Effects of a simulated system of straw phonation on the complete phonatory range of excised canine larynges

Abstract

Purpose

This study investigated the effects of straw phonation therapy on the aerodynamic and acoustic parameters of the vocal folds at different levels of elongation and subglottal pressure.

Methods

20 excised canine larynges were used in both experimental (straw phonation therapy simulation) and control conditions. Aerodynamic parameters, including phonation threshold pressure (PTP), phonation instability pressure (PIP), phonation pressure range (PPR), phonation threshold flow (PTF), phonation instability flow (PIF), phonation flow range (PFR), were obtained at different levels of vocal fold elongation (0%, 10%, 20%). Acoustic parameters, including fundamental frequency (F0), jitter, shimmer, signal noise ratio (SNR) were detected at different levels of vocal fold elongation (0%, 10%, 20%) and subglottal pressure (15 cmH₂O, 20 cmH₂O, 25 cmH₂O).

Results

Significant decreases in PTP and PTF and significant increases in PIP, PIF, PPR, and PFR occurred in experimental condition at all levels of elongation when compared with control condition. However, no significant changes of acoustic parameters were obtained between conditions at all levels.

Conclusion

At different levels of vocal fold elongation, straw phonation not only lowered the onset of normal voice, but also elevated the onset of chaotic voice, indicating a better voice economy and voice control. Moreover, the improved phonatory range demonstrated that straw phonation had the potential to prevent voice users who have high voice demand from voice fatigue and vocal damage.

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

Effects of a simulated system of straw phonation on the complete phonatory range of excised canine larynges

Abstract

Purpose

This study investigated the effects of straw phonation therapy on the aerodynamic and acoustic parameters of the vocal folds at different levels of elongation and subglottal pressure.

Methods

20 excised canine larynges were used in both experimental (straw phonation therapy simulation) and control conditions. Aerodynamic parameters, including phonation threshold pressure (PTP), phonation instability pressure (PIP), phonation pressure range (PPR), phonation threshold flow (PTF), phonation instability flow (PIF), phonation flow range (PFR), were obtained at different levels of vocal fold elongation (0%, 10%, 20%). Acoustic parameters, including fundamental frequency (F0), jitter, shimmer, signal noise ratio (SNR) were detected at different levels of vocal fold elongation (0%, 10%, 20%) and subglottal pressure (15 cmH₂O, 20 cmH₂O, 25 cmH₂O).

Results

Significant decreases in PTP and PTF and significant increases in PIP, PIF, PPR, and PFR occurred in experimental condition at all levels of elongation when compared with control condition. However, no significant changes of acoustic parameters were obtained between conditions at all levels.

Conclusion

At different levels of vocal fold elongation, straw phonation not only lowered the onset of normal voice, but also elevated the onset of chaotic voice, indicating a better voice economy and voice control. Moreover, the improved phonatory range demonstrated that straw phonation had the potential to prevent voice users who have high voice demand from voice fatigue and vocal damage.

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Children ’ s Books Written by SLPs

Do you have a passion for speech, language and children's literature? When I was a child, one of my favorite activities was reading children's books and writing stories. I also dreamed of publishing my own children's book. As an adult—and speech-language pathologist—I still love children's books and review them on my blog. I also achieved my dream and published three children's books so far! There's a natural connection for SLPs to write children's books, and I'm excited to highlight some of these fun stories—many of which are often full of useful activities for children needing help with speech and language skills. Many of our books focus on specific language goals such as articulation, communication, sequencing, retelling, answering "wh" quest...

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Children ’ s Books Written by SLPs

Do you have a passion for speech, language and children's literature? When I was a child, one of my favorite activities was reading children's books and writing stories. I also dreamed of publishing my own children's book. As an adult—and speech-language pathologist—I still love children's books and review them on my blog. I also achieved my dream and published three children's books so far! There's a natural connection for SLPs to write children's books, and I'm excited to highlight some of these fun stories—many of which are often full of useful activities for children needing help with speech and language skills. Many of our books focus on specific language goals such as articulation, communication, sequencing, retelling, answering "wh" quest...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H7M8CD

Children ’ s Books Written by SLPs

Do you have a passion for speech, language and children's literature? When I was a child, one of my favorite activities was reading children's books and writing stories. I also dreamed of publishing my own children's book. As an adult—and speech-language pathologist—I still love children's books and review them on my blog. I also achieved my dream and published three children's books so far! There's a natural connection for SLPs to write children's books, and I'm excited to highlight some of these fun stories—many of which are often full of useful activities for children needing help with speech and language skills. Many of our books focus on specific language goals such as articulation, communication, sequencing, retelling, answering "wh" quest...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H7M8CD

Children ’ s Books Written by SLPs

Do you have a passion for speech, language and children's literature? When I was a child, one of my favorite activities was reading children's books and writing stories. I also dreamed of publishing my own children's book. As an adult—and speech-language pathologist—I still love children's books and review them on my blog. I also achieved my dream and published three children's books so far! There's a natural connection for SLPs to write children's books, and I'm excited to highlight some of these fun stories—many of which are often full of useful activities for children needing help with speech and language skills. Many of our books focus on specific language goals such as articulation, communication, sequencing, retelling, answering "wh" quest...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H7M8CD

Genetic diagnosis of primary immunodeficiencies: a survey of the French national registry

The report describes the status of genetic diagnosis of PID based on a national registry. It shows that a genetic diagnosis has been achieved in half of them, reaching almost 80% of all PID but B cell immunodeficiencies. (Source: Journal of Allergy and Clinical Immunology)

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Dysfunctional ErbB2, an EGF receptor family member, hinders repair of asthmatic airway epithelial cells

Asthmatic airway epithelial cells have dysregulated wound repair, in association with lower activation of the ErbB2 pathway. Restoration of this pathway might be a novel therapeutic target, potentially restoring a disrupted airway epithelium in asthma. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C9NabI

Macrophage polarization: reaching across the aisle?

Macrophage polarization may influence the pathogenesis of many human diseases; however the transcriptional program regulating this process remains poorly characterized. Gharib et al.1 highlight the high diversity of M1-to-M2 re-polarization exerted by distinct M2 stimuli via transcriptome-based pathway analysis and provide a new approach to phenotype human macrophages in clinically relevant disease states such as cystic fibrosis and asthma (Source: Journal of Allergy and Clinical Immunology)

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A case of mistaken identity: The MAR-1 antibody to mouse Fc εRIα cross-reacts with FcγRI and FcγRIV

This study demonstrates that the MAR-1 antibody to mouse FcepsilonRI unexpectedly binds to two Fcgamma receptors, raising concerns regarding numerous studies that used this antibody to assess the distribution and function of FcepsilonRI+ cells. (Source: Journal of Allergy and Clinical Immunology)

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A new checkpoint in lupus

(Source: Journal of Allergy and Clinical Immunology)

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Report from the National Institute of Allergy and Infectious Diseases Workshop on “Atopic Dermatitis and the Atopic March: Mechanisms and Interventions”

Atopic dermatitis (AD) affects up to 20% of children world-wide and is an increasing public health problem particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized, increased risk of sequential progression from AD to other atopic diseases including food allergy, allergic rhinitis, allergic asthma and allergic rhinoconjunctivitis; a process referred to as the "atopic march". The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly food allergy, are incompletely understood and the subject of intense investigation. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Canyv5

Racial disparities in asthma-related health care use in the National Heart, Lung, and Blood Institute's Severe Asthma Research Program

Despite advances in asthma care, disparities persist. Black patients are disproportionally affected by asthma and also have poorer outcomes compared with white patients. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CeES2f

Genetic diagnosis of primary immunodeficiencies: a survey of the French national registry

The report describes the status of genetic diagnosis of PID based on a national registry. It shows that a genetic diagnosis has been achieved in half of them, reaching almost 80% of all PID but B cell immunodeficiencies. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rm4yUU

Dysfunctional ErbB2, an EGF receptor family member, hinders repair of asthmatic airway epithelial cells

Asthmatic airway epithelial cells have dysregulated wound repair, in association with lower activation of the ErbB2 pathway. Restoration of this pathway might be a novel therapeutic target, potentially restoring a disrupted airway epithelium in asthma. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C9NabI

Macrophage polarization: reaching across the aisle?

Macrophage polarization may influence the pathogenesis of many human diseases; however the transcriptional program regulating this process remains poorly characterized. Gharib et al.1 highlight the high diversity of M1-to-M2 re-polarization exerted by distinct M2 stimuli via transcriptome-based pathway analysis and provide a new approach to phenotype human macrophages in clinically relevant disease states such as cystic fibrosis and asthma (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rk76TH

A case of mistaken identity: The MAR-1 antibody to mouse Fc εRIα cross-reacts with FcγRI and FcγRIV

This study demonstrates that the MAR-1 antibody to mouse FcepsilonRI unexpectedly binds to two Fcgamma receptors, raising concerns regarding numerous studies that used this antibody to assess the distribution and function of FcepsilonRI+ cells. (Source: Journal of Allergy and Clinical Immunology)

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

A new checkpoint in lupus

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RjcB54

Report from the National Institute of Allergy and Infectious Diseases Workshop on “Atopic Dermatitis and the Atopic March: Mechanisms and Interventions”

Atopic dermatitis (AD) affects up to 20% of children world-wide and is an increasing public health problem particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized, increased risk of sequential progression from AD to other atopic diseases including food allergy, allergic rhinitis, allergic asthma and allergic rhinoconjunctivitis; a process referred to as the "atopic march". The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly food allergy, are incompletely understood and the subject of intense investigation. (Source: Journal of Allergy and Clinical Immunology)

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ALLERGY RELIEF (Cetirizine Hydrochloride) Tablet, Coated [CHAIN DRUG MARKETING ASSOCIATION INC.]

