Holidays' Pitfalls for Those With Food Allergies

MONDAY, Dec. 24, 2018 -- Holiday get-togethers can be risky for people with food allergies. About 15 million people in the United States have one or more food allergies. " It's unfortunate that there's been such an uptick in food allergy diagnoses,... (Source: Drugs.com - Daily MedNews)

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Holidays' Pitfalls for Those With Food Allergies

MONDAY, Dec. 24, 2018 -- Holiday get-togethers can be risky for people with food allergies. About 15 million people in the United States have one or more food allergies. " It's unfortunate that there's been such an uptick in food allergy diagnoses,... (Source: Drugs.com - Daily MedNews)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GRFcJA

Holidays' Pitfalls for Those With Food Allergies

MONDAY, Dec. 24, 2018 -- Holiday get-togethers can be risky for people with food allergies. About 15 million people in the United States have one or more food allergies. " It's unfortunate that there's been such an uptick in food allergy diagnoses,... (Source: Drugs.com - Daily MedNews)

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Holidays' Pitfalls for Those With Food Allergies

MONDAY, Dec. 24, 2018 -- Holiday get-togethers can be risky for people with food allergies. About 15 million people in the United States have one or more food allergies. " It's unfortunate that there's been such an uptick in food allergy diagnoses,... (Source: Drugs.com - Daily MedNews)

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Airway reversibility in asthma and phenotypes of Th2-biomarkers, lung function and disease control

Abstract

Background

High bronchodilator reversibility in adult asthma is associated with distinct clinical characteristics. In this study, we aim to make a comparison with T-helper 2 (Th2)-related biomarkers, lung function and asthma control between asthmatic patients with high airway reversibility (HR) and low airway reversibility (LR).

Methods

Patients with asthma diagnosed by pulmonologist according to Global Initiative for Asthma guidelines were recruited from the outpatient department of our hospital from August 2014 to July 2017. Patients were divided into HR and LR subgroups based on their response to bronchodilators of lung function (HR = Δforced expiratory volume in one second (FEV1) postbronchodilator ≥ 20%). Blood eosinophil count and serum IgE level, which are biomarkers of T-helper (Th)-2 phenotypes, were detected for patients. Asthma Control Test (ACT) was used to assess asthma control after the first-month initial treatment.

Results

A total of 265 patients with asthma were followed 1 month after initial treatment. HR group shows a higher level of Th2-high biomarkers (blood eosinophil count (10^9/L): 0.49 ± 0.28 vs 0.36 ± 0.19, P < 0.01; IgE (ng/ml): 1306 ± 842 vs 413 ± 261, P < 0.01), lower baseline lung function (FEV1%pred: 51.91 ± 19.34% vs 60.42 ± 19.22%, P < 0.01; forced expiratory flow (FEF)25–75: 0.76 ± 0.37 vs 1.00 ± 0.67, P < 0.01; FEF25–75%pred: 21.15 ± 10.09% vs 29.06 ± 16.50%, P < 0.01), and better asthma control (ACT score: 22 ± 4 vs 20 ± 4, P = 0.01) than LR group. HR was associated with a decreased risk of uncontrolled asthma after the first-month initial treatment (adjusted OR: 0.12 [95% confidence intervals: 0.03–0.50]).

Conclusions

HR is a physiologic indicator of lower lung function and severer small airway obstruction, and is more related with an increased level of Th2-biomarkers than LR. Moreover, HR may indicate controlled asthma after the first-month initial treatment. This finding may contribute to identification of asthma endotype.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ENehw0

Airway reversibility in asthma and phenotypes of Th2-biomarkers, lung function and disease control

Abstract

Background

High bronchodilator reversibility in adult asthma is associated with distinct clinical characteristics. In this study, we aim to make a comparison with T-helper 2 (Th2)-related biomarkers, lung function and asthma control between asthmatic patients with high airway reversibility (HR) and low airway reversibility (LR).

Methods

Patients with asthma diagnosed by pulmonologist according to Global Initiative for Asthma guidelines were recruited from the outpatient department of our hospital from August 2014 to July 2017. Patients were divided into HR and LR subgroups based on their response to bronchodilators of lung function (HR = Δforced expiratory volume in one second (FEV1) postbronchodilator ≥ 20%). Blood eosinophil count and serum IgE level, which are biomarkers of T-helper (Th)-2 phenotypes, were detected for patients. Asthma Control Test (ACT) was used to assess asthma control after the first-month initial treatment.

Results

A total of 265 patients with asthma were followed 1 month after initial treatment. HR group shows a higher level of Th2-high biomarkers (blood eosinophil count (10^9/L): 0.49 ± 0.28 vs 0.36 ± 0.19, P < 0.01; IgE (ng/ml): 1306 ± 842 vs 413 ± 261, P < 0.01), lower baseline lung function (FEV1%pred: 51.91 ± 19.34% vs 60.42 ± 19.22%, P < 0.01; forced expiratory flow (FEF)25–75: 0.76 ± 0.37 vs 1.00 ± 0.67, P < 0.01; FEF25–75%pred: 21.15 ± 10.09% vs 29.06 ± 16.50%, P < 0.01), and better asthma control (ACT score: 22 ± 4 vs 20 ± 4, P = 0.01) than LR group. HR was associated with a decreased risk of uncontrolled asthma after the first-month initial treatment (adjusted OR: 0.12 [95% confidence intervals: 0.03–0.50]).

Conclusions

HR is a physiologic indicator of lower lung function and severer small airway obstruction, and is more related with an increased level of Th2-biomarkers than LR. Moreover, HR may indicate controlled asthma after the first-month initial treatment. This finding may contribute to identification of asthma endotype.

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Nifedipine induced gingival enlargement in an edentulous patient: a case report with one year follow up

Abstract

Background

Gingival enlargement due to calcium channel blockers is a common complaint reported by patients. It can be localized or generalized and can range from mild to severe, affecting patients appearance and function. Nifedipine induced gingival enlargement is noticed only in 10 % of patients and very few cases of Nifedipine induced gingival enlargement in an edentulous patient have been documented in the literature.

Case presentation

Here in, we report a case of gingival enlargement in a 70 year old hypertensive edentulous patient who was on low dose Nifedipine therapy. Patient wanted complete dentures. We planned to excise the overgrowth and followed up for 1 year.

Conclusion

Nifedipine induced gingival enlargement noticed only in 10 % of patients. Hence, there is a need for physicians and dentist to make a coordinated treatment plan and practice care while prescribing these drugs which are associated with gingival overgrowth.

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Nifedipine induced gingival enlargement in an edentulous patient: a case report with one year follow up

Abstract

Background

Gingival enlargement due to calcium channel blockers is a common complaint reported by patients. It can be localized or generalized and can range from mild to severe, affecting patients appearance and function. Nifedipine induced gingival enlargement is noticed only in 10 % of patients and very few cases of Nifedipine induced gingival enlargement in an edentulous patient have been documented in the literature.

