Disruption of Gap Junction-Mediated Intercellular Communication in the Spiral Ligament Causes Hearing and Outer Hair Cell Loss in the Cochlea of Mice.

Authors: Nishiyama N, Yamaguchi T, Yoneyama M, Onaka Y, Ogita K Abstract It is well-known that outer hair cell (OHC) loss occurs in the cochlea of animal models of permanent hearing loss induced by intense noise exposure. Our earlier studies demonstrated the production of hydroxynonenal and peroxynitrite, as well as the disruption of gap junction-mediated intercellular communication (GJIC), in the cochlear spiral ligament prior to noise-induced sudden hearing loss. The goal of the present study was to evaluate the mechanism underlying cochlear OHC loss after sudden hearing loss induced by intense noise exposure. In organ of Corti explant cultures from mice, no significant OHC loss was observed after in vitro exposure to 4-hydroxynonenal (a product of lipid peroxidation), H2O2, SIN-...

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Coding-in-noise deficits are not seen in responses to amplitude modulation in subjects with cochlear synaptopathy induced by a single noise exposure

Publication date: Available online 4 January 2019Source: NeuroscienceAuthor(s): Hengchao Chen, Yazhi Xing, Zhen Zhang, Shan Tao, Hui Wang, Steve Aiken, Shankai Yin, Dongzhen Yu, Jian WangAbstractSince the first report of noise-induced synaptic damage in animals without permanent threshold shifts (PTS), the concept of noise-induced hidden hearing loss (NIHHL) has been proposed to cover the functional deficits in hearing associated with noise-induced synaptopathy. Moreover, the potential functional deficit associated with the noise-induced synaptopathy has been largely attributed to the loss of auditory nerve fibers (ANFs) with a low spontaneous spike rate (SSR). As this group of ANFs is critical for coding at suprathreshold levels and in noisy background, coding-in-noise deficit (CIND) has ...

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

Authors: Leão RM 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 inp...

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Parsonage Turner Syndrome MRI

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Disruption of Gap Junction-Mediated Intercellular Communication in the Spiral Ligament Causes Hearing and Outer Hair Cell Loss in the Cochlea of Mice.

Authors: Nishiyama N, Yamaguchi T, Yoneyama M, Onaka Y, Ogita K Abstract It is well-known that outer hair cell (OHC) loss occurs in the cochlea of animal models of permanent hearing loss induced by intense noise exposure. Our earlier studies demonstrated the production of hydroxynonenal and peroxynitrite, as well as the disruption of gap junction-mediated intercellular communication (GJIC), in the cochlear spiral ligament prior to noise-induced sudden hearing loss. The goal of the present study was to evaluate the mechanism underlying cochlear OHC loss after sudden hearing loss induced by intense noise exposure. In organ of Corti explant cultures from mice, no significant OHC loss was observed after in vitro exposure to 4-hydroxynonenal (a product of lipid peroxidation), H2O2, SIN-...

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Coding-in-noise deficits are not seen in responses to amplitude modulation in subjects with cochlear synaptopathy induced by a single noise exposure

Publication date: Available online 4 January 2019Source: NeuroscienceAuthor(s): Hengchao Chen, Yazhi Xing, Zhen Zhang, Shan Tao, Hui Wang, Steve Aiken, Shankai Yin, Dongzhen Yu, Jian WangAbstractSince the first report of noise-induced synaptic damage in animals without permanent threshold shifts (PTS), the concept of noise-induced hidden hearing loss (NIHHL) has been proposed to cover the functional deficits in hearing associated with noise-induced synaptopathy. Moreover, the potential functional deficit associated with the noise-induced synaptopathy has been largely attributed to the loss of auditory nerve fibers (ANFs) with a low spontaneous spike rate (SSR). As this group of ANFs is critical for coding at suprathreshold levels and in noisy background, coding-in-noise deficit (CIND) has ...

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

Authors: Leão RM 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 inp...

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Parsonage Turner Syndrome MRI

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Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months

Abstract

Objective

This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin.

Materials and methods

Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher's exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves.

Results

Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%).

Conclusion

No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months.

Clinic significant

HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.

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Letter to the Editor replying to Armen Nersesyan about the article published in Clinical Oral Investigations tilted “Smoking increases the frequency of micronuclei in the oral mucosa of adults relative to non-smokers—a systematic review and meta-analysis”

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

Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months

Abstract

Objective

This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin.

Materials and methods

Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher's exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves.

Results

Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%).

Conclusion

No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months.

Clinic significant

HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.

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

Letter to the Editor replying to Armen Nersesyan about the article published in Clinical Oral Investigations tilted “Smoking increases the frequency of micronuclei in the oral mucosa of adults relative to non-smokers—a systematic review and meta-analysis”

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

18 F-DOPA PET/CT in brain tumors: impact on multidisciplinary brain tumor board decisions

Abstract

Purpose

This study aimed to assess the therapeutic impact and diagnostic accuracy of ¹⁸F-DOPA PET/CT in patients with glioblastoma or brain metastases.

Methods

Patients with histologically proven glioblastoma or brain metastases were prospectively included in this monocentric clinical trial (IMOTEP). Patients were included either due to a clinical suspicion of relapse or to assess residual tumor infiltration after treatment. Multimodality brain MRI and ¹⁸F-DOPA PET were performed. Patients' data were discussed during a Multidisciplinary Neuro-oncology Tumor Board (MNTB) meeting. The discussion was first based on clinical and MRI data, and an initial diagnosis and treatment plan were proposed. Secondly, a new discussion was conducted based on the overall imaging results, including ¹⁸F-DOPA PET. A second diagnosis and therapeutic plan were proposed. A retrospective and definitive diagnosis was obtained after a 3-month follow-up and considered as the reference standard.

Results

One hundred six cases were prospectively investigated by the MNTB. All patients with brain metastases (N = 41) had a clinical suspicion of recurrence. The addition of ¹⁸F-DOPA PET data changed the diagnosis and treatment plan in 39.0% and 17.1% of patients' cases, respectively. Concerning patients with a suspicion of recurrent glioblastoma (N = 12), the implementation of ¹⁸F-DOPA PET changed the diagnosis and treatment plan in 33.3% of cases. In patients evaluated to assess residual glioblastoma infiltration after treatment (N = 53), ¹⁸F-DOPA PET data had a lower impact with only 5.7% (3/53) of diagnostic changes and 3.8% (2/53) of therapeutic plan changes. The definitive reference diagnosis was available in 98/106 patients. For patients with tumor recurrence suspicion, the adjunction of ¹⁸F-DOPA PET increased the Younden's index from 0.44 to 0.53 in brain metastases and from 0.2 to 1.0 in glioblastoma, reflecting an increase in diagnostic accuracy.

Conclusion

¹⁸F-DOPA PET has a significant impact on the management of patients with a suspicion of brain tumor recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate the residual glioblastoma infiltration after a first-line radio-chemotherapy or second-line bevacizumab.

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18 F-DOPA PET/CT in brain tumors: impact on multidisciplinary brain tumor board decisions

Abstract

Purpose

This study aimed to assess the therapeutic impact and diagnostic accuracy of ¹⁸F-DOPA PET/CT in patients with glioblastoma or brain metastases.

Methods

Patients with histologically proven glioblastoma or brain metastases were prospectively included in this monocentric clinical trial (IMOTEP). Patients were included either due to a clinical suspicion of relapse or to assess residual tumor infiltration after treatment. Multimodality brain MRI and ¹⁸F-DOPA PET were performed. Patients' data were discussed during a Multidisciplinary Neuro-oncology Tumor Board (MNTB) meeting. The discussion was first based on clinical and MRI data, and an initial diagnosis and treatment plan were proposed. Secondly, a new discussion was conducted based on the overall imaging results, including ¹⁸F-DOPA PET. A second diagnosis and therapeutic plan were proposed. A retrospective and definitive diagnosis was obtained after a 3-month follow-up and considered as the reference standard.