Updated Date: Jan 4, 2019 EST (Source: DailyMed Drug Label Updates)

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MAXIMUM STRENGTH ADULT ALLERGY RELIEF (Diphenhydramine Hcl) Liquid [AptaPharma Inc.]

Updated Date: Jan 9, 2019 EST (Source: DailyMed Drug Label Updates)

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ALLERGY RELIEF (Loratadine) Capsule, Liquid Filled [CHAIN DRUG MARKETING ASSOCIATION INC.]

Updated Date: Jan 4, 2019 EST (Source: DailyMed Drug Label Updates)

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ALLERGY RELIEF (Fexofenadine Hydrochloride) Tablet [CHAIN DRUG MARKETING ASSOCIATION INC.]

Updated Date: Jan 4, 2019 EST (Source: DailyMed Drug Label Updates)

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COLD AND ALLERGY (Chlorpheniramine Maleate And Phenylephrine Hydrochloride) Tablet, Coated [CHAIN DRUG MARKETING ASSOCIATION INC.]

Updated Date: Jan 4, 2019 EST (Source: DailyMed Drug Label Updates)

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ALLERGY RELIEF (Cetirizine Hydrochloride) Tablet, Coated [CHAIN DRUG MARKETING ASSOCIATION INC.]

Updated Date: Jan 4, 2019 EST (Source: DailyMed Drug Label Updates)

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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Impact of Sports-Related Subconcussive Injuries in Soccer Players.

Authors: Díaz-Rodríguez YI, Salvatore AP Abstract Sports-related subconcussive impacts to the head are receiving increased interest. Recent evidence indicates that subconcussive impacts will have greater relevance across time because of the number of repetitive impacts. Soccer players are at risk of receiving at least one impact during a soccer game. The authors review the cognitive-communication functioning following subconcussive head injuries in youth and recommendations for baseline assessments and cognitive-communication dysfunctions after subconcussive impacts in youth. The review is followed by a description and discussion of a study that assessed the cognitive-communicative dysfunction in young soccer players prior to and following a series of soccer matches and recommend...

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Physical Therapy Management of Adults with Mild Traumatic Brain Injury.

Authors: Kane AW, Diaz DS, Moore C Abstract Rehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibu...

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Multidisciplinary Management of Collegiate Sports-Related Concussions.

CONCLUSION:  Management of the complex sequelae of sports-related concussion for the varsity collegiate athlete necessitates implementation of a multidisciplinary, collaborative approach. Speech-language pathologists' training in the assessment and treatment of brain injury provides the team with an objective perspective in the evaluation and postinjury management of the injured student athlete. While our understanding of concussions has improved greatly over the past two decades, researchers and clinicians on the front lines of care recognize that continued voids exist in our knowledge, with the need to continually explore new methods to identify and manage the complex immediate and potentially long-term ramifications of concussion. PMID: 30616290 [PubMed - in process] (Source: Semi...

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Disorders of Emotional Communication in Traumatic Brain Injury.

This article summarizes the current evidence for evaluation and treatment of affective processing disorders in TBI. PMID: 30616291 [PubMed - in process] (Source: Seminars in Speech and Language)

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The Role of Speech-Language Pathology in an Interdisciplinary Care Model for Persistent Symptomatology of Mild Traumatic Brain Injury.

Authors: Hardin KY, Kelly JP Abstract The Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models. By implementing integrated practice units, patients receive advanced medic...

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Concussions: Interdisciplinary Management.

Authors: Salvatore AP Abstract PMID: 30616289 [PubMed - in process] (Source: Seminars in Speech and Language)

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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

Physical Therapy Management of Adults with Mild Traumatic Brain Injury.

Authors: Kane AW, Diaz DS, Moore C Abstract Rehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibu...

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

Multidisciplinary Management of Collegiate Sports-Related Concussions.

CONCLUSION:  Management of the complex sequelae of sports-related concussion for the varsity collegiate athlete necessitates implementation of a multidisciplinary, collaborative approach. Speech-language pathologists' training in the assessment and treatment of brain injury provides the team with an objective perspective in the evaluation and postinjury management of the injured student athlete. While our understanding of concussions has improved greatly over the past two decades, researchers and clinicians on the front lines of care recognize that continued voids exist in our knowledge, with the need to continually explore new methods to identify and manage the complex immediate and potentially long-term ramifications of concussion. PMID: 30616290 [PubMed - in process] (Source: Semi...

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Concussions: Activity Avoidance and Rest Recommendation.

Authors: Banks RE, Salvatore AP Abstract Research surrounding rest recommendations for the concussed population is discussed. Rest is compared with activity avoidance, which is common in several chronic disease and traumatic injury types. The case is made for rest recommendations tailored to each head-injured individual. Research is presented which suggests that activity in the initial stages of concussion recovery may be beneficial in reducing postconcussion symptom duration and severity. Furthermore, a gradual increase in activity may potentially aid in returning to normal daily activity sooner than those who avoid both physical and cognitive activity during the acute stage of a traumatic brain injury. Finally, the current state of rest recommendations is reviewed and anticipated...

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Disorders of Emotional Communication in Traumatic Brain Injury.

This article summarizes the current evidence for evaluation and treatment of affective processing disorders in TBI. PMID: 30616291 [PubMed - in process] (Source: Seminars in Speech and Language)

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Clinical Assessments of Balance in Adults with Concussion: An Update.

Authors: Murray NG, Reed-Jones RJ, Szekely BJ, Powell DW Abstract Postural instability is a cardinal indicator of concussion. Assessments of the postural control system range from clinical to laboratory tests that assess the balance of the individual. In a previous article regarding clinical assessment of balance in adults with concussion, we reviewed the importance of balance as a component in concussion evaluations. The purpose of this review article is to update the information previously published in 2014. Since 2014, research has provided evidence for the incorporation of dynamic methods for evaluating balance postconcussion with particular emphasis on sensory system integration and dual tasking. Therefore, this review will examine the current state of knowledge on how concuss...

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The Role of Speech-Language Pathology in an Interdisciplinary Care Model for Persistent Symptomatology of Mild Traumatic Brain Injury.

Authors: Hardin KY, Kelly JP Abstract The Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models. By implementing integrated practice units, patients receive advanced medic...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FiEd3M

Concussions: Interdisciplinary Management.

Authors: Salvatore AP Abstract PMID: 30616289 [PubMed - in process] (Source: Seminars in Speech and Language)

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Hauptsymptome und Elternerwartung bei Adenotomie und Adenotonsillotomie im Vorschulalter

Laryngo-Rhino-Otol
DOI: 10.1055/a-0816-5807

Hintergrund Um eine realistische Aufklärung vor Adeno(tonsillo)tomie zu leisten, wurden im Rahmen dieser Studie die kindliche Symptombelastung und die elterliche Erwartung an den Operationserfolg prospektiv erfasst. Material und Methoden Es wurden n = 111 Kinder (3–6 Jahre, ♂ 65 % ♀ 35 %) rekrutiert, welche an der HNO-Universitätsklinik Ulm eine Adenotomie (AT 66 %) oder Adenotonsillotomie (ATT 34 %) erhielten. In der fragebogenbasierten Befragung wurden die häufigsten Symptome und der Hauptgrund zur Operation aus Elternsicht erfasst (Operationstag, follow-up: 3,5 Mo.) und in Balkendiagrammen jeweils für Gesamtkollektiv und die Operationsgruppen AT und ATT visualisiert (Signifikanzniveau auf α = 5 %). Ergebnisse Am häufigsten wurden von den Eltern Zeichen einer Atemproblematik (Mundatmung 87 %, Nasenatmungsbehinderung 86 %, Schnarchen 78 %), Hörminderung (68 %) und vermehrter Infektneigung (66 %) beobachtet. Als Hauptgrund zur Operation wurden Nasenatmungsbehinderung (77,5 %) und Hörminderung (53,2 %) genannt. Bei reiner Rachenmandelhyperplasie dominierten Hörprobleme, während bei zusätzlich indizierter Tonsillotomie nächtlichen Apnoen als Operationsgrund am häufigsten genannt wurden. Bei allen abgefragten Symptomen konnte postoperativ eine wesentliche Verbesserung erzielt werden. Schlussfolgerungen Bei differenzierter Indikationsstellung ist es möglich, die Eltern über eine sehr gute und realistisch zu erwartende, effektive Symptomreduktion nach AT und ATT zu informieren.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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

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Erratum

For "Is there a difference in orbital volume between affected and unaffected sides in patients with unilateral craniofacial microsomia?" (Gribova MN, Pluijmers BI, Resnick CM, et al. J Oral Maxillofac Surg 2018 Dec;76(12):2625-2629), the authors would like to amend the acknowledgment. The complete acknowledgment is listed below. This has since been updated online.