Case presentation

Here in, we report a case of gingival enlargement in a 70 year old hypertensive edentulous patient who was on low dose Nifedipine therapy. Patient wanted complete dentures. We planned to excise the overgrowth and followed up for 1 year.

Conclusion

Nifedipine induced gingival enlargement noticed only in 10 % of patients. Hence, there is a need for physicians and dentist to make a coordinated treatment plan and practice care while prescribing these drugs which are associated with gingival overgrowth.

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Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

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Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QR7qZD

Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QR7qZD

Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QR7qZD

Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QR7qZD

Top 10 Articles in the ASHA Leader for 2018

Who doesn't love a top-10 list? With this list, you can peruse popular articles while honing your professional skills over the holidays. Enjoy re-reading or discovering for the first time some of the most-read articles printed in The ASHA Leader this past year. Top audiology articles Chomp. Slurp. Smack. SNAP! Hypersensitivity to certain trigger sounds—known as misophonia—can be socially and emotionally crippling for some people. Audiology Unbundled Wake Forest Baptist Health restructured its audiology clinic to establish an unbundled services model. Here's how they did it. Ear Care for All, On and Off the Job Companies expand hearing-protection efforts beyond employees exposed to occupational noise—to all employees at all hours. Maintaining Balance: Vestibular Help for Child...

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Psychological problems and quality of life of patients with oral mucosal diseases: a preliminary study in Chinese population

Abstract

Background

Psychological problems might play important roles in oral mucosal diseases such as recurrent aphthous ulcers (RAU), oral lichen planus (OLP), burning mouth syndrome (BMS), but the relevance to patients' quality of life remained controversial. The aim of this study was to investigate the psychological problems and oral health-related quality of life in patients with RAU, OLP, and BMS in China, to assess the relationship between psychological problems and quality of life.

Method

Thirty-nine RAU patients, 45 OLP patients, 15 BMS patients and 45 healthy controls were enrolled in the study. Hospital Anxiety and Depression Scale (HADS) were chosen to analyze the patients' psychological problems. Oral Health Impact Profile (OHIP-14) was used to measure the OHRQoL. The scores of HADS and OHIP-14 were used to analyze the relationship between psychological problems and the quality of life of oral mucosa patients.

Results

Each of OHIP-14 scores and HADS scores in RAU, OLP, BMS was higher than the control group, and there was significant difference in the patients groups with the control cases(P < 0.05). OHIP-14 score of RAU was the highest in three patient groups. Its OHRQoL was lowest in the three groups, which had statistical significance (P < 0.05). Positive correlations existed between the psychological problems and the quality of life of the three patient groups (r_s > 0, P < 0.05), except for the depression of the BMS group (r_s = 0.168, P = 0.395).

Conclusion

Patients with oral mucosal diseases such as RAU, OLP, and BMS had higher levels of anxiety, depression, and lower quality of life. The patient's psychological problems were related to their quality of life, suggesting that the psychological state of patients with oral mucosal disease need more attention.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CzQaPP

Psychological problems and quality of life of patients with oral mucosal diseases: a preliminary study in Chinese population

Abstract

Background

Psychological problems might play important roles in oral mucosal diseases such as recurrent aphthous ulcers (RAU), oral lichen planus (OLP), burning mouth syndrome (BMS), but the relevance to patients' quality of life remained controversial. The aim of this study was to investigate the psychological problems and oral health-related quality of life in patients with RAU, OLP, and BMS in China, to assess the relationship between psychological problems and quality of life.

Method

Thirty-nine RAU patients, 45 OLP patients, 15 BMS patients and 45 healthy controls were enrolled in the study. Hospital Anxiety and Depression Scale (HADS) were chosen to analyze the patients' psychological problems. Oral Health Impact Profile (OHIP-14) was used to measure the OHRQoL. The scores of HADS and OHIP-14 were used to analyze the relationship between psychological problems and the quality of life of oral mucosa patients.

Results

Each of OHIP-14 scores and HADS scores in RAU, OLP, BMS was higher than the control group, and there was significant difference in the patients groups with the control cases(P < 0.05). OHIP-14 score of RAU was the highest in three patient groups. Its OHRQoL was lowest in the three groups, which had statistical significance (P < 0.05). Positive correlations existed between the psychological problems and the quality of life of the three patient groups (r_s > 0, P < 0.05), except for the depression of the BMS group (r_s = 0.168, P = 0.395).

Conclusion

Patients with oral mucosal diseases such as RAU, OLP, and BMS had higher levels of anxiety, depression, and lower quality of life. The patient's psychological problems were related to their quality of life, suggesting that the psychological state of patients with oral mucosal disease need more attention.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CzQaPP

Prosodic Encoding of Focus in Hijazi Arabic

Publication date: Available online 24 December 2018Source: Speech CommunicationAuthor(s): Muhammad Swaileh Alzaidi, Yi Xu, Anqi XuAbstractThis paper presents findings of the first systematic acoustic analysis of focus prosody in Hijazi Arabic (HA), an under-researched Arabic dialect. A question-answer paradigm was used to elicit information and contrastive focus at different sentence locations in comparison with their neutral focus counterparts. Systematic acoustic analyses were performed to compare all the focus conditions, in terms of both continuous F0 trajectories and specific acoustic measurements. Results show that focused words have significantly expanded excursion size, higher maximum F0 and longer duration. Post-focus words have significantly lowered F0 (except in the case of penu...

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Linguistics as a biased discipline: Identifications and interventions

Publication date: Available online 24 December 2018Source: Language SciencesAuthor(s): Simon Borchmann, Carsten Levisen, Britta Schneider (Source: Language Sciences)

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Editorial Board

Publication date: January 2019Source: Lingua, Volume 217Author(s): (Source: Lingua)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Q2K9ik

Not speaking the same language: 17-month-olds shift their perception of novel labels following brief exposure to non-native language.

We examined if and when English-learning 17-month-olds would accommodate Japanese forms as labels for novel objects. In Experiment 1, infants (n = 22) who were habituated to Japanese word-object pairs looked longer at switched test pairs than familiar test pairs, suggesting that they had mapped Japanese word forms to objects. In Experiments 2 (n = 44) and 3 (n = 22), infants were presented with a spoken passage prior to habituation to assess whether experience with a different language would shift their perception of Japanese word forms. Here, infants did not demonstrate learning of Japanese word-object pairs. These findings offer insight into the flexibility of the developing perceptual system. That is, when there is no evidence to the contrary, 17-month-olds will accommodate forms that v...

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Evaluation of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging in qualitative diagnosis of hepatic masses

Abstract

Background

To explore the value of parameters of multiphase dynamic contrast-enhanced magnetic resonance imaging (MDCE-MRI) in the qualitative diagnosis of hepatic masses.

Methods

Eighty patients with hepatic masses were retrospectively analyzed. All the patients underwent MDCE-MRI at 3.0 T MR before treatment. Mean enhancement time (MET), positive enhancement integral (PEI), a maximum slope of increase (MSI), and a maximum slope of decrease (MSD) were measured.