Results

One hundred six cases were prospectively investigated by the MNTB. All patients with brain metastases (N = 41) had a clinical suspicion of recurrence. The addition of ¹⁸F-DOPA PET data changed the diagnosis and treatment plan in 39.0% and 17.1% of patients' cases, respectively. Concerning patients with a suspicion of recurrent glioblastoma (N = 12), the implementation of ¹⁸F-DOPA PET changed the diagnosis and treatment plan in 33.3% of cases. In patients evaluated to assess residual glioblastoma infiltration after treatment (N = 53), ¹⁸F-DOPA PET data had a lower impact with only 5.7% (3/53) of diagnostic changes and 3.8% (2/53) of therapeutic plan changes. The definitive reference diagnosis was available in 98/106 patients. For patients with tumor recurrence suspicion, the adjunction of ¹⁸F-DOPA PET increased the Younden's index from 0.44 to 0.53 in brain metastases and from 0.2 to 1.0 in glioblastoma, reflecting an increase in diagnostic accuracy.

Conclusion

¹⁸F-DOPA PET has a significant impact on the management of patients with a suspicion of brain tumor recurrence, either glioblastoma or brain metastases, but a low impact when used to evaluate the residual glioblastoma infiltration after a first-line radio-chemotherapy or second-line bevacizumab.

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Issue Information

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Issue Information

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Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Background

Pelvic ultrasound (US) diagnosis of uterine fibroids may overlook coexisting gynecological conditions that contribute to women's symptoms.

Purpose

To determine the added value of pelvic MRI for women diagnosed with symptomatic fibroids by US, and to identify clinical factors associated with additional MRI findings.

Study Type

Retrospective observational study.

Population

In all, 367 consecutive women with fibroids diagnosed by US and referred to our multidisciplinary fibroid center between 2013–2017.

Field Strength/Sequence

All patients had both pelvic US and MRI prior to their consultations. MRIs were performed at 1.5 T or 3 T and included multiplanar T₂‐weighted sequences, and precontrast and postcontrast T₁‐weighted imaging.

Assessment

Demographics, symptoms, uterine fibroid symptom severity scores, and health‐related quality of life scores, as well as imaging findings were evaluated.

Statistical Tests

Patients were separated into two subgroups according to whether MRI provided additional findings to the initial US. Univariate and multivariate regression analyses were performed.

Results

Pelvic MRI provided additional information in 162 patients (44%; 95% confidence interval [CI] 39–49%). The most common significant findings were adenomyosis (22%), endometriosis (17%), and partially endocavitary fibroids (15%). Women with pelvic pain, health‐related quality of life scores less than 30 out of 100, or multiple fibroids visualized on US had greater odds of additional MRI findings (odds ratio [OR] 1.68, 2.26, 1.63; P = 0.02, 0.004, 0.03, respectively), while nulliparous women had reduced odds (OR 0.55, P = 0.01). Patients with additional MRI findings were treated less often with uterine fibroid embolization (14% vs. 36%, P < 0.001) or MR‐guided focused US (1% vs. 5%, P = 0.04), and more often with medical management (17% vs. 8%, P = 0.01).

Data Conclusion

Pelvic MRI revealed additional findings in more than 40% of women presenting with symptoms initially ascribed to fibroids by US. Further evaluation using MRI is particularly useful for parous women with pelvic pain, poor quality of life scores, and/or multiple fibroids.

Level of Evidence: 4

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2019.

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Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Background

There is uncertainty regarding the clinical significance of findings on MRI in patients with whiplash associated disorder (WAD) or nonspecific neck pain (NSNP).

Purpose

To compare the presence of cervical spine MRI findings in people with WAD or NSNP with pain‐free controls.

Study Type

Systematic review and meta‐analysis.

Population

Adults with WAD (n = 994), NSNP (n = 715), or pain‐free controls (n = 2323).

Field Strength

0.5T, 1.5T, and 3.0T.

Assessment

Medline, EMBASE, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Overall quality of the evidence from meta‐analysis was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach.

Statistical Tests

Meta‐analysis was performed using a random‐effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data.

Results

In total, 31 studies were included (eight comparing acute WAD to controls, 14 comparing chronic WAD to controls, 12 comparing chronic NSNP to controls) comprising 4032 participants. Rectus capitis posterior major cross‐sectional area was smaller in people with chronic NSNP than controls (two studies: SMD –1.18 [95% confidence interval [CI] –1.65, –0.71]). The remaining meta‐analysis comparisons showed no group differences in MRI findings. The quality of evidence was mostly low due to small sample sizes and high heterogeneity.

Data Conclusion

Given the typically low‐quality evidence, definitive conclusions cannot be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain‐free controls.

Level of Evidence: 3

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2018.

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Prospective comparative diagnostic accuracy evaluation of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) MR perfusion in differentiating tumor recurrence from radiation necrosis in treated high‐grade gliomas

Background

The appearance of a new enhancing lesion after surgery and chemoradiation for high‐grade glioma (HGG) presents a common diagnostic dilemma. Histopathological analysis remains the reference standard in this situation.

Purpose

To prospectively compare the diagnostic accuracy of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) in differentiating tumor recurrence (TR) from radiation necrosis (RN).

Study Type

Prospective diagnostic accuracy study.

Population

In all, 98 consecutive treated HGG patients with new enhancing lesion. We excluded 32 patients due to inadequate follow‐up or technical limitation.

Field Strength/Sequence

3 T DCE and DSC MR.

Assessment

Histogram and hot‐spot analysis of cerebral blood volume (CBV), corrected CBV, K^trans, area under the curve (AUC), and plasma volume (Vp). The reference standard of TR and/or RN was determined by histopathology in 43 surgically resected lesions or by clinical/imaging follow‐up in the rest.

Statistical Tests

Mann–Whitney U‐tests, receiver operating characteristic (ROC) curve, and logistic regression analysis.

Results

A total of 68 lesions were included. There were 37 TR, 28 RN, and three lesions with equal proportions of TR and RN. TR had significantly higher CBV, corrected CBV, CBV ratio, corrected CBV ratio, AUC ratio, and Vp ratio (P < 0.05) than RN on hot‐spot analysis. CBV had the highest diagnostic accuracy (AUROC 0.71). On histogram analysis, TR had higher CBV and corrected CBV maximal value compared with RN (P = 0.006, AUROC = 0.70). Only CBV on hot‐spot analysis remained significant after correction for multiple comparison, with no significant improvement in diagnostic accuracy when using a combination of parameters (AUROC 0.71 vs. 0.76, P = 0.24).

Data Conclusion

DSC‐derived CBV is the most accurate perfusion parameter in differentiating TR and RN. DSC and DCE‐derived parameters reflecting the blood volume in an enhancing lesion are more accurate than the DCE‐derived parameter K^trans. Clinical practice may be best guided by blood volume measurements, rather than permeability assessment for differentiation of TR from RN.

Level of Evidence: 1

Technical Efficacy Stage: 4

J. Magn. Reson. Imaging 2019.

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Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Background

Pelvic ultrasound (US) diagnosis of uterine fibroids may overlook coexisting gynecological conditions that contribute to women's symptoms.

Purpose

To determine the added value of pelvic MRI for women diagnosed with symptomatic fibroids by US, and to identify clinical factors associated with additional MRI findings.

Study Type

Retrospective observational study.

Population

In all, 367 consecutive women with fibroids diagnosed by US and referred to our multidisciplinary fibroid center between 2013–2017.

Field Strength/Sequence

All patients had both pelvic US and MRI prior to their consultations. MRIs were performed at 1.5 T or 3 T and included multiplanar T₂‐weighted sequences, and precontrast and postcontrast T₁‐weighted imaging.

Assessment

Demographics, symptoms, uterine fibroid symptom severity scores, and health‐related quality of life scores, as well as imaging findings were evaluated.

Statistical Tests

Patients were separated into two subgroups according to whether MRI provided additional findings to the initial US. Univariate and multivariate regression analyses were performed.

Results

Pelvic MRI provided additional information in 162 patients (44%; 95% confidence interval [CI] 39–49%). The most common significant findings were adenomyosis (22%), endometriosis (17%), and partially endocavitary fibroids (15%). Women with pelvic pain, health‐related quality of life scores less than 30 out of 100, or multiple fibroids visualized on US had greater odds of additional MRI findings (odds ratio [OR] 1.68, 2.26, 1.63; P = 0.02, 0.004, 0.03, respectively), while nulliparous women had reduced odds (OR 0.55, P = 0.01). Patients with additional MRI findings were treated less often with uterine fibroid embolization (14% vs. 36%, P < 0.001) or MR‐guided focused US (1% vs. 5%, P = 0.04), and more often with medical management (17% vs. 8%, P = 0.01).

