Finding the Right Market for Your Private Practice, Part 1

Editor's note: This is part one of a two-part series. Look for part two: "Growing Your Client Base," in February. Private practice is a consistently growing area for communication sciences and disorders (CSD) professionals. Whether making the transition from employee to employer, or changing their current road map for an established business, private practitioners are searching for new ways to compete in today's market. Three key ways CSD professionals can make their private practice stand out include finding a niche, diversifying offerings and becoming business savvy. Creating a competitive edge One way to create a competitive edge and grow business is by finding a niche. Especially if you live in an area with several practitioners in your profession, it helps to stand out by focu...

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/2RCnXkQ

The future of music is for everyone —even the deaf

How Avnet helped an award-winning tech incubator take one of the most complex wearables from "possibly" to "possible" For Mick Ebeling, CEO of Not Impossible Labs, the fact that the deaf can't experience music in the same way as the hearing seemed absurd. While "hearing" music does involve the different parts of the ear, there are many other parts of the brain that play into our perception of music. People who are deaf still take in the sounds of music, just in a different format: as vibrations. To feel the vibrations of music, the deaf can stand close to speakers, hold balloons or go barefoot, but they're still essentially hacking their way in. In a live music setting, the deaf tend to miss out on a powerful personal and social experience. So, Mick ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ctc6uZ

The Good, The Bad and The Weird: Health Tech From CES 2019

Smart belt for weight loss, spider-like walking car, terrifying Robo-Sharks, IoT cat toilet, the real version of the monolith from Space Odyssey: the world's most famous tech circus brings the superlatives of innovation to Las Vegas every year. Here, we sorted out the most exciting, the less useful or the outright dumbest health technology from CES 2019. The year of the solar cow What do power banks and cows have in common? The 2019 CES Innovation Award, actually. It's a brilliant project of a South Korean solar energy company, Yolk, having partnered with a Kenyan educational institution, to keep children at school. What does solar energy have to do with education? A lot, actually. In developing regions, parents often send children to work at an early age instead of letting them go to...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rxr4KO

Finding the Right Market for Your Private Practice, Part 1

Editor's note: This is part one of a two-part series. Look for part two: "Growing Your Client Base," in February. Private practice is a consistently growing area for communication sciences and disorders (CSD) professionals. Whether making the transition from employee to employer, or changing their current road map for an established business, private practitioners are searching for new ways to compete in today's market. Three key ways CSD professionals can make their private practice stand out include finding a niche, diversifying offerings and becoming business savvy. Creating a competitive edge One way to create a competitive edge and grow business is by finding a niche. Especially if you live in an area with several practitioners in your profession, it helps to stand out by focu...

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/2RCnXkQ

The future of music is for everyone —even the deaf

How Avnet helped an award-winning tech incubator take one of the most complex wearables from "possibly" to "possible" For Mick Ebeling, CEO of Not Impossible Labs, the fact that the deaf can't experience music in the same way as the hearing seemed absurd. While "hearing" music does involve the different parts of the ear, there are many other parts of the brain that play into our perception of music. People who are deaf still take in the sounds of music, just in a different format: as vibrations. To feel the vibrations of music, the deaf can stand close to speakers, hold balloons or go barefoot, but they're still essentially hacking their way in. In a live music setting, the deaf tend to miss out on a powerful personal and social experience. So, Mick ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ctc6uZ

The Good, The Bad and The Weird: Health Tech From CES 2019

Smart belt for weight loss, spider-like walking car, terrifying Robo-Sharks, IoT cat toilet, the real version of the monolith from Space Odyssey: the world's most famous tech circus brings the superlatives of innovation to Las Vegas every year. Here, we sorted out the most exciting, the less useful or the outright dumbest health technology from CES 2019. The year of the solar cow What do power banks and cows have in common? The 2019 CES Innovation Award, actually. It's a brilliant project of a South Korean solar energy company, Yolk, having partnered with a Kenyan educational institution, to keep children at school. What does solar energy have to do with education? A lot, actually. In developing regions, parents often send children to work at an early age instead of letting them go to...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rxr4KO

Application of ASiR in combination with noise index in the chest CT examination of preschool-age children

Abstract

Purpose

To evaluate the application of adaptive statistical iterative reconstruction (ASIR) for chest CT scans of preschool-age children.