Results

There were significant differences between benign and malignant hepatic masses with respect to MET, PEI, and MSI values. The PEI and MSI values between hemangiomas, hepatocellular carcinomas (HCCs), cholangiocarcinomas, and metastatic tumors had significant differences. The MSD value between metastatic tumors, HCCs, and hemangiomas were significantly different. The area under the curve (AUC) values of the receiver operator characteristic curves for MET, PEI, and MSI were 0.70, 0.72, and 0.80, respectively. The specificity of MET, PEI, and MSI were all 77%, and the sensitivities of MSI was the highest, of which was 82.40%. Logistic regression analysis showed the regression equation to be P = 1/[1 + e^{0.008 × 1 + 0.007 × 2–6.707}], and taking the Youden index maximum points as a diagnostic point was 0.2946.

Conclusion

Some parameters of MDCE-MRI have significant roles in differentiating hepatic masses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Q36X1l

Prosodic Encoding of Focus in Hijazi Arabic

Publication date: Available online 24 December 2018Source: Speech CommunicationAuthor(s): Muhammad Swaileh Alzaidi, Yi Xu, Anqi XuAbstractThis paper presents findings of the first systematic acoustic analysis of focus prosody in Hijazi Arabic (HA), an under-researched Arabic dialect. A question-answer paradigm was used to elicit information and contrastive focus at different sentence locations in comparison with their neutral focus counterparts. Systematic acoustic analyses were performed to compare all the focus conditions, in terms of both continuous F0 trajectories and specific acoustic measurements. Results show that focused words have significantly expanded excursion size, higher maximum F0 and longer duration. Post-focus words have significantly lowered F0 (except in the case of penu...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Q47eBc

Linguistics as a biased discipline: Identifications and interventions

Publication date: Available online 24 December 2018Source: Language SciencesAuthor(s): Simon Borchmann, Carsten Levisen, Britta Schneider (Source: Language Sciences)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VcLAyc

Editorial Board

Publication date: January 2019Source: Lingua, Volume 217Author(s): (Source: Lingua)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Q2K9ik

Not speaking the same language: 17-month-olds shift their perception of novel labels following brief exposure to non-native language.

We examined if and when English-learning 17-month-olds would accommodate Japanese forms as labels for novel objects. In Experiment 1, infants (n = 22) who were habituated to Japanese word-object pairs looked longer at switched test pairs than familiar test pairs, suggesting that they had mapped Japanese word forms to objects. In Experiments 2 (n = 44) and 3 (n = 22), infants were presented with a spoken passage prior to habituation to assess whether experience with a different language would shift their perception of Japanese word forms. Here, infants did not demonstrate learning of Japanese word-object pairs. These findings offer insight into the flexibility of the developing perceptual system. That is, when there is no evidence to the contrary, 17-month-olds will accommodate forms that v...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Vas0Tg

Evaluation of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging in qualitative diagnosis of hepatic masses

Abstract

Background

To explore the value of parameters of multiphase dynamic contrast-enhanced magnetic resonance imaging (MDCE-MRI) in the qualitative diagnosis of hepatic masses.

Methods

Eighty patients with hepatic masses were retrospectively analyzed. All the patients underwent MDCE-MRI at 3.0 T MR before treatment. Mean enhancement time (MET), positive enhancement integral (PEI), a maximum slope of increase (MSI), and a maximum slope of decrease (MSD) were measured.

Results

There were significant differences between benign and malignant hepatic masses with respect to MET, PEI, and MSI values. The PEI and MSI values between hemangiomas, hepatocellular carcinomas (HCCs), cholangiocarcinomas, and metastatic tumors had significant differences. The MSD value between metastatic tumors, HCCs, and hemangiomas were significantly different. The area under the curve (AUC) values of the receiver operator characteristic curves for MET, PEI, and MSI were 0.70, 0.72, and 0.80, respectively. The specificity of MET, PEI, and MSI were all 77%, and the sensitivities of MSI was the highest, of which was 82.40%. Logistic regression analysis showed the regression equation to be P = 1/[1 + e^{0.008 × 1 + 0.007 × 2–6.707}], and taking the Youden index maximum points as a diagnostic point was 0.2946.

Conclusion

Some parameters of MDCE-MRI have significant roles in differentiating hepatic masses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Q36X1l

Quantitative Evaluation of Nasolabial Alterations following Nasoalveolar Molding (NAM) Therapy in Patients with Unilateral Cleft Lip

Facial plast Surg
DOI: 10.1055/s-0038-1675633

The clinical benefit of nasoalveolar molding (NAM) is actively debated between cleft centers without clear consensus. Nasolabial measurements were performed on pediatric patients with unilateral clefts of the lip, with or without cleft palate, at an academic cleft/craniofacial center prior to and following NAM therapy between June 2015 and August 2016. The parameters of interest were: columella height and width, cleft nostril height and width, and lip width. Measurements were performed using photographs taken alongside a reference object. The image output was then scaled to the size of the reference object and the capture angle. Intraclass correlation coefficient was calculated to assess reliability of the photographic measurements. Descriptive statistics (mean, standard deviation [SD]) were calculated to characterize the pre- and post-NAM measurements. Student's t-tests were performed to compare the pre-NAM versus post-NAM measurements. The primary objective was to measure the effect of NAM on the nasal aesthetic units that are known to be anatomically aberrant in the cleft lip patient. Nine patients were included in this study. Average pre-NAM age was 2.5 weeks, and average post-NAM age was 13 weeks. Average columellar height increased from 3.70 mm (SD = 0.14) pre-NAM to 5.85 mm (SD = 1.96) post-NAM (p < 0.01); average columellar width increased from 4.71 mm (SD = 0.49) to 5.93 mm (SD = 0.71) (p < 0.01); average cleft nostril height increased from 3.54 mm (SD = 2.97) to 6.81 mm (SD = 2.98) (p = 0.01); and average cleft nostril width decreased from 15.46 mm (SD = 2.91) to 11.05 mm (SD = 1.01) (p = 0.01). Average lip width decreased from 34.61 mm (SD = 1.73) to 33.87 mm (SD = 3.67); however, this change was not statistically significant (p = 0.16). This study objectively quantifies positive changes in nasal aesthetics associated with NAM therapy, providing further evidence for its utility as a presurgical treatment modality for optimal aesthetic nasal results in the unilateral cleft lip patient. The major limitation of this study was a lack of control group, as our center universally treats complete unilateral cleft lip patients with NAM therapy. However, the authors strongly believe that the positive aesthetic nasal findings would persist if compared with a non-NAM control group.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GQ50pQ

Quantitative Evaluation of Nasolabial Alterations following Nasoalveolar Molding (NAM) Therapy in Patients with Unilateral Cleft Lip