Data Conclusion

Pelvic MRI revealed additional findings in more than 40% of women presenting with symptoms initially ascribed to fibroids by US. Further evaluation using MRI is particularly useful for parous women with pelvic pain, poor quality of life scores, and/or multiple fibroids.

Level of Evidence: 4

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2019.

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Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Background

There is uncertainty regarding the clinical significance of findings on MRI in patients with whiplash associated disorder (WAD) or nonspecific neck pain (NSNP).

Purpose

To compare the presence of cervical spine MRI findings in people with WAD or NSNP with pain‐free controls.

Study Type

Systematic review and meta‐analysis.

Population

Adults with WAD (n = 994), NSNP (n = 715), or pain‐free controls (n = 2323).

Field Strength

0.5T, 1.5T, and 3.0T.

Assessment

Medline, EMBASE, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Overall quality of the evidence from meta‐analysis was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach.

Statistical Tests

Meta‐analysis was performed using a random‐effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data.

Results

In total, 31 studies were included (eight comparing acute WAD to controls, 14 comparing chronic WAD to controls, 12 comparing chronic NSNP to controls) comprising 4032 participants. Rectus capitis posterior major cross‐sectional area was smaller in people with chronic NSNP than controls (two studies: SMD –1.18 [95% confidence interval [CI] –1.65, –0.71]). The remaining meta‐analysis comparisons showed no group differences in MRI findings. The quality of evidence was mostly low due to small sample sizes and high heterogeneity.

Data Conclusion

Given the typically low‐quality evidence, definitive conclusions cannot be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain‐free controls.

Level of Evidence: 3

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2018.

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

Prospective comparative diagnostic accuracy evaluation of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) MR perfusion in differentiating tumor recurrence from radiation necrosis in treated high‐grade gliomas

Background

The appearance of a new enhancing lesion after surgery and chemoradiation for high‐grade glioma (HGG) presents a common diagnostic dilemma. Histopathological analysis remains the reference standard in this situation.

Purpose

To prospectively compare the diagnostic accuracy of dynamic contrast‐enhanced (DCE) vs. dynamic susceptibility contrast (DSC) in differentiating tumor recurrence (TR) from radiation necrosis (RN).

Study Type

Prospective diagnostic accuracy study.

Population

In all, 98 consecutive treated HGG patients with new enhancing lesion. We excluded 32 patients due to inadequate follow‐up or technical limitation.

Field Strength/Sequence

3 T DCE and DSC MR.

Assessment

Histogram and hot‐spot analysis of cerebral blood volume (CBV), corrected CBV, K^trans, area under the curve (AUC), and plasma volume (Vp). The reference standard of TR and/or RN was determined by histopathology in 43 surgically resected lesions or by clinical/imaging follow‐up in the rest.

Statistical Tests

Mann–Whitney U‐tests, receiver operating characteristic (ROC) curve, and logistic regression analysis.

Results

A total of 68 lesions were included. There were 37 TR, 28 RN, and three lesions with equal proportions of TR and RN. TR had significantly higher CBV, corrected CBV, CBV ratio, corrected CBV ratio, AUC ratio, and Vp ratio (P < 0.05) than RN on hot‐spot analysis. CBV had the highest diagnostic accuracy (AUROC 0.71). On histogram analysis, TR had higher CBV and corrected CBV maximal value compared with RN (P = 0.006, AUROC = 0.70). Only CBV on hot‐spot analysis remained significant after correction for multiple comparison, with no significant improvement in diagnostic accuracy when using a combination of parameters (AUROC 0.71 vs. 0.76, P = 0.24).

Data Conclusion

DSC‐derived CBV is the most accurate perfusion parameter in differentiating TR and RN. DSC and DCE‐derived parameters reflecting the blood volume in an enhancing lesion are more accurate than the DCE‐derived parameter K^trans. Clinical practice may be best guided by blood volume measurements, rather than permeability assessment for differentiation of TR from RN.

Level of Evidence: 1

Technical Efficacy Stage: 4

J. Magn. Reson. Imaging 2019.

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Osseointegrated Auditory Devices

Osseointegrated auditory devices (OADs) are hearing devices that use an external receiver/processor that stimulates bone conduction of sound via a titanium prosthesis that is drilled into the bone of the cranium. Since their introduction in 1977, OADs have undergone substantial evolution, including changes in manufacturing of the implant, improvements in the external sound processor, and simplification of implantation techniques. Expansion of criteria for patient candidacy for implantation has occurred corresponding with changes in the implants and processors.

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Electroacoustic Stimulation

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ayt3DR

Osseointegrated Auditory Devices

Osseointegrated auditory devices (OADs) are hearing devices that use an external receiver/processor that stimulates bone conduction of sound via a titanium prosthesis that is drilled into the bone of the cranium. Since their introduction in 1977, OADs have undergone substantial evolution, including changes in manufacturing of the implant, improvements in the external sound processor, and simplification of implantation techniques. Expansion of criteria for patient candidacy for implantation has occurred corresponding with changes in the implants and processors.

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

Electroacoustic Stimulation

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ayt3DR

Clinical Thyroidology®Top-Read Articles

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Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
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No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
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Current ATA Thyroid Cancer Guidelines Are Poor Predictors of the Extent of Thyroidectomy
Tracy S. Wang 

Using the American College of Radiology Thyroid Imaging Reporting and Data System Will Decrease the Number of Thyroid Nodule Biopsies While Improving Diagnostic Accuracy
Stephanie A. Fish

Levothyroxine Treatment Does Not Reduce Risk for Premature Delivery Among TPO-Negative Pregnant Women with a TSH of 2.5 to 10.0 mIU/L
Elizabeth N. Pearce 

Methimazole Has a Dose-Dependent Association With Congenital Malformations, but Switching to PTU in the First Trimester Seems Too Late
Tim I.M. Korevaar 

The post Clinical Thyroidology^®Top-Read Articles appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fae9rx

Clinical Thyroidology®Top-Read Articles

FREE ACCESS through January 17, 2019
Read Now:

Levothyroxine Replacement for Primary Hypothyroidism Can Be Given Between Meals with Similar Effectiveness at Various Times of the Day
Charles H. Emerson

Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann, Katrin Brauckhoff 

Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits 

No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung 

Current ATA Thyroid Cancer Guidelines Are Poor Predictors of the Extent of Thyroidectomy
Tracy S. Wang 

Using the American College of Radiology Thyroid Imaging Reporting and Data System Will Decrease the Number of Thyroid Nodule Biopsies While Improving Diagnostic Accuracy
Stephanie A. Fish

Levothyroxine Treatment Does Not Reduce Risk for Premature Delivery Among TPO-Negative Pregnant Women with a TSH of 2.5 to 10.0 mIU/L
Elizabeth N. Pearce 

Methimazole Has a Dose-Dependent Association With Congenital Malformations, but Switching to PTU in the First Trimester Seems Too Late
Tim I.M. Korevaar 

The post Clinical Thyroidology^®Top-Read Articles appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fae9rx

Allergic Reaction to Airborne Fish Proteins May Have Led to Boy ’ s Death in Brooklyn

The boy, Cameron Jean-Pierre, 11, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2GWF2kv

Allergic Reaction to Airborne Fish Proteins May Have Led to Boy ’ s Death in Brooklyn

The boy, Cameron Jean-Pierre, 11, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2GWF2kv

Wild vertebrates and their representation by urban/rural students in a region of northeast Brazil

Recognition of the diversity of living beings, including the classification and naming of species, is a fundamental condition for biological literacy with the aim of developing critical awareness of human rela...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RwCf5l

Allergic Reaction to Airborne Fish Proteins May Have Led to Boy ’ s Death in Brooklyn

The boy, Cameron Jean-Pierre, 11, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2GWF2kv

Wild vertebrates and their representation by urban/rural students in a region of northeast Brazil

Recognition of the diversity of living beings, including the classification and naming of species, is a fundamental condition for biological literacy with the aim of developing critical awareness of human rela...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RwCf5l