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Hauptsymptome und Elternerwartung bei Adenotomie und Adenotonsillotomie im Vorschulalter

Laryngo-Rhino-Otol
DOI: 10.1055/a-0816-5807

Hintergrund Um eine realistische Aufklärung vor Adeno(tonsillo)tomie zu leisten, wurden im Rahmen dieser Studie die kindliche Symptombelastung und die elterliche Erwartung an den Operationserfolg prospektiv erfasst. Material und Methoden Es wurden n = 111 Kinder (3–6 Jahre, ♂ 65 % ♀ 35 %) rekrutiert, welche an der HNO-Universitätsklinik Ulm eine Adenotomie (AT 66 %) oder Adenotonsillotomie (ATT 34 %) erhielten. In der fragebogenbasierten Befragung wurden die häufigsten Symptome und der Hauptgrund zur Operation aus Elternsicht erfasst (Operationstag, follow-up: 3,5 Mo.) und in Balkendiagrammen jeweils für Gesamtkollektiv und die Operationsgruppen AT und ATT visualisiert (Signifikanzniveau auf α = 5 %). Ergebnisse Am häufigsten wurden von den Eltern Zeichen einer Atemproblematik (Mundatmung 87 %, Nasenatmungsbehinderung 86 %, Schnarchen 78 %), Hörminderung (68 %) und vermehrter Infektneigung (66 %) beobachtet. Als Hauptgrund zur Operation wurden Nasenatmungsbehinderung (77,5 %) und Hörminderung (53,2 %) genannt. Bei reiner Rachenmandelhyperplasie dominierten Hörprobleme, während bei zusätzlich indizierter Tonsillotomie nächtlichen Apnoen als Operationsgrund am häufigsten genannt wurden. Bei allen abgefragten Symptomen konnte postoperativ eine wesentliche Verbesserung erzielt werden. Schlussfolgerungen Bei differenzierter Indikationsstellung ist es möglich, die Eltern über eine sehr gute und realistisch zu erwartende, effektive Symptomreduktion nach AT und ATT zu informieren.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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

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Depression Tied to Worse Asthma Outcomes in Urban Teens

More than a fourth with asthma reported depressive symptoms, greater symptom severity (Source: The Doctors Lounge - Psychiatry)

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Increase in Brand - Name Drug Cost Mainly Due to Existing Drugs

Rising costs of oral, injectable generic and specialty drugs mostly driven by new product entry (Source: The Doctors Lounge - Psychiatry)

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Many Female Health Care Workers Live in Poverty

Half of black and Latina female health care workers earn less than $ 15/hour (Source: The Doctors Lounge - Psychiatry)

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University of Cincinnati professor studies hamburger e. coli with NIAID grant

(University of Cincinnati Academic Health Center) Alison Weiss, PhD, professor in the Department of Molecular Genetics, Biochemistry and Microbiology in UC College of Medicine, has been awarded a four-year grant of $1.6 million from the National Institute of Allergy and Infectious Diseases (NIAID) to study Shiga toxin producing Escherichia coli 0157:H7, also sometimes referred to as Hamburger E. coli. (Source: EurekAlert! - Medicine and Health)

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Depression Tied to Worse Asthma Outcomes in Urban Teens

More than a fourth with asthma reported depressive symptoms, greater symptom severity (Source: The Doctors Lounge - Psychiatry)

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Increase in Brand - Name Drug Cost Mainly Due to Existing Drugs

Rising costs of oral, injectable generic and specialty drugs mostly driven by new product entry (Source: The Doctors Lounge - Psychiatry)

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

Many Female Health Care Workers Live in Poverty

Half of black and Latina female health care workers earn less than $ 15/hour (Source: The Doctors Lounge - Psychiatry)

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University of Cincinnati professor studies hamburger e. coli with NIAID grant

(University of Cincinnati Academic Health Center) Alison Weiss, PhD, professor in the Department of Molecular Genetics, Biochemistry and Microbiology in UC College of Medicine, has been awarded a four-year grant of $1.6 million from the National Institute of Allergy and Infectious Diseases (NIAID) to study Shiga toxin producing Escherichia coli 0157:H7, also sometimes referred to as Hamburger E. coli. (Source: EurekAlert! - Medicine and Health)

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Erratum

For "Is there a difference in orbital volume between affected and unaffected sides in patients with unilateral craniofacial microsomia?" (Gribova MN, Pluijmers BI, Resnick CM, et al. J Oral Maxillofac Surg 2018 Dec;76(12):2625-2629), the authors would like to amend the acknowledgment. The complete acknowledgment is listed below. This has since been updated online.

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Erratum

For "Is there a difference in orbital volume between affected and unaffected sides in patients with unilateral craniofacial microsomia?" (Gribova MN, Pluijmers BI, Resnick CM, et al. J Oral Maxillofac Surg 2018 Dec;76(12):2625-2629), the authors would like to amend the acknowledgment. The complete acknowledgment is listed below. This has since been updated online.

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HIV and salivary gland pathology: an update

Salivary gland disease is a common human immunodeficiency virus (HIV) manifestation, with a significant increase in prevalence over the last two decades. This review summarizes contemporary knowledge of non-neoplastic salivary gland disease in HIV infection. The aim is to update and focus on those lesions almost exclusive to salivary glands in the HIV setting. These include xerostomia or salivary gland hypofunction, Sjögren's syndrome-like illness, salivary gland enlargements including benign lymphoepithelial cysts (cystic lymphoid hyperplasia), diffuse infiltrative CD8+ lymphocytosis syndrome and mucous extravasation phenomena, especially ranula.

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Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system

To evaluate interpretation conditions in the subjective in vitro assessment of dental tissue-equivalent radiographic contrast.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H5db1z

HIV and salivary gland pathology: an update

Salivary gland disease is a common human immunodeficiency virus (HIV) manifestation, with a significant increase in prevalence over the last two decades. This review summarizes contemporary knowledge of non-neoplastic salivary gland disease in HIV infection. The aim is to update and focus on those lesions almost exclusive to salivary glands in the HIV setting. These include xerostomia or salivary gland hypofunction, Sjögren's syndrome-like illness, salivary gland enlargements including benign lymphoepithelial cysts (cystic lymphoid hyperplasia), diffuse infiltrative CD8+ lymphocytosis syndrome and mucous extravasation phenomena, especially ranula.

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

Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system

To evaluate interpretation conditions in the subjective in vitro assessment of dental tissue-equivalent radiographic contrast.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H5db1z

Depression Tied to Worse Asthma Outcomes in Urban Teens

More than a fourth with asthma reported depressive symptoms, greater symptom severity (Source: The Doctors Lounge - Psychiatry)

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/2Fh7ls9

Increase in Brand - Name Drug Cost Mainly Due to Existing Drugs

Rising costs of oral, injectable generic and specialty drugs mostly driven by new product entry (Source: The Doctors Lounge - Psychiatry)

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

Many Female Health Care Workers Live in Poverty

Half of black and Latina female health care workers earn less than $ 15/hour (Source: The Doctors Lounge - Psychiatry)

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

University of Cincinnati professor studies hamburger e. coli with NIAID grant

(University of Cincinnati Academic Health Center) Alison Weiss, PhD, professor in the Department of Molecular Genetics, Biochemistry and Microbiology in UC College of Medicine, has been awarded a four-year grant of $1.6 million from the National Institute of Allergy and Infectious Diseases (NIAID) to study Shiga toxin producing Escherichia coli 0157:H7, also sometimes referred to as Hamburger E. coli. (Source: EurekAlert! - Medicine and Health)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fp1uAq

Depression Tied to Worse Asthma Outcomes in Urban Teens

More than a fourth with asthma reported depressive symptoms, greater symptom severity (Source: The Doctors Lounge - Psychiatry)

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/2Fh7ls9

Increase in Brand - Name Drug Cost Mainly Due to Existing Drugs

Rising costs of oral, injectable generic and specialty drugs mostly driven by new product entry (Source: The Doctors Lounge - Psychiatry)

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

Many Female Health Care Workers Live in Poverty

Half of black and Latina female health care workers earn less than $ 15/hour (Source: The Doctors Lounge - Psychiatry)

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

University of Cincinnati professor studies hamburger e. coli with NIAID grant

(University of Cincinnati Academic Health Center) Alison Weiss, PhD, professor in the Department of Molecular Genetics, Biochemistry and Microbiology in UC College of Medicine, has been awarded a four-year grant of $1.6 million from the National Institute of Allergy and Infectious Diseases (NIAID) to study Shiga toxin producing Escherichia coli 0157:H7, also sometimes referred to as Hamburger E. coli. (Source: EurekAlert! - Medicine and Health)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fp1uAq

Sex differences in [ 11 C]ABP688 binding: a positron emission tomography study of mGlu5 receptors

Abstract

Purpose

The purpose of this study was to assess, in a large sample of healthy young adults, sex differences in the binding potential of [¹¹C]ABP688, a positron emission tomography (PET) tracer selective for the metabotropic glutamate type 5 (mGlu5) receptor.

Methods

High resolution [¹¹C]ABP688 PET scans were acquired in 74 healthy volunteers (25 male, 49 female, mean age 20 ± 3.0). Mean binding potential (BP_ND = f_ND * (B_avail / K_D)) values were calculated in the prefrontal cortex, striatum, and limbic regions using the simplified reference tissue model with cerebellar grey matter as the reference region.

Results

[¹¹C]ABP688 BP_ND was significantly higher in men compared to women in the prefrontal cortex (p < 0.01), striatum (p < 0.001), and hippocampus (p < 0.05). Whole-brain BP_ND was 17% higher in men. BP_ND was not related to menstrual phase in women.