Facial plast Surg
DOI: 10.1055/s-0038-1675633

The clinical benefit of nasoalveolar molding (NAM) is actively debated between cleft centers without clear consensus. Nasolabial measurements were performed on pediatric patients with unilateral clefts of the lip, with or without cleft palate, at an academic cleft/craniofacial center prior to and following NAM therapy between June 2015 and August 2016. The parameters of interest were: columella height and width, cleft nostril height and width, and lip width. Measurements were performed using photographs taken alongside a reference object. The image output was then scaled to the size of the reference object and the capture angle. Intraclass correlation coefficient was calculated to assess reliability of the photographic measurements. Descriptive statistics (mean, standard deviation [SD]) were calculated to characterize the pre- and post-NAM measurements. Student's t-tests were performed to compare the pre-NAM versus post-NAM measurements. The primary objective was to measure the effect of NAM on the nasal aesthetic units that are known to be anatomically aberrant in the cleft lip patient. Nine patients were included in this study. Average pre-NAM age was 2.5 weeks, and average post-NAM age was 13 weeks. Average columellar height increased from 3.70 mm (SD = 0.14) pre-NAM to 5.85 mm (SD = 1.96) post-NAM (p < 0.01); average columellar width increased from 4.71 mm (SD = 0.49) to 5.93 mm (SD = 0.71) (p < 0.01); average cleft nostril height increased from 3.54 mm (SD = 2.97) to 6.81 mm (SD = 2.98) (p = 0.01); and average cleft nostril width decreased from 15.46 mm (SD = 2.91) to 11.05 mm (SD = 1.01) (p = 0.01). Average lip width decreased from 34.61 mm (SD = 1.73) to 33.87 mm (SD = 3.67); however, this change was not statistically significant (p = 0.16). This study objectively quantifies positive changes in nasal aesthetics associated with NAM therapy, providing further evidence for its utility as a presurgical treatment modality for optimal aesthetic nasal results in the unilateral cleft lip patient. The major limitation of this study was a lack of control group, as our center universally treats complete unilateral cleft lip patients with NAM therapy. However, the authors strongly believe that the positive aesthetic nasal findings would persist if compared with a non-NAM control group.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ESEOZP

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Therapeutic Drug Monitoring of Tocilizumab in Rheumatoid Arthritis

Conditions:   Rheumatoid Arthritis;   Tocilizumab Intervention:   Drug: Tocilizumab Sponsors:   Tel-Aviv Sourasky Medical Center;   Amsterdam Rheumatology and Immunology Center Recruiting (Source: ClinicalTrials.gov)

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Identification of Allergic Asthmatics Reactive to Felis Catus (Cat Hair) Allergen Inhalation

Condition:   Asthma Atopic Intervention:   Biological: Felis Catus Sponsors:   University of North Carolina, Chapel Hill;   National Heart, Lung, and Blood Institute (NHLBI) Not yet recruiting (Source: ClinicalTrials.gov)

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Impact of Pollution on Allergic Rhinitis and Sleep Quality: the POLLAR Study

Conditions:   Sleep Apnea;   Allergic Rhinitis;   Allergic Asthma;   Pollution; Exposure;   Pollution Related Respiratory Disorder Intervention:   Other: Pollution exposure Sponsors:   University Hospital, Grenoble;   Assistance Publique - Hôpitaux de Paris Not yet recruiting (Source: ClinicalTrials.gov)

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The role of Vestibular Evoked Myogenic Potentials in multiple sclerosis-related vertigo. A systematic review of the literature

ConclusionsOur results suggest that VEMPs may detect very small lesions in the vestibular pathways of MS patients; thus, they could have a role in the diagnosis of MS-related vertigo and in the monitoring of vertigo in MS patients as a tool additional to traditional MRI.Graphical Abstract (Source: Multiple Sclerosis and Related Disorders)

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Bilirubin-induced neurotoxic and ototoxic effects in rat cochlear and vestibular organotypic cultures.

Authors: Ye H, Xing Y, Zhang L, Zhang J, Jiang H, Ding D, Shi H, Yin S Abstract Exposure to high levels of bilirubin in hyperbilirubinemia patients and animal models can result in sensorineural deafness. However, the mechanisms underlying bilirubin-induced damage to the inner ear, including the cochlear and vestibular organs, remain unknown. The present analyses of cochlear and vestibular organotypic cultures obtained from postnatal day 3 rats exposed to bilirubin at varying concentrations (0, 10, 50, 100, or 250 μM) for 24 h revealed that auditory nerve fibers (ANFs) and vestibular nerve endings were destroyed even at low doses (10 and 50 μM). Additionally, as the bilirubin dose increased, spiral ganglion neurons (SGNs) and vestibular ganglion neurons (VGNs) exhibited grad...

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The power of language: Functional brain network topology of deaf and hearing in relation to sign language experience.

In this study we investigated differences in functional brain network topology between deaf and hearing individuals. We also studied altered functional network responses between deaf and hearing individuals with a recording paradigm containing an eyes-closed and eyes-open condition. Electroencephalography activity was recorded in a group of sign language-trained deaf (N = 71) and hearing people (N = 122) living in rural Africa. Functional brain networks were constructed from the functional connectivity between fourteen electrodes distributed over the scalp. Functional connectivity was quantified with the phase lag index based on bandpass filtered epochs of brain signal. We studied the functional connectivity between the auditory, somatosensory and visual cortex and performed whole-...

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Effects of tympanic membrane perforation on middle ear transmission in gerbil.

Authors: Stomackin G, Kidd S, Jung TT, Martin GK, Dong W Abstract Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the infl...

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The role of Vestibular Evoked Myogenic Potentials in multiple sclerosis-related vertigo. A systematic review of the literature

ConclusionsOur results suggest that VEMPs may detect very small lesions in the vestibular pathways of MS patients; thus, they could have a role in the diagnosis of MS-related vertigo and in the monitoring of vertigo in MS patients as a tool additional to traditional MRI.Graphical Abstract (Source: Multiple Sclerosis and Related Disorders)

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Bilirubin-induced neurotoxic and ototoxic effects in rat cochlear and vestibular organotypic cultures.

Authors: Ye H, Xing Y, Zhang L, Zhang J, Jiang H, Ding D, Shi H, Yin S Abstract Exposure to high levels of bilirubin in hyperbilirubinemia patients and animal models can result in sensorineural deafness. However, the mechanisms underlying bilirubin-induced damage to the inner ear, including the cochlear and vestibular organs, remain unknown. The present analyses of cochlear and vestibular organotypic cultures obtained from postnatal day 3 rats exposed to bilirubin at varying concentrations (0, 10, 50, 100, or 250 μM) for 24 h revealed that auditory nerve fibers (ANFs) and vestibular nerve endings were destroyed even at low doses (10 and 50 μM). Additionally, as the bilirubin dose increased, spiral ganglion neurons (SGNs) and vestibular ganglion neurons (VGNs) exhibited grad...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BKLJjQ

The power of language: Functional brain network topology of deaf and hearing in relation to sign language experience.