Allergic Reaction to Airborne Fish Proteins May Have Led to Boy ’ s Death in Brooklyn

The boy, Cameron Jean-Pierre, 11, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2GWF2kv

Clinical Thyroidology®Top-Read Articles

FREE ACCESS through January 17, 2019
Read Now:

Levothyroxine Replacement for Primary Hypothyroidism Can Be Given Between Meals with Similar Effectiveness at Various Times of the Day
Charles H. Emerson

Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann, Katrin Brauckhoff 

Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits 

No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung 

Current ATA Thyroid Cancer Guidelines Are Poor Predictors of the Extent of Thyroidectomy
Tracy S. Wang 

Using the American College of Radiology Thyroid Imaging Reporting and Data System Will Decrease the Number of Thyroid Nodule Biopsies While Improving Diagnostic Accuracy
Stephanie A. Fish

Levothyroxine Treatment Does Not Reduce Risk for Premature Delivery Among TPO-Negative Pregnant Women with a TSH of 2.5 to 10.0 mIU/L
Elizabeth N. Pearce 

Methimazole Has a Dose-Dependent Association With Congenital Malformations, but Switching to PTU in the First Trimester Seems Too Late
Tim I.M. Korevaar 

The post Clinical Thyroidology^®Top-Read Articles appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fae9rx

Clinical Thyroidology®Top-Read Articles

FREE ACCESS through January 17, 2019
Read Now:

Levothyroxine Replacement for Primary Hypothyroidism Can Be Given Between Meals with Similar Effectiveness at Various Times of the Day
Charles H. Emerson

Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann, Katrin Brauckhoff 

Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits 

No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung 

Current ATA Thyroid Cancer Guidelines Are Poor Predictors of the Extent of Thyroidectomy
Tracy S. Wang 

Using the American College of Radiology Thyroid Imaging Reporting and Data System Will Decrease the Number of Thyroid Nodule Biopsies While Improving Diagnostic Accuracy
Stephanie A. Fish

Levothyroxine Treatment Does Not Reduce Risk for Premature Delivery Among TPO-Negative Pregnant Women with a TSH of 2.5 to 10.0 mIU/L
Elizabeth N. Pearce 

Methimazole Has a Dose-Dependent Association With Congenital Malformations, but Switching to PTU in the First Trimester Seems Too Late
Tim I.M. Korevaar 

The post Clinical Thyroidology^®Top-Read Articles appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fae9rx

Association of screen time and physical activity with health-related quality of life in Iranian children and adolescents

Health-related quality of life (HRQoL) is a multidimensional concept with significant effects and children and adolescence; while physical activity (PA) and screen time (ST) have been suggested as its probable...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fck4M0

Association of screen time and physical activity with health-related quality of life in Iranian children and adolescents

Health-related quality of life (HRQoL) is a multidimensional concept with significant effects and children and adolescence; while physical activity (PA) and screen time (ST) have been suggested as its probable...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fck4M0

Magnetic resonance imaging of cerebellar cysts in a neonate with congenital cytomegalovirus infection

Abstract

Congenital cytomegalovirus infection is one of the most common congenital viral infections in the world. Brain magnetic resonance imaging plays a key role in evaluating brain involvement and establishing prognosis; several characteristic features have been described. We present a description of cerebellar cysts in a neonate with polymerase chain reaction-confirmed cytomegalovirus congenital infection, and discuss the differential diagnosis and potential pathophysiological mechanisms.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R80jMF

Magnetic resonance imaging of cerebellar cysts in a neonate with congenital cytomegalovirus infection

Abstract

Congenital cytomegalovirus infection is one of the most common congenital viral infections in the world. Brain magnetic resonance imaging plays a key role in evaluating brain involvement and establishing prognosis; several characteristic features have been described. We present a description of cerebellar cysts in a neonate with polymerase chain reaction-confirmed cytomegalovirus congenital infection, and discuss the differential diagnosis and potential pathophysiological mechanisms.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R80jMF

11-Year-Old Boy ’ s Death in Brooklyn May Have Been Caused by Airborne Fish Proteins

The sixth grader, Cameron Jean-Pierre, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2QlJMzv

Soft Palate Subacute Necrotising Sialadenitis: A Case Report

We present an intriguing case of soft palate SANS in a 55  year old lady. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C6nA79

11-Year-Old Boy ’ s Death in Brooklyn May Have Been Caused by Airborne Fish Proteins

The sixth grader, Cameron Jean-Pierre, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2QlJMzv

Soft Palate Subacute Necrotising Sialadenitis: A Case Report

We present an intriguing case of soft palate SANS in a 55  year old lady. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C6nA79

Modified duct-to-mucosa versus conventional pancreaticoenterostomy for pancreaticoduodenectomy: a retrospective cohort study based on propensity score matching analysis

Clinically relevant postoperative pancreatic fistula (CR-POPF) remains the most common neopathy after pancreatoduodenectomy (PD). An ideal pancreaticoenterostomy (PE) which can effectively reduce the incidence...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CT5vLB

Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis

Perioperative transfusion can reduce the survival rate in colorectal cancer patients. The effects of transfusion on the short- and long-term prognoses are becoming intriguing.

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

Irreversible electroporation in a case of pancreatic leiomyosarcoma: a novel weapon versus a rare malignancy?

Primary pancreatic leiomyosarcoma is an extremely rare entity that needs high clinical suspicion in order to diagnose it at an early stage. Clinical characteristics, diagnosis, and management still remain chal...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CRE6tq

Modified duct-to-mucosa versus conventional pancreaticoenterostomy for pancreaticoduodenectomy: a retrospective cohort study based on propensity score matching analysis

Clinically relevant postoperative pancreatic fistula (CR-POPF) remains the most common neopathy after pancreatoduodenectomy (PD). An ideal pancreaticoenterostomy (PE) which can effectively reduce the incidence...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CT5vLB

Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis

Perioperative transfusion can reduce the survival rate in colorectal cancer patients. The effects of transfusion on the short- and long-term prognoses are becoming intriguing.

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

Irreversible electroporation in a case of pancreatic leiomyosarcoma: a novel weapon versus a rare malignancy?

Primary pancreatic leiomyosarcoma is an extremely rare entity that needs high clinical suspicion in order to diagnose it at an early stage. Clinical characteristics, diagnosis, and management still remain chal...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CRE6tq

11-Year-Old Boy ’ s Death in Brooklyn May Have Been Caused by Airborne Fish Proteins

The sixth grader, Cameron Jean-Pierre, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2QlJMzv

11-Year-Old Boy ’ s Death in Brooklyn May Have Been Caused by Airborne Fish Proteins

The sixth grader, Cameron Jean-Pierre, had asthma and was allergic to fish and peanuts. Experts said a combination of the two conditions could have caused a fatal reaction. (Source: NYT Health)

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 http://bit.ly/2QlJMzv

Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study

Abstract

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identification of dysphagia is recommended as part of the evaluation of at-risk patients, but available bedside screening tools perform inconsistently. In this study, we developed algorithms to detect swallowing impairment using a novel accelerometer-based dysphagia detection system (DDS). A sample of 344 individuals was enrolled across seven sites in the United States. Dual-axis accelerometry signals were collected prospectively with simultaneous videofluoroscopy (VFSS) during swallows of liquid barium stimuli in thin, mildly, moderately and extremely thick consistencies. Signal processing classifiers were trained using linear discriminant analysis and 10,000 random training–test data splits. The primary objective was to develop an algorithm to detect impaired swallowing safety with thin liquids with an area under receiver operating characteristic curve (AUC) > 80% compared to the VFSS reference standard. Impaired swallowing safety was identified in 7.2% of the thin liquid boluses collected. At least one unsafe thin liquid bolus was found in 19.7% of participants, but participants did not exhibit impaired safety consistently. The DDS classifier algorithms identified participants with impaired thin liquid swallowing safety with a mean AUC of 81.5%, (sensitivity 90.4%, specificity 60.0%). Thicker consistencies were effective for reducing the frequency of penetration–aspiration. This DDS reached targeted performance goals in detecting impaired swallowing safety with thin liquids. Simultaneous measures by DDS and VFSS, as performed here, will be used for future validation studies.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CPH6GD

Dysphagia-Related Quality of Life in Adults with Cerebral Palsy on Full Oral Diet Without Enteral Nutrition