Conclusions

Binding availability of mGlu5 receptors as measured by PET [¹¹C]ABP688 is higher in healthy men than women. This likely represents a source of variability in [¹¹C]ABP688 studies and could have relevance for sex differences in cognitive-behavioral functions and neuropsychiatric disorders.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AGje71

Cortical atrophic-hypometabolic dissociation in the transition from premanifest to early-stage Huntington’s disease

Abstract

Purpose

Huntington's disease (HD) is a fatal neurodegenerative disorder with no effective treatment currently available. Although the pathological hallmark of HD is massive striatal atrophy, it has been suggested that cortical deterioration may concomitantly occur and play a major role in the patient's functional independence. Our objective was to characterize cortical structural and metabolic neurodegeneration in the transition from premanifest to early-stage Huntington's disease (HD).

Methods

Using a surface-based neuroimaging approach, we compared cortical thickness and intracortical FDG-PET uptake in 19 early-symptomatic HD patients with respect to 21 premanifest HD individuals.

Results

Early-HD patients showed significant cortical atrophy and intracortical hypometabolism when compared to premanifest subjects (p < 0.05, corrected for multiple comparisons). However, whereas the atrophy pattern was restricted to precentral and parieto-occipital regions, a pronounced frontotemporal hypometabolism was observed. Importantly, structural changes correlated with motor and cognitive performance, and metabolic changes were associated with the presence and severity of apathy in this population, a core neuropsychiatric feature of this disorder.

Conclusion

Our findings reveal an asynchronous neuronal loss and metabolic compromise across the cerebral cortex in early HD. Hence, the use of structural and metabolic imaging indicators to characterize disease progression in this population should take into consideration the dissociation which occurs between cortical atrophy and hypometabolism.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SO0KZi

Sex differences in [ 11 C]ABP688 binding: a positron emission tomography study of mGlu5 receptors

Abstract

Purpose

The purpose of this study was to assess, in a large sample of healthy young adults, sex differences in the binding potential of [¹¹C]ABP688, a positron emission tomography (PET) tracer selective for the metabotropic glutamate type 5 (mGlu5) receptor.

Methods

High resolution [¹¹C]ABP688 PET scans were acquired in 74 healthy volunteers (25 male, 49 female, mean age 20 ± 3.0). Mean binding potential (BP_ND = f_ND * (B_avail / K_D)) values were calculated in the prefrontal cortex, striatum, and limbic regions using the simplified reference tissue model with cerebellar grey matter as the reference region.

Results

[¹¹C]ABP688 BP_ND was significantly higher in men compared to women in the prefrontal cortex (p < 0.01), striatum (p < 0.001), and hippocampus (p < 0.05). Whole-brain BP_ND was 17% higher in men. BP_ND was not related to menstrual phase in women.

Conclusions

Binding availability of mGlu5 receptors as measured by PET [¹¹C]ABP688 is higher in healthy men than women. This likely represents a source of variability in [¹¹C]ABP688 studies and could have relevance for sex differences in cognitive-behavioral functions and neuropsychiatric disorders.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AGje71

Cortical atrophic-hypometabolic dissociation in the transition from premanifest to early-stage Huntington’s disease

Abstract

Purpose

Huntington's disease (HD) is a fatal neurodegenerative disorder with no effective treatment currently available. Although the pathological hallmark of HD is massive striatal atrophy, it has been suggested that cortical deterioration may concomitantly occur and play a major role in the patient's functional independence. Our objective was to characterize cortical structural and metabolic neurodegeneration in the transition from premanifest to early-stage Huntington's disease (HD).

Methods

Using a surface-based neuroimaging approach, we compared cortical thickness and intracortical FDG-PET uptake in 19 early-symptomatic HD patients with respect to 21 premanifest HD individuals.

Results

Early-HD patients showed significant cortical atrophy and intracortical hypometabolism when compared to premanifest subjects (p < 0.05, corrected for multiple comparisons). However, whereas the atrophy pattern was restricted to precentral and parieto-occipital regions, a pronounced frontotemporal hypometabolism was observed. Importantly, structural changes correlated with motor and cognitive performance, and metabolic changes were associated with the presence and severity of apathy in this population, a core neuropsychiatric feature of this disorder.

Conclusion

Our findings reveal an asynchronous neuronal loss and metabolic compromise across the cerebral cortex in early HD. Hence, the use of structural and metabolic imaging indicators to characterize disease progression in this population should take into consideration the dissociation which occurs between cortical atrophy and hypometabolism.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SO0KZi

Outcome prediction for Bonebridge candidates based on audiological indication criteria

To re-evaluate current indication criteria and to estimate the audiological outcomes of patients with Bonebridge bone conduction implants based on preoperative bone conduction thresholds. (Source: Auris, Nasus, Larynx)

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/2TC1sZB

Report from the National Institute of Allergy and Infectious Diseases Workshop on “Atopic Dermatitis and the Atopic March: Mechanisms and Interventions”

Atopic dermatitis (AD) affects up to 20% of children world-wide and is an increasing public health problem particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized, increased risk of sequential progression from AD to other atopic diseases including food allergy, allergic rhinitis, allergic asthma and allergic rhinoconjunctivitis; a process referred to as the "atopic march". The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly food allergy, are incompletely understood and the subject of intense investigation.

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A case of mistaken identity: The MAR-1 antibody to mouse FcεRIα cross-reacts with FcγRI and FcγRIV

This study demonstrates that the MAR-1 antibody to mouse FcepsilonRI unexpectedly binds to two Fcgamma receptors, raising concerns regarding numerous studies that used this antibody to assess the distribution and function of FcepsilonRI+ cells.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AzVu4f

A new checkpoint in lupus

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

Management of Median and Paramedian Craniofacial Clefts

Median and paramedian craniofacial clefts are associated with hypertelorism, anterior encephalocele, positional abnormalities of the maxilla and nasal deformity. Cleft lip and palate, eyelid coloboma and widow's peak are frequently present.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RC3mMG

“Surgical Outcomes of VRAM versus Gracilis Flaps for the Reconstruction of Pelvic Defects following Oncologic Resection”

Pelvic reconstruction following abdominoperineal resection or pelvic exenteration is associated with signification surgical site morbidity. Immediate pelvic reconstruction with a muscle flap is now the gold standard, associated with reduced perineal morbidity compared to primary closure alone.2,3 The purpose of the present study was to directly compare outcomes of VRAM and gracilis flap pelvic reconstruction following oncologic resection.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RD0WNO

PART 2: CAN IMPROVEMENT IN OUTCOME MEASUREMENT IN PLASTIC SURGERY BE ACHIEVED IN TODAY'S HEALTH SYSTEMS?

Being able to accurately measure relevant constructs is particularly valuable in plastic surgery, where the objective of treatment may range across improving hand function, identifying satisfaction with breast reconstruction, or establishing quality of life changes from surgery. This matters in research applications such as clinical trials, and for quality assurance of surgery through routine data collection in clinical practice. The technical aspects of refining measurement to ensure that it is accurate and the process for selecting outcome measures have both been described in recent articles in this journal.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H4ONwO

A Novel Modification of Keystone Flap for Superficial Defects Repair

In 2003, Behan1 was the first to report the Keystone Design Perforator Island Flap (KDPIF). The KDPIF has the advantages of simple design, convenient operation, certain perforator blood supply, adjacent tissue, good appearance and nearby texture. Therefore, it has been widely applied to repairing skin soft tissue defects caused by trauma, tumor resection, and scars.2,3 However, the KDPIF has certain issues such as excessive tension, constraint on the closure of the donor area,4,5 and skin contractures due to straight line scars across the joints in repairing large-size defects of the trunk, the joints or other moving areas.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ryb7Dl

Long-term pre- and postconditioning with low doses of erythropoietin protects critically perfused musculo-cutaneous tissue from necrosis

It has been shown that pre- and postconditioning of ischemically challenged tissue with erythropoietin (EPO) is able to reduce necrosis in a dose-dependent manner. The aim of this study was to determine the tissue-protective effects of different EPO dosages and administration regimes.Three groups of six C57Bl/6-mice each were analyzed. 1. Pre- and postconditioning with initial high doses of EPO (starting at 2500 I.U./kg bw i.p.) followed by low doses of EPO (125 I.U./kg bw i.p.) (EPO-high-dose); 2.

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

Relationship between the expression of PD-1/PD-L1 and 18 F-FDG uptake in bladder cancer

Abstract

Purpose

Immunotherapy aimed at inhibiting the PD-1/PD-L1 immune checkpoint has been approved and used successfully for the treatment of bladder cancer. The identification of markers predictive of response to immune checkpoint inhibitors is critical to advancing the success of this therapy. ¹⁸F-FDG PET/CT is a molecular imaging technique that can provide phenotypic information on malignant tumours. It is currently unknown whether there is a relationship between ¹⁸F-FDG uptake and expression of PD-1/PD-L1 in bladder cancer. In this study, we investigated whether PD-1/PD-L1 expression is associated with ¹⁸F-FDG uptake in bladder cancer, and whether ¹⁸F-FDG PET/CT imaging can be used to predict the PD-1/PD-L1 status of bladder cancer.

Methods

A retrospective analysis was performed in 63 patients with bladder cancer who had undergone ¹⁸F-FDG PET/CT before surgical resection. Maximum standardized uptake values (SUVmax) were determined.