In this study we investigated differences in functional brain network topology between deaf and hearing individuals. We also studied altered functional network responses between deaf and hearing individuals with a recording paradigm containing an eyes-closed and eyes-open condition. Electroencephalography activity was recorded in a group of sign language-trained deaf (N = 71) and hearing people (N = 122) living in rural Africa. Functional brain networks were constructed from the functional connectivity between fourteen electrodes distributed over the scalp. Functional connectivity was quantified with the phase lag index based on bandpass filtered epochs of brain signal. We studied the functional connectivity between the auditory, somatosensory and visual cortex and performed whole-...

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 http://bit.ly/2QQGhpN

Effects of tympanic membrane perforation on middle ear transmission in gerbil.

Authors: Stomackin G, Kidd S, Jung TT, Martin GK, Dong W Abstract Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the infl...

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Teva ’s ProAir Digihaler FDA Approved to Monitor Asthma and COPD Treatment

Teva Pharmaceutical, based in Israel, landed the first FDA approval for a digital inhaler with built-in sensors. The ProAir Digihaler (albuterol sulfate 117 mcg) Inhalation Powder is indicated for people suffering from asthma & COPD as a way of preventing and treating bronchospasm, a tightening of the muscles that line the airways. The ProAir Digihaler monitors how it's used and uploads the data to an accompanying smartphone app via Bluetooth wireless connectivity. Specifically, the device detects every time it has been use to administer treatment, as well as the inspiratory airflow during each inhalation. "There are 25 million Americans living with asthma, many of whom use inhalers as part of their treatment regimen. Despite advancements in care over the years, we know that...

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A patient sues when a DNR is ignored

A New Mexico woman, suffering from Dercum 's disease (adiposis dolorosa) which causes painful fatty tumors, is suing a Santa Fe hospital and an emergency physician claiming she was the victim of two negligent acts in 2016. One, according to the Albuquerque Journal, she told hospital personnel she was allergic to Dilaudid but went into ca rdiac arrest […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more. (Source: Kevin, M.D. - Medical Weblog)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EOpjC5

Teva ’s ProAir Digihaler FDA Approved to Monitor Asthma and COPD Treatment

Teva Pharmaceutical, based in Israel, landed the first FDA approval for a digital inhaler with built-in sensors. The ProAir Digihaler (albuterol sulfate 117 mcg) Inhalation Powder is indicated for people suffering from asthma & COPD as a way of preventing and treating bronchospasm, a tightening of the muscles that line the airways. The ProAir Digihaler monitors how it's used and uploads the data to an accompanying smartphone app via Bluetooth wireless connectivity. Specifically, the device detects every time it has been use to administer treatment, as well as the inspiratory airflow during each inhalation. "There are 25 million Americans living with asthma, many of whom use inhalers as part of their treatment regimen. Despite advancements in care over the years, we know that...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2EMY0qQ

A patient sues when a DNR is ignored

A New Mexico woman, suffering from Dercum 's disease (adiposis dolorosa) which causes painful fatty tumors, is suing a Santa Fe hospital and an emergency physician claiming she was the victim of two negligent acts in 2016. One, according to the Albuquerque Journal, she told hospital personnel she was allergic to Dilaudid but went into ca rdiac arrest […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more. (Source: Kevin, M.D. - Medical Weblog)

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Diffusion-Weighted Magnetic Resonance Imaging in the Detection of Residual and Recurrent Cholesteatoma in Children: A Systematic Review and Meta-Analysis

Publication date: Available online 26 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Khalil Bazzi, Eugene Wong, Nicholas Jufas, Nirmal Patel

Abstract

Objective

To examine the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual and recurrent cholesteatoma in children.

Methods

A systematic review and meta-analysis was conducted as per PRISMA guidelines using the following databases from their date of inception: MEDLINE, PubMed, Embase, Cochrane Library, Web of Science. Bivariate meta-analysis using a random effects model was used to calculate summarized pooled estimates of sensitivity, specificity, and diagnostic odds ratios, using second-look surgery as the gold standard comparison.

Results

A total of ten articles (141 cases) were included for qualitative and quantitative analysis. Pooled sensitivity and specificity of non-echo planar imaging (non-EPI) DW-MRI were 89.4% (95%CI 51.9%-98.5%) and 92.9% (95%CI 81.4%-97.5%) respectively. DW-MRI appears limited in its ability to detect lesions less than 3mm in size.

Conclusion

Non-EPI DW-MRI is highly specific but carries uncertain sensitivity in the detection of residual and recurrent cholesteatoma in children. Further research is warranted to determine the specific role of DW-MRI in this patient group, namely when and how often children should be referred for imaging and in which cases the method can be used to completely replace second-look surgery.

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Deep interarytenoid notch in young children managed with systematic thickener wean and injection laryngoplasty

Publication date: Available online 26 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Usmaan Basharat, Scott Schraff, Lindsay M. Stevens, Pamela Y. Clarke, Paul Kang, Jim Woodward, Shauna R. Schroeder, Aparna Rao, Nathan Page, Dana I. Williams

Abstract

Objectives

Deep interarytenoid notch (DIN) is a congenital variation of the larynx often associated with dysphagia and aspiration (DA) in young children. Feeding therapy with thickeners and surgical management with injection larygoplasty (IL) are used with various efficacies. Thickeners address the functional domain and IL addresses the anatomical domain of treatment. Our objective was to evaluate DIN patients managed with both interventions.

Methods

We conducted a retrospective pilot descriptive study of DIN patients with DA aged 1-3 years receiving thickeners and IL. Patients received a systematic weekly reduction of thickeners, referred to as the Thickener Weaning Protocol (TWP), based on clinical signs and symptoms of DA. The outcomes were assessed by the rate of thickener level reduction and DA-related sign/symptom frequency achieved at 6 months post-treatment.

Results

Thirteen patients with DIN associated DA were analyzed. The TWP was initiated within 2 months in 77% of patients, and within 4 months in 100% of patients. Thickener scores improved from an average of 5.76 (3/4 honey) to 2.15 (thin) (p = 0.001). DA-related signs/symptoms frequency improved from an average of 3.3 to 0.84 (p = 0.05).

Conclusions

These findings suggest that treatment of DIN associated DA with a combination of thickeners and IL results in significant clinical improvements in young children.

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Diffusion-Weighted Magnetic Resonance Imaging in the Detection of Residual and Recurrent Cholesteatoma in Children: A Systematic Review and Meta-Analysis

Publication date: Available online 26 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Khalil Bazzi, Eugene Wong, Nicholas Jufas, Nirmal Patel

Abstract

Objective

To examine the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of residual and recurrent cholesteatoma in children.

Methods

A systematic review and meta-analysis was conducted as per PRISMA guidelines using the following databases from their date of inception: MEDLINE, PubMed, Embase, Cochrane Library, Web of Science. Bivariate meta-analysis using a random effects model was used to calculate summarized pooled estimates of sensitivity, specificity, and diagnostic odds ratios, using second-look surgery as the gold standard comparison.