Abstract

There have been no quantitative studies on dysphagia and its impact on quality of life (QOL) of adults with cerebral palsy (CP). In this cross-sectional study, we aimed to investigate the characteristics of dysphagia symptoms and their impact on QOL in adults with CP on a full oral diet compared with healthy adults. Additionally, we aimed to determine the factors affecting dysphagia-related QOL in this population. We enrolled adults with CP on full oral diet (N = 117) and healthy individuals (N = 117) and interviewed them using the swallowing-quality of life (SWAL-QOL) questionnaire which includes 14 items regarding dysphagia symptoms and 30 items regarding swallowing-related QOL. The functional status of each participant with CP was evaluated using the gross motor function classification system, the manual ability classification system (MACS), and the Functional Oral Intake Scale (FOIS). Among pharyngeal symptoms, choking on food was reported most frequently (sometimes or more 76.9%), followed by coughing and choking on liquid. Among oral symptoms, chewing problems were reported most frequently (sometimes or more 59.8%), followed by food dribbling from the mouth (sometimes or more 53.8%). Compared to healthy adults, those with CP reported worse QOL across all SWAL-QOL items, with the lowest scores obtained for meal duration, followed by communication, burden, fatigue, sleep, and eating desire. On multiple linear regression analysis, higher MACS level, lower FOIS level, and older age were predictors of worse SWAL-QOL score. Among adults with CP, it is necessary to evaluate swallowing function and establish an active intervention plan even if a full oral diet is established.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TvM3d9

Melkersson–Rosenthal syndrome: a case report of a rare disease with overlapping features

Melkersson–Rosenthal syndrome (MRS) is a rare, neuro-mucocutaneous disease which presents as orofacial swelling, facial palsy and fissured tongue. These symptoms may occur simultaneously or, more frequently, w...

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

IL2RG hypomorphic mutation: identification of a novel pathogenic mutation in exon 8 and a review of the literature

Atypical X-linked severe combined immunodeficiency (X-SCID) is a variant of cellular immunodeficiency due to hypomorphic mutations in the interleukin 2 receptor gamma (IL2RG) gene. Due to a leaky clinical phenoty...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Qre2J4

Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study

Abstract

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identification of dysphagia is recommended as part of the evaluation of at-risk patients, but available bedside screening tools perform inconsistently. In this study, we developed algorithms to detect swallowing impairment using a novel accelerometer-based dysphagia detection system (DDS). A sample of 344 individuals was enrolled across seven sites in the United States. Dual-axis accelerometry signals were collected prospectively with simultaneous videofluoroscopy (VFSS) during swallows of liquid barium stimuli in thin, mildly, moderately and extremely thick consistencies. Signal processing classifiers were trained using linear discriminant analysis and 10,000 random training–test data splits. The primary objective was to develop an algorithm to detect impaired swallowing safety with thin liquids with an area under receiver operating characteristic curve (AUC) > 80% compared to the VFSS reference standard. Impaired swallowing safety was identified in 7.2% of the thin liquid boluses collected. At least one unsafe thin liquid bolus was found in 19.7% of participants, but participants did not exhibit impaired safety consistently. The DDS classifier algorithms identified participants with impaired thin liquid swallowing safety with a mean AUC of 81.5%, (sensitivity 90.4%, specificity 60.0%). Thicker consistencies were effective for reducing the frequency of penetration–aspiration. This DDS reached targeted performance goals in detecting impaired swallowing safety with thin liquids. Simultaneous measures by DDS and VFSS, as performed here, will be used for future validation studies.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CPH6GD

Dysphagia-Related Quality of Life in Adults with Cerebral Palsy on Full Oral Diet Without Enteral Nutrition

Abstract

There have been no quantitative studies on dysphagia and its impact on quality of life (QOL) of adults with cerebral palsy (CP). In this cross-sectional study, we aimed to investigate the characteristics of dysphagia symptoms and their impact on QOL in adults with CP on a full oral diet compared with healthy adults. Additionally, we aimed to determine the factors affecting dysphagia-related QOL in this population. We enrolled adults with CP on full oral diet (N = 117) and healthy individuals (N = 117) and interviewed them using the swallowing-quality of life (SWAL-QOL) questionnaire which includes 14 items regarding dysphagia symptoms and 30 items regarding swallowing-related QOL. The functional status of each participant with CP was evaluated using the gross motor function classification system, the manual ability classification system (MACS), and the Functional Oral Intake Scale (FOIS). Among pharyngeal symptoms, choking on food was reported most frequently (sometimes or more 76.9%), followed by coughing and choking on liquid. Among oral symptoms, chewing problems were reported most frequently (sometimes or more 59.8%), followed by food dribbling from the mouth (sometimes or more 53.8%). Compared to healthy adults, those with CP reported worse QOL across all SWAL-QOL items, with the lowest scores obtained for meal duration, followed by communication, burden, fatigue, sleep, and eating desire. On multiple linear regression analysis, higher MACS level, lower FOIS level, and older age were predictors of worse SWAL-QOL score. Among adults with CP, it is necessary to evaluate swallowing function and establish an active intervention plan even if a full oral diet is established.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TvM3d9

Melkersson–Rosenthal syndrome: a case report of a rare disease with overlapping features

Melkersson–Rosenthal syndrome (MRS) is a rare, neuro-mucocutaneous disease which presents as orofacial swelling, facial palsy and fissured tongue. These symptoms may occur simultaneously or, more frequently, w...

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

IL2RG hypomorphic mutation: identification of a novel pathogenic mutation in exon 8 and a review of the literature

Atypical X-linked severe combined immunodeficiency (X-SCID) is a variant of cellular immunodeficiency due to hypomorphic mutations in the interleukin 2 receptor gamma (IL2RG) gene. Due to a leaky clinical phenoty...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Qre2J4

Olde York Potato Chips Issues Allergy Alert on Undeclared Milk in One Lot of Clancy's Wavy Potato Chips 10 Oz

Olde York Potato Chips of Brampton, Ontario is recalling Clancy's Wavy Potato Chips 10 oz (UPC 0 41498 16306 8) with the specific lot code BEST If Used By FEB 22 19 1A6 because they may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume these products. No other lot codes and no other products are involved in this action. (Source: Food and Drug Administration)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C4SwEU

Olde York Potato Chips Issues Allergy Alert on Undeclared Milk in One Lot of Clancy's Wavy Potato Chips 10 Oz

Olde York Potato Chips of Brampton, Ontario is recalling Clancy's Wavy Potato Chips 10 oz (UPC 0 41498 16306 8) with the specific lot code BEST If Used By FEB 22 19 1A6 because they may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume these products. No other lot codes and no other products are involved in this action. (Source: Food and Drug Administration)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C4SwEU

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Abstract

Background

The oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal.

Methods

The design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors.

Results

We enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15).

Conclusions

Gingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal.

Trial registration

ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).

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

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Abstract

Background

The oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal.

Methods

The design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors.

Results

We enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15).

Conclusions

Gingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal.

Trial registration

ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).

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

Olde York Potato Chips Issues Allergy Alert on Undeclared Milk in One Lot of Clancy's Wavy Potato Chips 10 Oz

Olde York Potato Chips of Brampton, Ontario is recalling Clancy's Wavy Potato Chips 10 oz (UPC 0 41498 16306 8) with the specific lot code BEST If Used By FEB 22 19 1A6 because they may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume these products. No other lot codes and no other products are involved in this action. (Source: Food and Drug Administration)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C4SwEU

Olde York Potato Chips Issues Allergy Alert on Undeclared Milk in One Lot of Clancy's Wavy Potato Chips 10 Oz

Olde York Potato Chips of Brampton, Ontario is recalling Clancy's Wavy Potato Chips 10 oz (UPC 0 41498 16306 8) with the specific lot code BEST If Used By FEB 22 19 1A6 because they may contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume these products. No other lot codes and no other products are involved in this action. (Source: Food and Drug Administration)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C4SwEU

Electroacoustic Stimulation

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear. (Source: Otolaryngologic clinics of North America)

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Electroacoustic Stimulation

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear. (Source: Otolaryngologic clinics of North America)

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Cancer Stem Cell based molecular predictors of tumor recurrence in Oral squamous cell carcinoma

Publication date: Available online 4 January 2019

Source: Archives of Oral Biology

Author(s): Simple Mohanta, Samanta Sekhar Khora, Amritha Suresh

Abstract

Objective

This study aimed to identify the cancer stem cell specific biomarkers that can be effective candidate prognosticators of oral squamous cell carcinoma.