Results

SUVmax was significantly higher in PD-1-positive patients than in PD-1-negative patients (33.0 ± 13.9 and 19.6 ± 14.2, respectively; P = 0.032), and in PD-L1-positive patients than in PD-L1-negative patients (29.1 ± 15.6 and 15.8 ± 11.4, respectively; P < 0.0001). In a multivariate analysis SUVmax was significantly associated with both PD-1 expression and PD-L1 expression (P = 0.021 and P = 0.003, respectively). Using a SUVmax cut-off value of 22.7, PD-1 status and PD-L1 status could be predicted with accuracies of 71.4% and 77.8%, respectively.

Conclusion

Higher ¹⁸F-FDG uptake by bladder cancer is associated with elevated PD-1/PD-L1 expression. ¹⁸F-FDG PET/CT may be useful for predicting the PD-1/PD-L1 status of bladder cancer and for determining the optimal therapeutic strategy.

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

Dysfunctional ErbB2, an EGF receptor family member, hinders repair of asthmatic airway epithelial cells

Asthmatic airway epithelial cells have dysregulated wound repair, in association with lower activation of the ErbB2 pathway. Restoration of this pathway might be a novel therapeutic target, potentially restoring a disrupted airway epithelium in asthma.

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

A case of mistaken identity: The MAR-1 antibody to mouse FcεRIα cross-reacts with FcγRI and FcγRIV

This study demonstrates that the MAR-1 antibody to mouse FcepsilonRI unexpectedly binds to two Fcgamma receptors, raising concerns regarding numerous studies that used this antibody to assess the distribution and function of FcepsilonRI+ cells.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AzVu4f

Macrophage polarization: reaching across the aisle?

Macrophage polarization may influence the pathogenesis of many human diseases; however the transcriptional program regulating this process remains poorly characterized. Gharib et al.1 highlight the high diversity of M1-to-M2 re-polarization exerted by distinct M2 stimuli via transcriptome-based pathway analysis and provide a new approach to phenotype human macrophages in clinically relevant disease states such as cystic fibrosis and asthma

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Genetic diagnosis of primary immunodeficiencies: a survey of the French national registry

The report describes the status of genetic diagnosis of PID based on a national registry. It shows that a genetic diagnosis has been achieved in half of them, reaching almost 80% of all PID but B cell immunodeficiencies.

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

Can Facial Proportions Provide an Objective Assessment of Prominent Ears? A survey of healthcare professionals

Evaluation of facial aesthetics is inherently subjective, though for centuries we have tried to objectify these assessments by using measures such as the 'Golden Ratio'. This study aims to make similar descriptions of prominent ears using a simple ratio observed in standard anterior pre-operative clinical photographs.1

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H3i2jJ

Management of Median and Paramedian Craniofacial Clefts

Median and paramedian craniofacial clefts are associated with hypertelorism, anterior encephalocele, positional abnormalities of the maxilla and nasal deformity. Cleft lip and palate, eyelid coloboma and widow's peak are frequently present.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RC3mMG

Treatment of fingertip avulsion injuries using two periposition pedicled flaps

We described a treatment of fingertip avulsion injury by two periposition pedicled flaps, the reversed pedicle island flap of dorsal branch of proper digital artery and the cross-finger flap. From February 2009 to January 2017, 22 patients (22 fingers) with fingertip avulsion injury were treated with two periposition pedicled flaps, 14 male and 8 female, aged from 17 to 47 years (mean 32±9 years). All of the patients were followed up more than 6 months after operations (mean 9.6±2.6 months). All flaps survived completely.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H3hkmz

“Surgical Outcomes of VRAM versus Gracilis Flaps for the Reconstruction of Pelvic Defects following Oncologic Resection”

Pelvic reconstruction following abdominoperineal resection or pelvic exenteration is associated with signification surgical site morbidity. Immediate pelvic reconstruction with a muscle flap is now the gold standard, associated with reduced perineal morbidity compared to primary closure alone.2,3 The purpose of the present study was to directly compare outcomes of VRAM and gracilis flap pelvic reconstruction following oncologic resection.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RD0WNO

PART 2: CAN IMPROVEMENT IN OUTCOME MEASUREMENT IN PLASTIC SURGERY BE ACHIEVED IN TODAY'S HEALTH SYSTEMS?

Being able to accurately measure relevant constructs is particularly valuable in plastic surgery, where the objective of treatment may range across improving hand function, identifying satisfaction with breast reconstruction, or establishing quality of life changes from surgery. This matters in research applications such as clinical trials, and for quality assurance of surgery through routine data collection in clinical practice. The technical aspects of refining measurement to ensure that it is accurate and the process for selecting outcome measures have both been described in recent articles in this journal.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H4ONwO

A Novel Modification of Keystone Flap for Superficial Defects Repair

In 2003, Behan1 was the first to report the Keystone Design Perforator Island Flap (KDPIF). The KDPIF has the advantages of simple design, convenient operation, certain perforator blood supply, adjacent tissue, good appearance and nearby texture. Therefore, it has been widely applied to repairing skin soft tissue defects caused by trauma, tumor resection, and scars.2,3 However, the KDPIF has certain issues such as excessive tension, constraint on the closure of the donor area,4,5 and skin contractures due to straight line scars across the joints in repairing large-size defects of the trunk, the joints or other moving areas.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ryb7Dl

Long-term pre- and postconditioning with low doses of erythropoietin protects critically perfused musculo-cutaneous tissue from necrosis

It has been shown that pre- and postconditioning of ischemically challenged tissue with erythropoietin (EPO) is able to reduce necrosis in a dose-dependent manner. The aim of this study was to determine the tissue-protective effects of different EPO dosages and administration regimes.Three groups of six C57Bl/6-mice each were analyzed. 1. Pre- and postconditioning with initial high doses of EPO (starting at 2500 I.U./kg bw i.p.) followed by low doses of EPO (125 I.U./kg bw i.p.) (EPO-high-dose); 2.

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

Relationship between the expression of PD-1/PD-L1 and 18 F-FDG uptake in bladder cancer

Abstract

Purpose

Immunotherapy aimed at inhibiting the PD-1/PD-L1 immune checkpoint has been approved and used successfully for the treatment of bladder cancer. The identification of markers predictive of response to immune checkpoint inhibitors is critical to advancing the success of this therapy. ¹⁸F-FDG PET/CT is a molecular imaging technique that can provide phenotypic information on malignant tumours. It is currently unknown whether there is a relationship between ¹⁸F-FDG uptake and expression of PD-1/PD-L1 in bladder cancer. In this study, we investigated whether PD-1/PD-L1 expression is associated with ¹⁸F-FDG uptake in bladder cancer, and whether ¹⁸F-FDG PET/CT imaging can be used to predict the PD-1/PD-L1 status of bladder cancer.

Methods

A retrospective analysis was performed in 63 patients with bladder cancer who had undergone ¹⁸F-FDG PET/CT before surgical resection. Maximum standardized uptake values (SUVmax) were determined.

Results

SUVmax was significantly higher in PD-1-positive patients than in PD-1-negative patients (33.0 ± 13.9 and 19.6 ± 14.2, respectively; P = 0.032), and in PD-L1-positive patients than in PD-L1-negative patients (29.1 ± 15.6 and 15.8 ± 11.4, respectively; P < 0.0001). In a multivariate analysis SUVmax was significantly associated with both PD-1 expression and PD-L1 expression (P = 0.021 and P = 0.003, respectively). Using a SUVmax cut-off value of 22.7, PD-1 status and PD-L1 status could be predicted with accuracies of 71.4% and 77.8%, respectively.

Conclusion

Higher ¹⁸F-FDG uptake by bladder cancer is associated with elevated PD-1/PD-L1 expression. ¹⁸F-FDG PET/CT may be useful for predicting the PD-1/PD-L1 status of bladder cancer and for determining the optimal therapeutic strategy.

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

Shocking international study reveals that adolescents who eat fast food are 40% more likely to have severe asthma

(Natural News) A study has revealed one more reason to stop eating fast food: it is linked to the "the rising prevalence of asthma and allergies, especially among children." How is fast food linked to asthma? Published data from the Centers for Disease Control and Prevention (CDC)'s National Health and Nutrition Examination Survey has revealed that over... (Source: NaturalNews.com)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C8OQ57

Shocking international study reveals that adolescents who eat fast food are 40% more likely to have severe asthma

(Natural News) A study has revealed one more reason to stop eating fast food: it is linked to the "the rising prevalence of asthma and allergies, especially among children." How is fast food linked to asthma? Published data from the Centers for Disease Control and Prevention (CDC)'s National Health and Nutrition Examination Survey has revealed that over... (Source: NaturalNews.com)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C8OQ57

Genetic associations of the response to inhaled corticosteroids in asthma: a systematic review