Results

A total of ten articles (141 cases) were included for qualitative and quantitative analysis. Pooled sensitivity and specificity of non-echo planar imaging (non-EPI) DW-MRI were 89.4% (95%CI 51.9%-98.5%) and 92.9% (95%CI 81.4%-97.5%) respectively. DW-MRI appears limited in its ability to detect lesions less than 3mm in size.

Conclusion

Non-EPI DW-MRI is highly specific but carries uncertain sensitivity in the detection of residual and recurrent cholesteatoma in children. Further research is warranted to determine the specific role of DW-MRI in this patient group, namely when and how often children should be referred for imaging and in which cases the method can be used to completely replace second-look surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VaZPne

Deep interarytenoid notch in young children managed with systematic thickener wean and injection laryngoplasty

Publication date: Available online 26 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Usmaan Basharat, Scott Schraff, Lindsay M. Stevens, Pamela Y. Clarke, Paul Kang, Jim Woodward, Shauna R. Schroeder, Aparna Rao, Nathan Page, Dana I. Williams

Abstract

Objectives

Deep interarytenoid notch (DIN) is a congenital variation of the larynx often associated with dysphagia and aspiration (DA) in young children. Feeding therapy with thickeners and surgical management with injection larygoplasty (IL) are used with various efficacies. Thickeners address the functional domain and IL addresses the anatomical domain of treatment. Our objective was to evaluate DIN patients managed with both interventions.

Methods

We conducted a retrospective pilot descriptive study of DIN patients with DA aged 1-3 years receiving thickeners and IL. Patients received a systematic weekly reduction of thickeners, referred to as the Thickener Weaning Protocol (TWP), based on clinical signs and symptoms of DA. The outcomes were assessed by the rate of thickener level reduction and DA-related sign/symptom frequency achieved at 6 months post-treatment.

Results

Thirteen patients with DIN associated DA were analyzed. The TWP was initiated within 2 months in 77% of patients, and within 4 months in 100% of patients. Thickener scores improved from an average of 5.76 (3/4 honey) to 2.15 (thin) (p = 0.001). DA-related signs/symptoms frequency improved from an average of 3.3 to 0.84 (p = 0.05).

Conclusions

These findings suggest that treatment of DIN associated DA with a combination of thickeners and IL results in significant clinical improvements in young children.

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The ion channels and synapses responsible for the physiological diversity of mammalian lower brainstem auditory neurons

Publication date: Available online 26 December 2018

Source: Hearing Research

Author(s): Ricardo M. Leão

Abstract

The auditory part of the brainstem is composed of several nuclei specialized in the computation of the different spectral and temporal features of the sound before it reaches the higher auditory regions. There are a high diversity of neuronal types in these nuclei, many with remarkable electrophysiological and synaptic properties unique to these structures. This diversity reflects specializations necessary to process the different auditory signals in order to extract precisely the acoustic information necessary for the auditory perception by the animal. Low threshold Kv1 channels and HCN channels are expressed in neurons that use timing clues for auditory processing, like Bushy and octopus cells, in order to restrict action potential firing and reduce input resistance and membrane time constant. Kv3 channels allow principal neurons of the MNTB and pyramidal DCN neurons to fire fast trains of action potentials. Calcium channels on cartwheel DCN neurons produce complex spikes characteristic of these neurons. Calyceal synapses compensate the low input resistance of several of Bushy and principal neurons of the MNTB by releasing hundreds of glutamate vesicles resulting in large EPSCs acting in fast ionotropic glutamate receptors, in order to reduce temporal summation of synaptic potentials, allowing more precise correspondence of pre- and post-synaptic potentials, and phase-locking. Pre-synaptic calyceal sodium channels have fast recovery from inactivation allowing extremely fast trains of action potential firing, and persistent sodium channels produce spontaneous activity of fusiform neurons at rest, which expands the dynamic range of these neurons. The unique combinations of different ion channels, ionotropic receptors and synaptic structures create a unique functional diversity of neurons extremely adapted to their complex functions in the auditory processing.

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The ion channels and synapses responsible for the physiological diversity of mammalian lower brainstem auditory neurons

Publication date: Available online 26 December 2018

Source: Hearing Research

Author(s): Ricardo M. Leão

Abstract

The auditory part of the brainstem is composed of several nuclei specialized in the computation of the different spectral and temporal features of the sound before it reaches the higher auditory regions. There are a high diversity of neuronal types in these nuclei, many with remarkable electrophysiological and synaptic properties unique to these structures. This diversity reflects specializations necessary to process the different auditory signals in order to extract precisely the acoustic information necessary for the auditory perception by the animal. Low threshold Kv1 channels and HCN channels are expressed in neurons that use timing clues for auditory processing, like Bushy and octopus cells, in order to restrict action potential firing and reduce input resistance and membrane time constant. Kv3 channels allow principal neurons of the MNTB and pyramidal DCN neurons to fire fast trains of action potentials. Calcium channels on cartwheel DCN neurons produce complex spikes characteristic of these neurons. Calyceal synapses compensate the low input resistance of several of Bushy and principal neurons of the MNTB by releasing hundreds of glutamate vesicles resulting in large EPSCs acting in fast ionotropic glutamate receptors, in order to reduce temporal summation of synaptic potentials, allowing more precise correspondence of pre- and post-synaptic potentials, and phase-locking. Pre-synaptic calyceal sodium channels have fast recovery from inactivation allowing extremely fast trains of action potential firing, and persistent sodium channels produce spontaneous activity of fusiform neurons at rest, which expands the dynamic range of these neurons. The unique combinations of different ion channels, ionotropic receptors and synaptic structures create a unique functional diversity of neurons extremely adapted to their complex functions in the auditory processing.

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Sensation seeking to marijuana use: Exploring the mediating roles of risk appraisal and social norms

Publication date: Available online 26 December 2018

Source: Addictive Behaviors

Author(s): Timothy C. Barnum, Todd Armstrong

Abstract

While studies have shown a robust association between sensation seeking (SS) and adolescent marijuana use, comparatively little is known about the mechanisms that potentially account for this association. The current study tests a theoretical model linking SS to marijuana use through risk appraisal and normative influences (i.e., perceived behavior and attitudes of others). Utilizing a nationally representative, cross-sectional sample of high school seniors (N = 2117), the current study finds risk appraisal and normative influences mediate the relationship between SS and marijuana use. Furthermore, perceptions of risk appear to be strongly influenced by proximal peer norms. These results indicate risk appraisal and normative processes may be key explanatory mechanisms in the association between SS and adolescent marijuana use. Theoretical and policy implications for this model are discussed.

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“..that warm feeling that [alcohol] gave me was what I interpreted love would feel like..” Lived experience of excessive alcohol use and care proceedings by mothers in the family justice system in the UK

Publication date: Available online 26 December 2018

Source: Addictive Behaviors

Author(s): Maggie Boreham, Sally Marlow, Gail Gilchrist

Abstract

Background

When mothers who have been identified as using alcohol excessively appear in child care proceedings seeking to retain care of, or be reunited with, their children, family courts primarily focus on whether those mothers can make lasting changes to their use of alcohol, very often requiring them to achieve abstinence. The aim of this study was to advance the evidence base around how such mothers make sense of their alcohol use, and their position as mothers, in the systems and processes around care proceedings.