Design

Microarray-based meta-analysis derived transcriptional profile of head and neck cancers was compared with the cancer stem cell database to arrive at a subset of markers. This subset was further co-related with clinico-pathological parameters, recurrence and survival of oral cancer patients (n = 313) in The Cancer Genome Atlas database and in oral cancer (n = 28) patients.

Results

Meta-analysis in combination with database comparison identified a panel of 221 genes specific to head and neck cancers. Correlation of expression levels of these markers in the oral cancer cohort of The Cancer Genome Atlas (n = 313) with treatment outcome identified 54 genes (p < 0.05 or fold change >2) associated with disease recurrence, 8 genes (NQO1, UBE2C, EDNRB, FKBP4, STAT3, HOXA1, RIT1, AURKA) being significant with high fold change. Assessment of the efficacy of the subset (n = 54) as survival predictors identified an additional 4 genes (CDK1, GINS2, PHF5 A, ERBB2) that co-related with poor disease-free survival (p < 0.05). CDK1 showed a significant association with the clinical stage, margin status and with advanced pathological parameters. Initial patient validation indicated that CDK1 and NQO1 significantly co-related with the poor disease-free and overall survival (p < 0.05).

Conclusion

This panel of oral cancer specific, cancer stem cell associated markers identified in this study, a subset of which was validated, is of clinical benefit subject to large scale validation studies.

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Cancer Stem Cell based molecular predictors of tumor recurrence in Oral squamous cell carcinoma

Publication date: Available online 4 January 2019

Source: Archives of Oral Biology

Author(s): Simple Mohanta, Samanta Sekhar Khora, Amritha Suresh

Abstract

Objective

This study aimed to identify the cancer stem cell specific biomarkers that can be effective candidate prognosticators of oral squamous cell carcinoma.

Design

Microarray-based meta-analysis derived transcriptional profile of head and neck cancers was compared with the cancer stem cell database to arrive at a subset of markers. This subset was further co-related with clinico-pathological parameters, recurrence and survival of oral cancer patients (n = 313) in The Cancer Genome Atlas database and in oral cancer (n = 28) patients.

Results

Meta-analysis in combination with database comparison identified a panel of 221 genes specific to head and neck cancers. Correlation of expression levels of these markers in the oral cancer cohort of The Cancer Genome Atlas (n = 313) with treatment outcome identified 54 genes (p < 0.05 or fold change >2) associated with disease recurrence, 8 genes (NQO1, UBE2C, EDNRB, FKBP4, STAT3, HOXA1, RIT1, AURKA) being significant with high fold change. Assessment of the efficacy of the subset (n = 54) as survival predictors identified an additional 4 genes (CDK1, GINS2, PHF5 A, ERBB2) that co-related with poor disease-free survival (p < 0.05). CDK1 showed a significant association with the clinical stage, margin status and with advanced pathological parameters. Initial patient validation indicated that CDK1 and NQO1 significantly co-related with the poor disease-free and overall survival (p < 0.05).

Conclusion

This panel of oral cancer specific, cancer stem cell associated markers identified in this study, a subset of which was validated, is of clinical benefit subject to large scale validation studies.

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Coherence and congruency mediate medial temporal and medial prefrontal activity during event construction

Publication date: March 2019

Source: NeuroImage, Volume 188

Author(s): Kristoffer Romero, Morgan D. Barense, Morris Moscovitch

Abstract

The precise roles of the hippocampus (HPC) and medial prefrontal cortex (mPFC) in initially constructing imagined events remains unclear. HPC activity during imagination may be modulated by mnemonic load, given its role in working memory for complex materials, and/or by the semantic relatedness (i.e. congruency) between items and their context. MPFC activation may track with congruency or mnemonic load, given the role of ventral mPFC in schema processing and the dorsal mPFC in working memory for social information. Sixteen healthy adults (M age = 22.3) underwent an event construction task, wherein participants were provided with a context and item words and imagined an event, forming as many inter-item associations as possible among the items. The stimuli varied by set size and by normatively-defined congruence (normative congruency) to explore their effects on HPC and mPFC activity and functional connectivity. We observed HPC connectivity during event construction in general, whereas dorsal mPFC connectivity occurred during imagining only at higher set sizes. Moreover, anterior hippocampal activity correlated positively with increasing coherence between items during imagining, suggesting that the anterior HPC is sensitive to the relational demands of constructing a novel event. Parahippocampal, hippocampal, temporal pole, and mPFC activity tracked only with individual differences in subjective ratings of congruency of imagined events, which may contribute to construction by retrieving existing schema-related information. Collectively, these findings provide new insights into the factors that modulate HPC and mPFC activity when constructing mental simulations.

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Genotoxic effects in oral mucosal cells caused by the use of orthodontic fixed appliances in patients after short and long periods of treatment

Abstract

Objective

This study aimed to evaluate the genotoxic effects in the oral epithelial cells of patients undergoing fixed orthodontic treatment and to compare these to a control group without treatment. The null hypothesis to be tested is that corrective orthodontic treatment at different periods does not cause genotoxic effects in patients.

Material and methods

An observational cross-sectional study including 74 patients enrolled in corrective orthodontic treatment and 21 control patients, between 11 and 35 years of age, of both genders, participated in the research. Patients undergoing treatment were divided into four treatment groups differentiated by treatment periods: G1, n = 21 (1 month to 12 months); G2, n = 21 (13 to 24 months); G3, n = 23 (25 to 48 months); and G4, n = 9 (over 48 months). Cells were collected by scraping the internal side of the cheek and subsequently placed in tubes containing 0.9% sodium chloride solution. The sample underwent evaluation for genotoxic effects by means of the micronucleus test (MNT). Bivariate analyses were performed using parametric tests (t test or ANOVA) and nonparametric tests (Chi-square test, Kruskal-Wallis test, Dunn post-test). The adopted level of significance was 5%.

Results

Statistically significant differences for any of the genotoxic abnormalities (binucleated, trinucleated, karyolysis, piknosis, nuclear buds) were not found except for karyolysis, which was higher in the control group than in G4 (p < 0.05).

Conclusions

This study did not demonstrate evidence of genotoxic effects even after long periods of corrective orthodontic treatment.

Clinical relevance

This study explores genotoxic effects in fixed orthodontic patients.

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

How far do calcium release measurements properly reflect its multiple roles in dental tissue mineralization?

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Accuracy of tactile assessment in order to detect proximal cavitation of caries lesions in vitro

Abstract

Objectives

Discriminating non-cavitated from cavitated proximal lesions without tooth separation is only limitedly possible using visual-radiographic assessment alone. We evaluated how additional tactile assessment might increase the accuracy of this discrimination in vitro.

Methods

Surface integrity of 46 primary molars with proximal lesions extending radiographically into outer third of dentin (ICDAS-codes: 2 n = 34, 3 n = 8 and 5 n = 4) were mounted in groups of two in manikin heads and independently assessed by three examiners using visual-radiographic and additional tactile assessment using a cow-horn-ended explorer with or without gingival displacement. After examination, lesion surfaces were evaluated for possible damage using scanning-electronic microscopy. Analysis of variance (ANOVA) was performed for evaluating if tactile assessment and gingival displacement significantly affected accuracy.

Results

Tactile assessment significantly increased sensitivity of detecting cavities (p < 0.001, ANOVA), but decreased specificity (p < 0.05). Sensitivities/specificities varied between 33 (8)%/96 (1)% and 86 (6)%/84 (5)%. Gingival displacement had no significant impact on accuracy (p > 0.05). Scanning-electron microscopy revealed no cavitation.

Conclusions

In vitro, tactile assessment of proximal surfaces was useful and safe.

Clinical relevance

Analysis of the cavitation level by using a cow-horn-ended probe might be leading to useful information in addition to bitewing assessment under clinical circumstances.