Abstract

There is wide variability in the response to inhaled corticosteroids (ICS) in asthma. While some of this heterogeneity of response is due to adherence and environmental causes, genetic variation also influences response to treatment and genetic markers may help guide treatment. Over the past years, researchers have investigated the relationship between a large number of genetic variations and response to ICS by performing pharmacogenomic studies. In this systematic review we will provide a summary of recent pharmacogenomic studies on ICS and discuss the latest insight into the potential functional role of identified genetic variants. To date, seven genome wide association studies (GWAS) examining ICS response have been published. There is little overlap between identified variants and methodologies vary largely. However, in vitro and/or in silico analyses provide additional evidence that genes discovered in these GWAS (e.g. GLCCI1, FBXL7, T gene, ALLC, CMTR1) might play a direct or indirect role in asthma/treatment response pathways. Furthermore, more than 30 candidate-gene studies have been performed, mainly attempting to replicate variants discovered in GWAS or candidate genes likely involved in the corticosteroid drug pathway. Single nucleotide polymorphisms located in GLCCI1, NR3C1 and the 17q21 locus were positively replicated in independent populations. Although none of the genetic markers has currently reached clinical practise, these studies might provide novel insights in the complex pathways underlying corticosteroids response in asthmatic patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H40hAX

Genetic associations of the response to inhaled corticosteroids in asthma: a systematic review

Abstract

There is wide variability in the response to inhaled corticosteroids (ICS) in asthma. While some of this heterogeneity of response is due to adherence and environmental causes, genetic variation also influences response to treatment and genetic markers may help guide treatment. Over the past years, researchers have investigated the relationship between a large number of genetic variations and response to ICS by performing pharmacogenomic studies. In this systematic review we will provide a summary of recent pharmacogenomic studies on ICS and discuss the latest insight into the potential functional role of identified genetic variants. To date, seven genome wide association studies (GWAS) examining ICS response have been published. There is little overlap between identified variants and methodologies vary largely. However, in vitro and/or in silico analyses provide additional evidence that genes discovered in these GWAS (e.g. GLCCI1, FBXL7, T gene, ALLC, CMTR1) might play a direct or indirect role in asthma/treatment response pathways. Furthermore, more than 30 candidate-gene studies have been performed, mainly attempting to replicate variants discovered in GWAS or candidate genes likely involved in the corticosteroid drug pathway. Single nucleotide polymorphisms located in GLCCI1, NR3C1 and the 17q21 locus were positively replicated in independent populations. Although none of the genetic markers has currently reached clinical practise, these studies might provide novel insights in the complex pathways underlying corticosteroids response in asthmatic patients.

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Shocking international study reveals that adolescents who eat fast food are 40% more likely to have severe asthma

(Natural News) A study has revealed one more reason to stop eating fast food: it is linked to the "the rising prevalence of asthma and allergies, especially among children." How is fast food linked to asthma? Published data from the Centers for Disease Control and Prevention (CDC)'s National Health and Nutrition Examination Survey has revealed that over... (Source: NaturalNews.com)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C8OQ57

Immediate Use of Continuous Positive Airway Pressure in Patients With Obstructive Sleep Apnea Following Transsphenoidal Pituitary Surgery: A Case Series

Background: Patients who undergo transsphenoidal pituitary resection have an elevated risk of obstructive sleep apnea (OSA) yet their outcomes and the safety of continuous positive airway pressure (CPAP) remains unclear. Our study objective was to determine the incidence of complications related to the use of early positive airway pressure following pituitary resection. Methods: We retrospectively identified all patients who underwent endoscopic transsphenoidal pituitary tumor resection between January 1, 2005 and March 24, 2016 at our institution, including those with diagnosed or suspected OSA. We compared characteristics and postoperative complications of OSA patients who did and did not receive CPAP postoperatively. Results: In total, 427 patients underwent transsphenoidal pituitary resection. Of these, 64 (15%) had OSA. Acromegaly was more common in patients with OSA (42% vs. 10%; P

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JNA Journal Club

No abstract available

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SNACC Is Moving and We Are Really Excited!

No abstract available

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

Improving Severe Traumatic Brain Injury Observational Research: Not All Questions Need an RCT

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Cg3FCS

Histopathological Characteristics of the Orbicularis Oculi Muscle After Lower Blepharoplasty With or Without Myotomy

Abstract

Lower blepharoplasty is a challenging aesthetic procedure. Despite advances in clinical and neuroanatomical studies related to orbicularis oculi muscle innervation, no study has examined its histopathological aspects in different lower blepharoplasty procedures. This study aimed to assess changes in the pretarsal muscle complex in patients treated with transcutaneous lower blepharoplasty with orbicularis myotomy versus those treated with transconjunctival blepharoplasty without myotomy.

Methods

A total of 268 patients underwent blepharoplasty performed by a single surgeon: transcutaneous lower blepharoplasty in 112 (41.7%) and transconjunctival lower blepharoplasty with retroseptal access in 156 (58.2%). Subsequent minor blepharoplasty procedures were performed in 32 patients with lower pretarsal orbicularis oculi muscle biopsy. Connective tissue, fibrillar elastic system, nerves, blood vessels, fiber diameter, and sarcomeres were analyzed.

Results

Without myotomy: collagen, 9.46 ± 0.41%; elastin, 7.03 ± 0.62%; blood vessels, 4.25 ± 0.06%; nerves, 5.2 ± 0.55%; fiber diameter, 62 ± 8.0 μm; and sarcomere, 1.9 ± 0.11 μm. With myotomy: collagen, 19.02 ± 1.66%; elastin, 7.88 ± 1.10%; blood vessels, 5.13 ± 0.70%; nerves, 2.9 ± 0.48%; fiber diameter, 49 ± 6.5 μm; and sarcomere, 1.8 ± 0.17 μm.

Discussion

Excess endomysial connective tissue, particularly between muscle fibers, should be considered pathological. The pathological changes in the pretarsal muscle complex after blepharoplasty with myotomy may have resulted from innervation interruptions as well as vascularization blockages.

Conclusions

Surgeries with myotomy caused significant changes in collagen, nerves, and muscle fiber diameter. These observations strongly suggest the superiority of a technique that preserves orbicularis oculi muscle integrity.

Level of Evidence III

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

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Pseudoesotropia in Chinese Children: A Triphasic Development of the Interepicanthal Folds Distance-to-Interpupillary Distance Ratio and Its Changing Perception

Abstract

Purpose

To delineate the development of the interepicanthal fold distance (IEFD) to interpupillary distance (IPD) in Chinese children, and to quantify how their ratio (EFDPD ratio) affects parent's judgment on whether a child's two eyes appear misaligned.

Methods

The values of IPD and IEFD were measured in 750 children, aged between 3 and 17 years. The developmental trend of EFDPD ratio was established. Two hundred parents were shown a series of pictures of children with varying EFDPD ratios and asked to judge whether the child in each picture demonstrated misaligned eyes. Based on the parent's responses, psychometric functional associations with EFDPD ratios were established.

Results

The EFDPD ratios were significantly higher (0.63 ± 0.027) and showed little change among children from 3 to 6 years of age (p = 0.704). During the age of seven to 12 years, however, the EFDPD ratio significantly decreased (p < 0.001) before stabilizing at 0.59 ± 0.023 by the ages of 13 to 17 years (p = 0.376). Children with EFDPD ratios > 0.65 were more likely to be perceived as strabismic by the parents, while children with an EFDPD ratio < 0.55 were rarely perceived as so. As many as 30% of the children aged between 3 and 6 years demonstrated EFDPD ratios > 0.65, and this number reduced to 5% by the age of 12 years.

Conclusions

The development of the EFDPD ratio in Chinese children shows a triphasic pattern, with a large value before the age of 6 years, a quick drop between 7 and 12 years, and little change after 13 years of age. As the EFDPD ratio declines, fewer children appear as strabismic.

Level of Evidence IV

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RH4zSS

Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Abstract

Background

Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes.

Methods

Patients presenting one pathological scar were prospectively recruited and treated with two IAL-SYSTEM ACP injections carried out two weeks apart. Scar improvement was measured comparing the patient and observer scar assessment scale (POSAS) scores collected before treatment (T0) and 90 days after the second injection (T90) using nonparametric tests. The effect of age and scar type over score variation was investigated through quantile regression analysis.

Results

Forty-one patients, 10 women and 31 men (median age, 34 years) were recruited. No patient dropped out, and no significant adverse event was observed. At T90, the median observer total score decreased by 11 units (− 77.5%) and the median patient total score decreased by 15 units (− 73.7%). The difference was significant (p < 0.001) in both cases. Traumatic injuries and young patient's age were the most significant predictors of a positive treatment outcome.

Conclusions

Treatment of pathological scars by two IAL-SYSTEM ACP injections, carried out two weeks apart, may provide significant clinical benefits. These findings should be the subject of further investigations.

Level of Evidence IV

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

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

Shocking international study reveals that adolescents who eat fast food are 40% more likely to have severe asthma

(Natural News) A study has revealed one more reason to stop eating fast food: it is linked to the "the rising prevalence of asthma and allergies, especially among children." How is fast food linked to asthma? Published data from the Centers for Disease Control and Prevention (CDC)'s National Health and Nutrition Examination Survey has revealed that over... (Source: NaturalNews.com)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C8OQ57

Immediate Use of Continuous Positive Airway Pressure in Patients With Obstructive Sleep Apnea Following Transsphenoidal Pituitary Surgery: A Case Series

Background: Patients who undergo transsphenoidal pituitary resection have an elevated risk of obstructive sleep apnea (OSA) yet their outcomes and the safety of continuous positive airway pressure (CPAP) remains unclear. Our study objective was to determine the incidence of complications related to the use of early positive airway pressure following pituitary resection. Methods: We retrospectively identified all patients who underwent endoscopic transsphenoidal pituitary tumor resection between January 1, 2005 and March 24, 2016 at our institution, including those with diagnosed or suspected OSA. We compared characteristics and postoperative complications of OSA patients who did and did not receive CPAP postoperatively. Results: In total, 427 patients underwent transsphenoidal pituitary resection. Of these, 64 (15%) had OSA. Acromegaly was more common in patients with OSA (42% vs. 10%; P

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RkwF74

JNA Journal Club

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Cdd6D9

SNACC Is Moving and We Are Really Excited!