Methods

Qualitative, face-to-face interviews were carried out at various children and families' services locations across the UK. These yielded in-depth accounts, to which Interpretative Phenomenological Analysis (IPA) was applied.

Results

Six mothers were recruited from collaborations with 31 local authorities. Themes relating to alcohol use included relationships in childhood, repeated traumatic events, and the use of alcohol to self-manage these. In response to extreme fear arising from violence in their relationships with older men, alcohol provided the means to function. Escalation of alcohol use in participants' lives was accompanied by greater isolation, alongside shameful feelings about being a "drunk", which were barriers to help-seeking. Themes relating to motherhood in the context of care proceedings included wanting to change behaviour for themselves and their children, being excluded from their children's lives, and experiencing a continual requirement to prove their parenting and their abstinence from alcohol. Language used by social services, the courts and alcohol treatment services, placed mothers in conflicting positions of being in recovery, but having to present as recovered.

Conclusion

Despite excessive alcohol misuse in mothers being closely enmeshed with other issues, awareness and understanding of factors such as complex trauma, and how to support mothers with these factors, is limited, and should be considered in terms of improving research and best practice.

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Sensation seeking to marijuana use: Exploring the mediating roles of risk appraisal and social norms

Publication date: Available online 26 December 2018

Source: Addictive Behaviors

Author(s): Timothy C. Barnum, Todd Armstrong

Abstract

While studies have shown a robust association between sensation seeking (SS) and adolescent marijuana use, comparatively little is known about the mechanisms that potentially account for this association. The current study tests a theoretical model linking SS to marijuana use through risk appraisal and normative influences (i.e., perceived behavior and attitudes of others). Utilizing a nationally representative, cross-sectional sample of high school seniors (N = 2117), the current study finds risk appraisal and normative influences mediate the relationship between SS and marijuana use. Furthermore, perceptions of risk appear to be strongly influenced by proximal peer norms. These results indicate risk appraisal and normative processes may be key explanatory mechanisms in the association between SS and adolescent marijuana use. Theoretical and policy implications for this model are discussed.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SkYGrB

“..that warm feeling that [alcohol] gave me was what I interpreted love would feel like..” Lived experience of excessive alcohol use and care proceedings by mothers in the family justice system in the UK

Publication date: Available online 26 December 2018

Source: Addictive Behaviors

Author(s): Maggie Boreham, Sally Marlow, Gail Gilchrist

Abstract

Background

When mothers who have been identified as using alcohol excessively appear in child care proceedings seeking to retain care of, or be reunited with, their children, family courts primarily focus on whether those mothers can make lasting changes to their use of alcohol, very often requiring them to achieve abstinence. The aim of this study was to advance the evidence base around how such mothers make sense of their alcohol use, and their position as mothers, in the systems and processes around care proceedings.

Methods

Qualitative, face-to-face interviews were carried out at various children and families' services locations across the UK. These yielded in-depth accounts, to which Interpretative Phenomenological Analysis (IPA) was applied.

Results

Six mothers were recruited from collaborations with 31 local authorities. Themes relating to alcohol use included relationships in childhood, repeated traumatic events, and the use of alcohol to self-manage these. In response to extreme fear arising from violence in their relationships with older men, alcohol provided the means to function. Escalation of alcohol use in participants' lives was accompanied by greater isolation, alongside shameful feelings about being a "drunk", which were barriers to help-seeking. Themes relating to motherhood in the context of care proceedings included wanting to change behaviour for themselves and their children, being excluded from their children's lives, and experiencing a continual requirement to prove their parenting and their abstinence from alcohol. Language used by social services, the courts and alcohol treatment services, placed mothers in conflicting positions of being in recovery, but having to present as recovered.

Conclusion

Despite excessive alcohol misuse in mothers being closely enmeshed with other issues, awareness and understanding of factors such as complex trauma, and how to support mothers with these factors, is limited, and should be considered in terms of improving research and best practice.

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Intraductal carcinoma of the prostate (IDC‐P) lowers apparent diffusion coefficient (ADC) values among intermediate risk prostate cancers

Background

Prostatic intraductal carcinoma (IDC‐P) is an aggressive variant of prostate cancer (PCa) characterized by proliferation of malignant cells within prostatic ducts/acini and nucleomegaly.

Purpose/Hypothesis

To compare apparent diffusion coefficient (ADC) values and Prostate Imaging and Data Reporting System (PI‐RADS) v. 2 scores in intermediate risk (International Society of Urological Pathology [ISUP] Grade Group [GG] 2 and 3) PCa with/without IDC‐P to determine if IDC‐P alters the MRI appearance of PCa.

Study Type

Retrospective, case–control.

Population

Fifteen consecutive men with ISUP GG 2/3 (Gleason score 3+4 = 7 [N = 4], 4+3 = 7 [N = 11]) PCa with IDC‐P diagnosed at radical prostatectomy were compared with: 1) ISUP GG 2/3 PCa without IDC‐P (matched for percentage Gleason pattern 4), and 2) ISUP GG 4 and 5 (Gleason score 8/9) PCa without IDC‐P.

Field Strength/Sequence

3T multiparametric MRI.

Assessment

Two blinded radiologists (R1/R2) measured mean ADC, ADC.ratio (ADC.tumor/ADC.normal peripheral zone) and assigned PI‐RADS v2 scores.

Statistical Tests: Chi‐square and analysis of variance (ANOVA).

Results

There were no differences in age, prostate serum antigen, tumor size, or stage between groups (P = 0.063‐0.912). Tumors with IDC‐P had lower mean ADC and ADC.ratio (0.741 ± 0.152 mm²/sec and 0.44 ± 0.07) compared with ISUP GG 2/3 tumors without IDC‐P (0.888 ± 0.167 mm²/sec and 0.62 ± 0.14), P = 0.012 and <0.001; and did not differ compared with ISUP GG 4/5 tumors (0.705 ± 0.141 mm²/sec and 0.44 ± 0.08), P = 0.509 and 0.868. Tumors with IDC‐P were nearly all PI‐RADS v2 score 5 (14/15) compared with ISUP GG 2/3 tumors without IDC‐P (10/15 R1, 8/15 R2) and GG 4/5 tumors (9/15), (P = 0.040 = 0.092). Agreement in PI‐RADS v2 scoring was moderate (K = 0.68).

Data Conclusion

ISUP GG 2 and 3 (intermediate risk, Gleason score 7) PCa with IDC‐P have lower ADC compared with tumors without IDC‐P with a similar percentage of Gleason pattern 4 and resemble ISUP GG 4 and 5 high risk tumors on MRI. IDC‐P lowers ADC values among intermediate risk prostate cancers.