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

Coherence and congruency mediate medial temporal and medial prefrontal activity during event construction

Publication date: March 2019

Source: NeuroImage, Volume 188

Author(s): Kristoffer Romero, Morgan D. Barense, Morris Moscovitch

Abstract

The precise roles of the hippocampus (HPC) and medial prefrontal cortex (mPFC) in initially constructing imagined events remains unclear. HPC activity during imagination may be modulated by mnemonic load, given its role in working memory for complex materials, and/or by the semantic relatedness (i.e. congruency) between items and their context. MPFC activation may track with congruency or mnemonic load, given the role of ventral mPFC in schema processing and the dorsal mPFC in working memory for social information. Sixteen healthy adults (M age = 22.3) underwent an event construction task, wherein participants were provided with a context and item words and imagined an event, forming as many inter-item associations as possible among the items. The stimuli varied by set size and by normatively-defined congruence (normative congruency) to explore their effects on HPC and mPFC activity and functional connectivity. We observed HPC connectivity during event construction in general, whereas dorsal mPFC connectivity occurred during imagining only at higher set sizes. Moreover, anterior hippocampal activity correlated positively with increasing coherence between items during imagining, suggesting that the anterior HPC is sensitive to the relational demands of constructing a novel event. Parahippocampal, hippocampal, temporal pole, and mPFC activity tracked only with individual differences in subjective ratings of congruency of imagined events, which may contribute to construction by retrieving existing schema-related information. Collectively, these findings provide new insights into the factors that modulate HPC and mPFC activity when constructing mental simulations.

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

Genotoxic effects in oral mucosal cells caused by the use of orthodontic fixed appliances in patients after short and long periods of treatment

Abstract

Objective

This study aimed to evaluate the genotoxic effects in the oral epithelial cells of patients undergoing fixed orthodontic treatment and to compare these to a control group without treatment. The null hypothesis to be tested is that corrective orthodontic treatment at different periods does not cause genotoxic effects in patients.

Material and methods

An observational cross-sectional study including 74 patients enrolled in corrective orthodontic treatment and 21 control patients, between 11 and 35 years of age, of both genders, participated in the research. Patients undergoing treatment were divided into four treatment groups differentiated by treatment periods: G1, n = 21 (1 month to 12 months); G2, n = 21 (13 to 24 months); G3, n = 23 (25 to 48 months); and G4, n = 9 (over 48 months). Cells were collected by scraping the internal side of the cheek and subsequently placed in tubes containing 0.9% sodium chloride solution. The sample underwent evaluation for genotoxic effects by means of the micronucleus test (MNT). Bivariate analyses were performed using parametric tests (t test or ANOVA) and nonparametric tests (Chi-square test, Kruskal-Wallis test, Dunn post-test). The adopted level of significance was 5%.

Results

Statistically significant differences for any of the genotoxic abnormalities (binucleated, trinucleated, karyolysis, piknosis, nuclear buds) were not found except for karyolysis, which was higher in the control group than in G4 (p < 0.05).

Conclusions

This study did not demonstrate evidence of genotoxic effects even after long periods of corrective orthodontic treatment.

Clinical relevance

This study explores genotoxic effects in fixed orthodontic patients.

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

How far do calcium release measurements properly reflect its multiple roles in dental tissue mineralization?

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CPx3kT

Accuracy of tactile assessment in order to detect proximal cavitation of caries lesions in vitro

Abstract

Objectives

Discriminating non-cavitated from cavitated proximal lesions without tooth separation is only limitedly possible using visual-radiographic assessment alone. We evaluated how additional tactile assessment might increase the accuracy of this discrimination in vitro.

Methods

Surface integrity of 46 primary molars with proximal lesions extending radiographically into outer third of dentin (ICDAS-codes: 2 n = 34, 3 n = 8 and 5 n = 4) were mounted in groups of two in manikin heads and independently assessed by three examiners using visual-radiographic and additional tactile assessment using a cow-horn-ended explorer with or without gingival displacement. After examination, lesion surfaces were evaluated for possible damage using scanning-electronic microscopy. Analysis of variance (ANOVA) was performed for evaluating if tactile assessment and gingival displacement significantly affected accuracy.

Results

Tactile assessment significantly increased sensitivity of detecting cavities (p < 0.001, ANOVA), but decreased specificity (p < 0.05). Sensitivities/specificities varied between 33 (8)%/96 (1)% and 86 (6)%/84 (5)%. Gingival displacement had no significant impact on accuracy (p > 0.05). Scanning-electron microscopy revealed no cavitation.

Conclusions

In vitro, tactile assessment of proximal surfaces was useful and safe.

Clinical relevance

Analysis of the cavitation level by using a cow-horn-ended probe might be leading to useful information in addition to bitewing assessment under clinical circumstances.

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

Assessing the educational quality of ‘YouTube’ videos for facelifts

Publication date: Available online 4 January 2019

Source: American Journal of Otolaryngology

Author(s): Adeeb Derakhshan, Linda Lee, Prabhat Bhama, Eric Barbarite, David Shaye

Abstract

Objectives

Facelifts are among the most common facial plastic procedures performed. Given the existence of a variety of surgical approaches and the proximity of key anatomical structures, the development of proper surgical skills and knowledge is necessary to ensure positive outcomes. Many surgical learners utilize YouTube videos as supplemental tools in their education. Our aim was to gauge the quality and quantity of available YouTube videos describing the surgical approach to rhytidectomy.

Methods

The YouTube video platform was searched using predefined keywords. Videos meeting inclusion criteria were reviewed and scored by 3 practicing facial plastic and reconstructive surgeons. Thirteen different intraoperative, pre/postoperative, and video quality characteristics were scored on a binary scale by each grader. Descriptive statistics were obtained and interrater reliability was assessed using Kappa's coefficient.

Results

Thirteen videos met criteria for analysis. A high degree of interrater reliability was confirmed using Kappa's coefficient, with κ values = 0.73, 0.75, and 0.59 for each combination of scorers. In general, YouTube videos were found to be deficient in discussing key criteria of rhytidectomy, particularly with regards to pre/postoperative points such as indications, patient selection, and possible complications. Intraoperative benchmarks were also lacking, with 8/13 videos not discussing the facial nerve and 8/13 failing to demonstrate an appropriate facelift incision.

Conclusions

YouTube instructional videos depicting rhytidectomy lack discussion of key tenets of successful facelift surgery. Until improvement in the educational quality of such material occurs, surgical trainees should implement discretion when choosing YouTube videos to complement their learning.

Level of Evidence: Not Applicable.

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Screening mammography for second breast cancers in women with history of early-stage breast cancer: factors and causes associated with non-detection

Abstract

Background

The aim of our study was to identify the factors and causes associated with non-detection for second breast cancers on screening mammography in women with a personal history of early-stage breast cancer.

Methods

Between January 2000 and December 2008, 7976 women with early-stage breast cancer underwent breast surgery in our institution. The inclusion criteria of our study were patients who had: (a) subsequent in-breast recurrence, (b) surveillance mammography within 1 year before recurrence. Retrospective analysis of mammography was performed. Non-detection was defined as second breast cancers that were not visible on screening mammography. Imaging features, demographics, primary breast cancer (PBC) characteristics, and clinical features were evaluated to determine its association with non-detection. Univariate and multivariate logistic regression analyses were also performed to identify the factors related to non-detection.

Results

We identified 188 patients that met the criteria. Among them, 39% of patients showed non-detection (n = 74). Of the 74 patients with non-detection, 53 (72%) were classified as having no detectable mammographic abnormality (i.e., true negative) due to overlapping dense breast tissue (n = 32), obscured by postoperative scar (n = 12) or difficult anatomic location / poor positioning (n = 9). The remaining 21 patients were categorized as having subtle findings (n = 11) or missed cancer (n = 10). Non-detection for second breast cancers were significantly associated with mammographic breast density (p = 0.001, OR = 2.959) and detectability of PBC on mammography (p = 0.011, OR = 3.013).

Conclusion

Non-detection of second breast cancer in women with a personal history of early-stage breast cancer were associated with mammographic dense breast and lower detectability of PBC on mammography.