No abstract available

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

Improving Severe Traumatic Brain Injury Observational Research: Not All Questions Need an RCT

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Cg3FCS

Histopathological Characteristics of the Orbicularis Oculi Muscle After Lower Blepharoplasty With or Without Myotomy

Abstract

Lower blepharoplasty is a challenging aesthetic procedure. Despite advances in clinical and neuroanatomical studies related to orbicularis oculi muscle innervation, no study has examined its histopathological aspects in different lower blepharoplasty procedures. This study aimed to assess changes in the pretarsal muscle complex in patients treated with transcutaneous lower blepharoplasty with orbicularis myotomy versus those treated with transconjunctival blepharoplasty without myotomy.

Methods

A total of 268 patients underwent blepharoplasty performed by a single surgeon: transcutaneous lower blepharoplasty in 112 (41.7%) and transconjunctival lower blepharoplasty with retroseptal access in 156 (58.2%). Subsequent minor blepharoplasty procedures were performed in 32 patients with lower pretarsal orbicularis oculi muscle biopsy. Connective tissue, fibrillar elastic system, nerves, blood vessels, fiber diameter, and sarcomeres were analyzed.

Results

Without myotomy: collagen, 9.46 ± 0.41%; elastin, 7.03 ± 0.62%; blood vessels, 4.25 ± 0.06%; nerves, 5.2 ± 0.55%; fiber diameter, 62 ± 8.0 μm; and sarcomere, 1.9 ± 0.11 μm. With myotomy: collagen, 19.02 ± 1.66%; elastin, 7.88 ± 1.10%; blood vessels, 5.13 ± 0.70%; nerves, 2.9 ± 0.48%; fiber diameter, 49 ± 6.5 μm; and sarcomere, 1.8 ± 0.17 μm.

Discussion

Excess endomysial connective tissue, particularly between muscle fibers, should be considered pathological. The pathological changes in the pretarsal muscle complex after blepharoplasty with myotomy may have resulted from innervation interruptions as well as vascularization blockages.

Conclusions

Surgeries with myotomy caused significant changes in collagen, nerves, and muscle fiber diameter. These observations strongly suggest the superiority of a technique that preserves orbicularis oculi muscle integrity.

Level of Evidence III

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

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

Pseudoesotropia in Chinese Children: A Triphasic Development of the Interepicanthal Folds Distance-to-Interpupillary Distance Ratio and Its Changing Perception

Abstract

Purpose

To delineate the development of the interepicanthal fold distance (IEFD) to interpupillary distance (IPD) in Chinese children, and to quantify how their ratio (EFDPD ratio) affects parent's judgment on whether a child's two eyes appear misaligned.

Methods

The values of IPD and IEFD were measured in 750 children, aged between 3 and 17 years. The developmental trend of EFDPD ratio was established. Two hundred parents were shown a series of pictures of children with varying EFDPD ratios and asked to judge whether the child in each picture demonstrated misaligned eyes. Based on the parent's responses, psychometric functional associations with EFDPD ratios were established.

Results

The EFDPD ratios were significantly higher (0.63 ± 0.027) and showed little change among children from 3 to 6 years of age (p = 0.704). During the age of seven to 12 years, however, the EFDPD ratio significantly decreased (p < 0.001) before stabilizing at 0.59 ± 0.023 by the ages of 13 to 17 years (p = 0.376). Children with EFDPD ratios > 0.65 were more likely to be perceived as strabismic by the parents, while children with an EFDPD ratio < 0.55 were rarely perceived as so. As many as 30% of the children aged between 3 and 6 years demonstrated EFDPD ratios > 0.65, and this number reduced to 5% by the age of 12 years.

Conclusions

The development of the EFDPD ratio in Chinese children shows a triphasic pattern, with a large value before the age of 6 years, a quick drop between 7 and 12 years, and little change after 13 years of age. As the EFDPD ratio declines, fewer children appear as strabismic.

Level of Evidence IV

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RH4zSS

Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Abstract

Background

Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes.

Methods

Patients presenting one pathological scar were prospectively recruited and treated with two IAL-SYSTEM ACP injections carried out two weeks apart. Scar improvement was measured comparing the patient and observer scar assessment scale (POSAS) scores collected before treatment (T0) and 90 days after the second injection (T90) using nonparametric tests. The effect of age and scar type over score variation was investigated through quantile regression analysis.

Results

Forty-one patients, 10 women and 31 men (median age, 34 years) were recruited. No patient dropped out, and no significant adverse event was observed. At T90, the median observer total score decreased by 11 units (− 77.5%) and the median patient total score decreased by 15 units (− 73.7%). The difference was significant (p < 0.001) in both cases. Traumatic injuries and young patient's age were the most significant predictors of a positive treatment outcome.

Conclusions

Treatment of pathological scars by two IAL-SYSTEM ACP injections, carried out two weeks apart, may provide significant clinical benefits. These findings should be the subject of further investigations.

Level of Evidence IV

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

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

Double check patients with'penicillin allergy' to avoid increased MRSA risk.

Healthcare staff should be aware of this and ensure that only people with a true allergy to penicillin are documented as such, NICE is urging. Incorrectly identifying people as allergic could also contribute to antimicrobial resistance, as these people are likely to instead be given broad-spectrum antibiotics. The warning comes in a new medicines evidence commentary (MEC) on research conducted in the UK and published in the BMJ in June 2018. (Source: Current Awareness Service for Health (CASH))

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

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UTSA microbiologist Floyd Wormley elected AAAS Fellow

(University of Texas at San Antonio) Wormley's research has the potential to lead to the development of vaccines, immune-based therapies and novel anti-fungal drugs that protect immune-compromised patients from infections. The UTSA faculty member has extensive experience investigating various vaccine strategies, and he has a vast understanding of host cellular-mediated and antibody-mediated immune responses. His research is supported by grants from the National Institutes of Health's National Institute of Allergy and Infectious Diseases and the Department of Defense. (Source: EurekAlert! - Infectious and Emerging Diseases)

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Double check patients with'penicillin allergy' to avoid increased MRSA risk.

Healthcare staff should be aware of this and ensure that only people with a true allergy to penicillin are documented as such, NICE is urging. Incorrectly identifying people as allergic could also contribute to antimicrobial resistance, as these people are likely to instead be given broad-spectrum antibiotics. The warning comes in a new medicines evidence commentary (MEC) on research conducted in the UK and published in the BMJ in June 2018. (Source: Current Awareness Service for Health (CASH))

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/2RJVDw8

UTSA microbiologist Floyd Wormley elected AAAS Fellow

(University of Texas at San Antonio) Wormley's research has the potential to lead to the development of vaccines, immune-based therapies and novel anti-fungal drugs that protect immune-compromised patients from infections. The UTSA faculty member has extensive experience investigating various vaccine strategies, and he has a vast understanding of host cellular-mediated and antibody-mediated immune responses. His research is supported by grants from the National Institutes of Health's National Institute of Allergy and Infectious Diseases and the Department of Defense. (Source: EurekAlert! - Infectious and Emerging Diseases)

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Nasofacial Anthropometric Study Among Students of Shiraz University of Medical Sciences, Iran: A Population Based Study

In this study, facial and nasal anthropometric factors were studied in students of Shiraz University of Medical Sciences. In a cross-sectional study, 200 students of Shiraz University of Medical Sciences (100 male and 100 female and age range of 18 –30 years) were selected. Nasal width (NW), nasal length (NL), nasal height (NH), face height (FH) and face width (FW) were measured in and the nasal (NI) and facial index (FI) were calculated for each case. Then, the data were analyzed using SPSS-22. The mean age was 21.84 ± 3.18 years. Th ere were significant differences in the facial and nasal measurements including FH (P = 0.0001), FW (P = 0.0001), FI (P = 0.0001), NL (P = 0.002), NH (P = 0.001), NW (P = 0.0001) and NI (P = 0.0001) of sex groups. The most...

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Décoloration blanchâtre des dents post-anesthésie

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D0fRJQ

Nasofacial Anthropometric Study Among Students of Shiraz University of Medical Sciences, Iran: A Population Based Study

In this study, facial and nasal anthropometric factors were studied in students of Shiraz University of Medical Sciences. In a cross-sectional study, 200 students of Shiraz University of Medical Sciences (100 male and 100 female and age range of 18 –30 years) were selected. Nasal width (NW), nasal length (NL), nasal height (NH), face height (FH) and face width (FW) were measured in and the nasal (NI) and facial index (FI) were calculated for each case. Then, the data were analyzed using SPSS-22. The mean age was 21.84 ± 3.18 years. Th ere were significant differences in the facial and nasal measurements including FH (P = 0.0001), FW (P = 0.0001), FI (P = 0.0001), NL (P = 0.002), NH (P = 0.001), NW (P = 0.0001) and NI (P = 0.0001) of sex groups. The most...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TCv09q

Décoloration blanchâtre des dents post-anesthésie

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D0fRJQ

Histopathological Characteristics of the Orbicularis Oculi Muscle After Lower Blepharoplasty With or Without Myotomy

Abstract

Lower blepharoplasty is a challenging aesthetic procedure. Despite advances in clinical and neuroanatomical studies related to orbicularis oculi muscle innervation, no study has examined its histopathological aspects in different lower blepharoplasty procedures. This study aimed to assess changes in the pretarsal muscle complex in patients treated with transcutaneous lower blepharoplasty with orbicularis myotomy versus those treated with transconjunctival blepharoplasty without myotomy.