Level of Evidence: 3

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2018.

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Quantitative 3T multiparametric MRI of benign and malignant prostatic tissue in patients with and without local recurrent prostate cancer after external‐beam radiation therapy

Background

Post‐radiotherapy locally recurrent prostate cancer (PCa) patients are candidates for focal salvage treatment. Multiparametric MRI (mp‐MRI) is attractive for tumor localization. However, radiotherapy‐induced tissue changes complicate image interpretation. To develop focal salvage strategies, accurate tumor localization and distinction from benign tissue is necessary.

Purpose

To quantitatively characterize radio‐recurrent tumor and benign radiation‐induced changes using mp‐MRI, and investigate which sequences optimize the distinction between tumor and benign surroundings.

Study Type

Prospective case–control.

Subjects

Thirty‐three patients with biochemical failure after external‐beam radiotherapy (cases), 35 patients without post‐radiotherapy recurrent disease (controls), and 13 patients with primary PCa (untreated).

Field Strength/Sequences

3T; quantitative mp‐MRI: T₂‐mapping, ADC, and K^trans and k_ep maps.

Assessment

Quantitative image‐analysis of prostatic regions, within and between cases, controls, and untreated patients.

Statistical Tests

Within‐groups: nonparametric Friedman analysis of variance with post‐hoc Wilcoxon signed‐rank tests; between‐groups: Mann–Whitney tests. All with Bonferroni corrections. Generalized linear mixed modeling to ascertain the contribution of each map and location to tumor likelihood.

Results

Benign imaging values were comparable between cases and controls (P = 0.15 for ADC in the central gland up to 0.91 for k_ep in the peripheral zone), both with similarly high peri‐urethral K^trans and k_ep values (min⁻¹) (median [range]: K^trans = 0.22 [0.14–0.43] and 0.22 [0.14–0.36], P = 0.60, k_ep = 0.43 [0.24–0.57] and 0.48 [0.32–0.67], P = 0.05). After radiotherapy, benign central gland values were significantly decreased for all maps (P ≤ 0.001) as well as T₂, K^trans, and k_ep of benign peripheral zone (all with P ≤ 0.002). All imaging maps distinguished recurrent tumor from benign peripheral zone, but only ADC, K^trans, and k_ep were able to distinguish it from benign central gland. Recurrent tumor and peri‐urethral K^trans values were not significantly different (P = 0.81), but k_ep values were (P < 0.001). Combining all quantitative maps and voxel location resulted in an optimal distinction between tumor and benign voxels.

Data Conclusion

Mp‐MRI can distinguish recurrent tumor from benign tissue.

Level of Evidence: 2

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2018.

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Immediate provisionalization of bone level implants with a hydrophilic surface. A 5‐year follow‐up of a randomised controlled clinical trial

Abstract

Objectives

To follow‐up the radiographic bone level changes and the clinical outcomes of immediately provisionalized and conventionally restored implants with a hydrophilic surface following 5 years of function.

Materials and methods

This was a 5‐year follow‐up of a prospective, randomized, single blind controlled study involving 16 out of the 24 originally recruited patients in need of a single tooth replacement in the esthetic area. Implants were either immediately provisionalized with a non‐occluding temporary crown (test group, n=7), or left without a crown (control group, n=9). In both groups, the definitive restoration was placed 16 weeks after implant placement. Radiographic and clinical parameters were evaluated at 36, 48 and 60 months post‐implant placement, together with implant survival and success rates. The esthetic outcomes were measured with the Papilla Fill Index (PFI) and the Pink Esthetic Score (PES).

Results

At 60 months, similar peri‐implant bone loss was observed in the test (‐0.42 mm ± 0.17 mm) and in the control (‐0.37 mm ± 0.35 mm) groups. A tendency for an improved esthetic outcome from implant loading to the subsequent follow‐ups was noticed in both groups. Both groups presented with high levels of long‐term implant survival and success.

Conclusions

This study supports non‐functional immediate provisionalization as a viable long‐term option for the management of single‐tooth implants in the esthetic area. However, the small sample size does not allow statistical inference at 60 months of follow‐up and future adequately powered studies are warranted

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Intraductal carcinoma of the prostate (IDC‐P) lowers apparent diffusion coefficient (ADC) values among intermediate risk prostate cancers

Background

Prostatic intraductal carcinoma (IDC‐P) is an aggressive variant of prostate cancer (PCa) characterized by proliferation of malignant cells within prostatic ducts/acini and nucleomegaly.

Purpose/Hypothesis

To compare apparent diffusion coefficient (ADC) values and Prostate Imaging and Data Reporting System (PI‐RADS) v. 2 scores in intermediate risk (International Society of Urological Pathology [ISUP] Grade Group [GG] 2 and 3) PCa with/without IDC‐P to determine if IDC‐P alters the MRI appearance of PCa.

Study Type

Retrospective, case–control.

Population

Fifteen consecutive men with ISUP GG 2/3 (Gleason score 3+4 = 7 [N = 4], 4+3 = 7 [N = 11]) PCa with IDC‐P diagnosed at radical prostatectomy were compared with: 1) ISUP GG 2/3 PCa without IDC‐P (matched for percentage Gleason pattern 4), and 2) ISUP GG 4 and 5 (Gleason score 8/9) PCa without IDC‐P.

Field Strength/Sequence

3T multiparametric MRI.

Assessment

Two blinded radiologists (R1/R2) measured mean ADC, ADC.ratio (ADC.tumor/ADC.normal peripheral zone) and assigned PI‐RADS v2 scores.

Statistical Tests: Chi‐square and analysis of variance (ANOVA).

Results

There were no differences in age, prostate serum antigen, tumor size, or stage between groups (P = 0.063‐0.912). Tumors with IDC‐P had lower mean ADC and ADC.ratio (0.741 ± 0.152 mm²/sec and 0.44 ± 0.07) compared with ISUP GG 2/3 tumors without IDC‐P (0.888 ± 0.167 mm²/sec and 0.62 ± 0.14), P = 0.012 and <0.001; and did not differ compared with ISUP GG 4/5 tumors (0.705 ± 0.141 mm²/sec and 0.44 ± 0.08), P = 0.509 and 0.868. Tumors with IDC‐P were nearly all PI‐RADS v2 score 5 (14/15) compared with ISUP GG 2/3 tumors without IDC‐P (10/15 R1, 8/15 R2) and GG 4/5 tumors (9/15), (P = 0.040 = 0.092). Agreement in PI‐RADS v2 scoring was moderate (K = 0.68).

Data Conclusion

ISUP GG 2 and 3 (intermediate risk, Gleason score 7) PCa with IDC‐P have lower ADC compared with tumors without IDC‐P with a similar percentage of Gleason pattern 4 and resemble ISUP GG 4 and 5 high risk tumors on MRI. IDC‐P lowers ADC values among intermediate risk prostate cancers.

Level of Evidence: 3

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2018.

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