony defects, who underwent periodontal therapy and were advised for surgical therapy, were included in this study. Diagnostic images were obtained by periapical radiographs and CBCT before the surgical procedure. The distance from the cementoenamel junction to the base of the periodontal defect (CEJ–BD), the distance from the crest of bone to the deepest point of the defect, and mesiodistal (M-D) width of the periodontal defect were measured on CBCT and periapical radiographs during the surgical procedure. The faciolingual width of the defect was only measured on CBCT images during the surgical procedure. The linear measurements obtained during the surgical therapy were compared with that obtained by intraoral radiographs and CBCT imaging. Results: The M-D width of the defect measured during the surgical procedure was similar to that measured on the periapical radiograph. The distance of CEJ to BD and the distance from the crest of bone to the deepest point of the defect measured on the periapical radiographs were less than that of intrasurgical measurements. No significant difference was noted regarding the CBCT measurements of the faciolingual width and M-D width of the defect when compared with the measurements obtained during the surgical procedures. A significant difference was noted in the CBCT measurements from the CEJ to BD and the distance from the crest of bone to the deepest point of the defect when compared with the intrasurgical measurements. Conclusion: CBCT may lend comparatively discriminative dimensions of the periodontal defect similar to that of intrasurgical measurements.

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A review of oral and maxillofacial biopsies from a new academic health facility in remote Northwestern Nigeria

Adebayo Aremu Ibikunle, Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah, Mohammed Sambas Umar

International Journal of Oral Health Sciences 2018 8(2):86-91

Background: Histological diagnosis is invaluable in charting the overall management of human pathologies. Knowledge of the general trend of histological diagnosis in a population may impact the clinician's practice as well as public health policy formulation. There is a paucity of literature on biopsy-driven epidemiology of oral and maxillofacial lesions, especially in sub-Saharan Africa. Objective: This study aims to determine the pattern of biopsied oral and maxillofacial lesions at a Nigerian tertiary hospital. Materials and Methods: A 5-year retrospective review of the histological diagnoses of patients who had biopsies of oral and/or maxillofacial lesions done at our teaching hospital was done. Biopsy reports obtained within the study period were retrieved and analyzed. Analysis was performed using the IBM SPSS statistics for windows version 20 (IBM Corp, Armonk, NY) software. Results: Three hundred and sixteen biopsy reports were included in this review. A slight male preponderance was observed, with a male-to-female ratio of 1:0.96. The age ranged from 6 months to 90 years (mean ± standard deviation, 33.3 ± 19.9). The posterior mandible was the most commonly affected site 13.9% (44). Most of the lesions were neoplastic 70.9% (224) with a slight majority being malignant. Squamous cell carcinoma (SCC) was the most frequently diagnosed malignancy 11.7% (37). Most nonneoplastic lesions were inflammatory/infectious 52.8% (47). Conclusion: Nearly equal gender prevalence for oral and maxillofacial biopsies was observed. In contrast to several studies, malignancies were more frequently diagnosed than benign neoplasms. The high incidence of SCC suggests the need for population interventions targeted at screening and early diagnosis.

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Clear-cell squamous cell carcinoma: An uncommon variant of very common malignancy in the head and neck

Lopa Mudra Kakoti, Debanwita Mahanta, Jagannath Dev Sharma, Zachariah Chowdhury

International Journal of Oral Health Sciences 2018 8(2):136-139

Clear-cell squamous cell carcinoma (SCC) is an extremely rare and incompletely understood entity. Clear-cell change occurs due to cytoplasmic accumulation of glycogen, water, intermediate filaments, immature zymogen granules, or a paucity of cellular organelles. Clear-cell change can be seen in any of the neoplasms, but as pure form variant, it is difficult to find in head-and-neck SCC. The World Health Organization has recognized clear-cell SCC as separate entity at other few sites such as penis but not in the head-and-neck SCC, and these are known to aggressive variant. We, hereby, present a case of clear-cell variant of squamous carcinoma in lower gingivobuccal mucosa in a 59-year-old male patient. Histopathology showed sheets of clear cell separated by fibrous septa and foci showing squamous cells with malignant features. Periodic acid–Schiff and immunohistochemistry (IHC) were done to rule out differentials of clear-cell variants of different sites such as salivary gland, odontogenic origin, and cutaneous adnexal origin. To establish the prevalence, biological nature, significance, and clinical course of clear-cell SCC in the head-and-neck region, more number of case reports are expected to be published in future. We concluded by emphasizing on the need of further analysis of all clear-cell tumors in the head and neck with histochemistry and IHC investigations to arrive at the proper diagnosis.

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