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Probing the intravascular and interstitial compartments of remodeled myocardium in heart failure patients with preserved and reduced ejection fraction: a CMR study

Abstract

Background

Recent autopsy studies found microvascular rarefaction in remodeled myocardium of patients who died of heart failure with preserved ejection-fraction (HFpEF). This condition has not been investigated so far by non-invasive methods in patients with HFpEF. The aim was to quantify the intravascular volume (IVV) compartment by CMR in HFpEF patients.

Methods

In two separate CMR examinations, HFpEF patients (n = 6; 12 examinations) and post-myocardial infarction patients (post-MI; n = 6; 12 examinations) were studied with T₁-mapping (MOLLI-sequence) before and after IV bolus of 0.03 mmol/Kg of the intravascular contrast-medium (CM) Gadofosveset and 0.2 mmol/Kg of the extravascular CM Gadobutrol yielding IVV and extracellular volume (ECV), respectively. Healthy controls (n = 10 with Gadofosveset only, n = 10 with Gadobutrol only) were also studied with the same protocol. IVV and ECV were measured in the basal septum (without ischemic scar in post-MI patients). In post-MI patients, ECV and IVV were also measured in the ischemic scar. Left ventricular (LV) volumes, mass, and ejection-fraction were measured by standard protocol. LV global longitudinal strain (GLS) was calculated by feature tracking on long-axis cine acquisitions.

Results

LV mass to end-diastolic volume ratio and GLS in HFpEF were higher and lower, respectively, than in healthy controls and post-MI patients, whereas the post-MI patients showed lower LV ejection-fraction. Compared to healthy myocardium of controls, IVV in scar was reduced (0.135 ± 0.018 vs 0.109 ± 0.008, respectively, p = 0.005), while ECV was increased (0.244 ± 0.037 vs 0.698 ± 0.106, respectively, p < 0.001). However, IVV did not differ among HFpEF, post-MI, and healthy controls (0.155 ± 0.033, 0.146 ± 0.038, and 0.135 ± 0.018, respectively, p = 0.413), whereas ECV was higher in HFpEF than in post-MI and healthy controls (0.304 ± 0.159, 0.270 ± 0.017, and 0.244 ± 0.037, respectively, p = 0.003).

Conclusions

The T₁-mapping technique combined with an intravascular CM shows potential to measure IVV. In infarct scar with substantially increased ECV, IVV was significantly reduced. Unlike in infarct scar, in remodeled myocardium of HFpEF patients, increased ECV was not accompanied by a reduction of IVV.

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Assessing the educational quality of ‘YouTube’ videos for facelifts

Publication date: Available online 4 January 2019

Source: American Journal of Otolaryngology

Author(s): Adeeb Derakhshan, Linda Lee, Prabhat Bhama, Eric Barbarite, David Shaye

Abstract

Objectives

Facelifts are among the most common facial plastic procedures performed. Given the existence of a variety of surgical approaches and the proximity of key anatomical structures, the development of proper surgical skills and knowledge is necessary to ensure positive outcomes. Many surgical learners utilize YouTube videos as supplemental tools in their education. Our aim was to gauge the quality and quantity of available YouTube videos describing the surgical approach to rhytidectomy.

Methods

The YouTube video platform was searched using predefined keywords. Videos meeting inclusion criteria were reviewed and scored by 3 practicing facial plastic and reconstructive surgeons. Thirteen different intraoperative, pre/postoperative, and video quality characteristics were scored on a binary scale by each grader. Descriptive statistics were obtained and interrater reliability was assessed using Kappa's coefficient.

Results

Thirteen videos met criteria for analysis. A high degree of interrater reliability was confirmed using Kappa's coefficient, with κ values = 0.73, 0.75, and 0.59 for each combination of scorers. In general, YouTube videos were found to be deficient in discussing key criteria of rhytidectomy, particularly with regards to pre/postoperative points such as indications, patient selection, and possible complications. Intraoperative benchmarks were also lacking, with 8/13 videos not discussing the facial nerve and 8/13 failing to demonstrate an appropriate facelift incision.

Conclusions

YouTube instructional videos depicting rhytidectomy lack discussion of key tenets of successful facelift surgery. Until improvement in the educational quality of such material occurs, surgical trainees should implement discretion when choosing YouTube videos to complement their learning.

Level of Evidence: Not Applicable.

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Screening mammography for second breast cancers in women with history of early-stage breast cancer: factors and causes associated with non-detection

Abstract

Background

The aim of our study was to identify the factors and causes associated with non-detection for second breast cancers on screening mammography in women with a personal history of early-stage breast cancer.

Methods

Between January 2000 and December 2008, 7976 women with early-stage breast cancer underwent breast surgery in our institution. The inclusion criteria of our study were patients who had: (a) subsequent in-breast recurrence, (b) surveillance mammography within 1 year before recurrence. Retrospective analysis of mammography was performed. Non-detection was defined as second breast cancers that were not visible on screening mammography. Imaging features, demographics, primary breast cancer (PBC) characteristics, and clinical features were evaluated to determine its association with non-detection. Univariate and multivariate logistic regression analyses were also performed to identify the factors related to non-detection.

Results

We identified 188 patients that met the criteria. Among them, 39% of patients showed non-detection (n = 74). Of the 74 patients with non-detection, 53 (72%) were classified as having no detectable mammographic abnormality (i.e., true negative) due to overlapping dense breast tissue (n = 32), obscured by postoperative scar (n = 12) or difficult anatomic location / poor positioning (n = 9). The remaining 21 patients were categorized as having subtle findings (n = 11) or missed cancer (n = 10). Non-detection for second breast cancers were significantly associated with mammographic breast density (p = 0.001, OR = 2.959) and detectability of PBC on mammography (p = 0.011, OR = 3.013).

Conclusion

Non-detection of second breast cancer in women with a personal history of early-stage breast cancer were associated with mammographic dense breast and lower detectability of PBC on mammography.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Vtk3c6

Probing the intravascular and interstitial compartments of remodeled myocardium in heart failure patients with preserved and reduced ejection fraction: a CMR study

Abstract

Background

Recent autopsy studies found microvascular rarefaction in remodeled myocardium of patients who died of heart failure with preserved ejection-fraction (HFpEF). This condition has not been investigated so far by non-invasive methods in patients with HFpEF. The aim was to quantify the intravascular volume (IVV) compartment by CMR in HFpEF patients.

Methods

In two separate CMR examinations, HFpEF patients (n = 6; 12 examinations) and post-myocardial infarction patients (post-MI; n = 6; 12 examinations) were studied with T₁-mapping (MOLLI-sequence) before and after IV bolus of 0.03 mmol/Kg of the intravascular contrast-medium (CM) Gadofosveset and 0.2 mmol/Kg of the extravascular CM Gadobutrol yielding IVV and extracellular volume (ECV), respectively. Healthy controls (n = 10 with Gadofosveset only, n = 10 with Gadobutrol only) were also studied with the same protocol. IVV and ECV were measured in the basal septum (without ischemic scar in post-MI patients). In post-MI patients, ECV and IVV were also measured in the ischemic scar. Left ventricular (LV) volumes, mass, and ejection-fraction were measured by standard protocol. LV global longitudinal strain (GLS) was calculated by feature tracking on long-axis cine acquisitions.

Results

LV mass to end-diastolic volume ratio and GLS in HFpEF were higher and lower, respectively, than in healthy controls and post-MI patients, whereas the post-MI patients showed lower LV ejection-fraction. Compared to healthy myocardium of controls, IVV in scar was reduced (0.135 ± 0.018 vs 0.109 ± 0.008, respectively, p = 0.005), while ECV was increased (0.244 ± 0.037 vs 0.698 ± 0.106, respectively, p < 0.001). However, IVV did not differ among HFpEF, post-MI, and healthy controls (0.155 ± 0.033, 0.146 ± 0.038, and 0.135 ± 0.018, respectively, p = 0.413), whereas ECV was higher in HFpEF than in post-MI and healthy controls (0.304 ± 0.159, 0.270 ± 0.017, and 0.244 ± 0.037, respectively, p = 0.003).

Conclusions

The T₁-mapping technique combined with an intravascular CM shows potential to measure IVV. In infarct scar with substantially increased ECV, IVV was significantly reduced. Unlike in infarct scar, in remodeled myocardium of HFpEF patients, increased ECV was not accompanied by a reduction of IVV.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QrCMB0