Methods

A total of 268 patients underwent blepharoplasty performed by a single surgeon: transcutaneous lower blepharoplasty in 112 (41.7%) and transconjunctival lower blepharoplasty with retroseptal access in 156 (58.2%). Subsequent minor blepharoplasty procedures were performed in 32 patients with lower pretarsal orbicularis oculi muscle biopsy. Connective tissue, fibrillar elastic system, nerves, blood vessels, fiber diameter, and sarcomeres were analyzed.

Results

Without myotomy: collagen, 9.46 ± 0.41%; elastin, 7.03 ± 0.62%; blood vessels, 4.25 ± 0.06%; nerves, 5.2 ± 0.55%; fiber diameter, 62 ± 8.0 μm; and sarcomere, 1.9 ± 0.11 μm. With myotomy: collagen, 19.02 ± 1.66%; elastin, 7.88 ± 1.10%; blood vessels, 5.13 ± 0.70%; nerves, 2.9 ± 0.48%; fiber diameter, 49 ± 6.5 μm; and sarcomere, 1.8 ± 0.17 μm.

Discussion

Excess endomysial connective tissue, particularly between muscle fibers, should be considered pathological. The pathological changes in the pretarsal muscle complex after blepharoplasty with myotomy may have resulted from innervation interruptions as well as vascularization blockages.

Conclusions

Surgeries with myotomy caused significant changes in collagen, nerves, and muscle fiber diameter. These observations strongly suggest the superiority of a technique that preserves orbicularis oculi muscle integrity.

Level of Evidence III

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

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

Pseudoesotropia in Chinese Children: A Triphasic Development of the Interepicanthal Folds Distance-to-Interpupillary Distance Ratio and Its Changing Perception

Abstract

Purpose

To delineate the development of the interepicanthal fold distance (IEFD) to interpupillary distance (IPD) in Chinese children, and to quantify how their ratio (EFDPD ratio) affects parent's judgment on whether a child's two eyes appear misaligned.

Methods

The values of IPD and IEFD were measured in 750 children, aged between 3 and 17 years. The developmental trend of EFDPD ratio was established. Two hundred parents were shown a series of pictures of children with varying EFDPD ratios and asked to judge whether the child in each picture demonstrated misaligned eyes. Based on the parent's responses, psychometric functional associations with EFDPD ratios were established.

Results

The EFDPD ratios were significantly higher (0.63 ± 0.027) and showed little change among children from 3 to 6 years of age (p = 0.704). During the age of seven to 12 years, however, the EFDPD ratio significantly decreased (p < 0.001) before stabilizing at 0.59 ± 0.023 by the ages of 13 to 17 years (p = 0.376). Children with EFDPD ratios > 0.65 were more likely to be perceived as strabismic by the parents, while children with an EFDPD ratio < 0.55 were rarely perceived as so. As many as 30% of the children aged between 3 and 6 years demonstrated EFDPD ratios > 0.65, and this number reduced to 5% by the age of 12 years.

Conclusions

The development of the EFDPD ratio in Chinese children shows a triphasic pattern, with a large value before the age of 6 years, a quick drop between 7 and 12 years, and little change after 13 years of age. As the EFDPD ratio declines, fewer children appear as strabismic.

Level of Evidence IV

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RH4zSS

Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Abstract

Background

Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes.

Methods

Patients presenting one pathological scar were prospectively recruited and treated with two IAL-SYSTEM ACP injections carried out two weeks apart. Scar improvement was measured comparing the patient and observer scar assessment scale (POSAS) scores collected before treatment (T0) and 90 days after the second injection (T90) using nonparametric tests. The effect of age and scar type over score variation was investigated through quantile regression analysis.

Results

Forty-one patients, 10 women and 31 men (median age, 34 years) were recruited. No patient dropped out, and no significant adverse event was observed. At T90, the median observer total score decreased by 11 units (− 77.5%) and the median patient total score decreased by 15 units (− 73.7%). The difference was significant (p < 0.001) in both cases. Traumatic injuries and young patient's age were the most significant predictors of a positive treatment outcome.

Conclusions

Treatment of pathological scars by two IAL-SYSTEM ACP injections, carried out two weeks apart, may provide significant clinical benefits. These findings should be the subject of further investigations.

Level of Evidence IV

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

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

Histopathological Characteristics of the Orbicularis Oculi Muscle After Lower Blepharoplasty With or Without Myotomy

Abstract

Lower blepharoplasty is a challenging aesthetic procedure. Despite advances in clinical and neuroanatomical studies related to orbicularis oculi muscle innervation, no study has examined its histopathological aspects in different lower blepharoplasty procedures. This study aimed to assess changes in the pretarsal muscle complex in patients treated with transcutaneous lower blepharoplasty with orbicularis myotomy versus those treated with transconjunctival blepharoplasty without myotomy.

Methods

A total of 268 patients underwent blepharoplasty performed by a single surgeon: transcutaneous lower blepharoplasty in 112 (41.7%) and transconjunctival lower blepharoplasty with retroseptal access in 156 (58.2%). Subsequent minor blepharoplasty procedures were performed in 32 patients with lower pretarsal orbicularis oculi muscle biopsy. Connective tissue, fibrillar elastic system, nerves, blood vessels, fiber diameter, and sarcomeres were analyzed.

Results

Without myotomy: collagen, 9.46 ± 0.41%; elastin, 7.03 ± 0.62%; blood vessels, 4.25 ± 0.06%; nerves, 5.2 ± 0.55%; fiber diameter, 62 ± 8.0 μm; and sarcomere, 1.9 ± 0.11 μm. With myotomy: collagen, 19.02 ± 1.66%; elastin, 7.88 ± 1.10%; blood vessels, 5.13 ± 0.70%; nerves, 2.9 ± 0.48%; fiber diameter, 49 ± 6.5 μm; and sarcomere, 1.8 ± 0.17 μm.

Discussion

Excess endomysial connective tissue, particularly between muscle fibers, should be considered pathological. The pathological changes in the pretarsal muscle complex after blepharoplasty with myotomy may have resulted from innervation interruptions as well as vascularization blockages.

Conclusions

Surgeries with myotomy caused significant changes in collagen, nerves, and muscle fiber diameter. These observations strongly suggest the superiority of a technique that preserves orbicularis oculi muscle integrity.

Level of Evidence III

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

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Pseudoesotropia in Chinese Children: A Triphasic Development of the Interepicanthal Folds Distance-to-Interpupillary Distance Ratio and Its Changing Perception

Abstract

Purpose

To delineate the development of the interepicanthal fold distance (IEFD) to interpupillary distance (IPD) in Chinese children, and to quantify how their ratio (EFDPD ratio) affects parent's judgment on whether a child's two eyes appear misaligned.

Methods

The values of IPD and IEFD were measured in 750 children, aged between 3 and 17 years. The developmental trend of EFDPD ratio was established. Two hundred parents were shown a series of pictures of children with varying EFDPD ratios and asked to judge whether the child in each picture demonstrated misaligned eyes. Based on the parent's responses, psychometric functional associations with EFDPD ratios were established.

Results

The EFDPD ratios were significantly higher (0.63 ± 0.027) and showed little change among children from 3 to 6 years of age (p = 0.704). During the age of seven to 12 years, however, the EFDPD ratio significantly decreased (p < 0.001) before stabilizing at 0.59 ± 0.023 by the ages of 13 to 17 years (p = 0.376). Children with EFDPD ratios > 0.65 were more likely to be perceived as strabismic by the parents, while children with an EFDPD ratio < 0.55 were rarely perceived as so. As many as 30% of the children aged between 3 and 6 years demonstrated EFDPD ratios > 0.65, and this number reduced to 5% by the age of 12 years.

Conclusions

The development of the EFDPD ratio in Chinese children shows a triphasic pattern, with a large value before the age of 6 years, a quick drop between 7 and 12 years, and little change after 13 years of age. As the EFDPD ratio declines, fewer children appear as strabismic.

Level of Evidence IV

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

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Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Abstract

Background

Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes.

Methods

Patients presenting one pathological scar were prospectively recruited and treated with two IAL-SYSTEM ACP injections carried out two weeks apart. Scar improvement was measured comparing the patient and observer scar assessment scale (POSAS) scores collected before treatment (T0) and 90 days after the second injection (T90) using nonparametric tests. The effect of age and scar type over score variation was investigated through quantile regression analysis.

Results

Forty-one patients, 10 women and 31 men (median age, 34 years) were recruited. No patient dropped out, and no significant adverse event was observed. At T90, the median observer total score decreased by 11 units (− 77.5%) and the median patient total score decreased by 15 units (− 73.7%). The difference was significant (p < 0.001) in both cases. Traumatic injuries and young patient's age were the most significant predictors of a positive treatment outcome.

Conclusions

Treatment of pathological scars by two IAL-SYSTEM ACP injections, carried out two weeks apart, may provide significant clinical benefits. These findings should be the subject of further investigations.

Level of Evidence IV

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

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