Method

Sixty children, ages 0 to < 1, 1 to < 3, and 3 to < 6 years, who underwent CT non-contrast-enhanced and enhanced scans were included. The non-contrast-enhanced scan sequences were performed with noise indexes (NIs) of 11, 14, and 16 for the 0 to < 1, 1 to < 3, and 3 to < 6 year age groups, respectively. Collected data were reconstructed using ASIR in increments of 10%, ranging from 0 to 100%, to generate 11 image groups. The signal-to-noise ratio, image noise, and other features of images obtained using ASIR with different weights were compared and analyzed. The best weight ranges for ASIR of chest CT scans of children at different ages within the range of 0–6 years were obtained. Enhanced scan sequence: The NI default was 9, and the data were subjected to the filtered back projection reconstruction algorithm. All other scanning parameters were the same as those used in the non-contrast-enhanced scan sequence.

Results

In the 0 to < 1 year group, the image qualities were scored as 3 or above with ASIR weights of 50% for the lung window and 40% for the mediastinal window; in the 1 to < 3 year group, the image qualities were scored as 3 or above with ASIR weights of 60% for the lung window and 50% for the mediastinal window; in the 3 to < 6 year group, the image qualities were scored as 3 or above with ASIR weights of 70% for the lung window and 60% for the mediastinal window.

Conclusion

For low-dose chest CT scans of preschool-age children, application of the ASIR technique significantly improved image quality and reduced image noise. The optimum weights of image ASIR were 50%, 60%, and 70% for the lung window and 40%, 50%, and 60% for the mediastinal window for the 0 to < 1, 1 to < 3, and 3 to < 6 year groups, respectively.

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

Patients Who Say They're Allergic to Penicillin Are Usually Wrong

(MedPage Today) -- All " allergic " patients should be evaluated, review concludes (Source: MedPage Today Allergy)

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/2AQnD7D

Application of ASiR in combination with noise index in the chest CT examination of preschool-age children

Abstract

Purpose

To evaluate the application of adaptive statistical iterative reconstruction (ASIR) for chest CT scans of preschool-age children.

Method

Sixty children, ages 0 to < 1, 1 to < 3, and 3 to < 6 years, who underwent CT non-contrast-enhanced and enhanced scans were included. The non-contrast-enhanced scan sequences were performed with noise indexes (NIs) of 11, 14, and 16 for the 0 to < 1, 1 to < 3, and 3 to < 6 year age groups, respectively. Collected data were reconstructed using ASIR in increments of 10%, ranging from 0 to 100%, to generate 11 image groups. The signal-to-noise ratio, image noise, and other features of images obtained using ASIR with different weights were compared and analyzed. The best weight ranges for ASIR of chest CT scans of children at different ages within the range of 0–6 years were obtained. Enhanced scan sequence: The NI default was 9, and the data were subjected to the filtered back projection reconstruction algorithm. All other scanning parameters were the same as those used in the non-contrast-enhanced scan sequence.

Results

In the 0 to < 1 year group, the image qualities were scored as 3 or above with ASIR weights of 50% for the lung window and 40% for the mediastinal window; in the 1 to < 3 year group, the image qualities were scored as 3 or above with ASIR weights of 60% for the lung window and 50% for the mediastinal window; in the 3 to < 6 year group, the image qualities were scored as 3 or above with ASIR weights of 70% for the lung window and 60% for the mediastinal window.

Conclusion

For low-dose chest CT scans of preschool-age children, application of the ASIR technique significantly improved image quality and reduced image noise. The optimum weights of image ASIR were 50%, 60%, and 70% for the lung window and 40%, 50%, and 60% for the mediastinal window for the 0 to < 1, 1 to < 3, and 3 to < 6 year groups, respectively.

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

Pilot study for permanent resolution of axillary hyperhidrosis: elimination of sweat glands with intradermal microneedle radiofrequency

Abstract

Background

Hyperhidrosis is a disorder of the autonomic nervous system that creates severe social and work problems through the production of excess uncontrolled perspiration. This disease affects about 1 to 3% of the world's population. Essential or primary hyperhidrosis being most frequently seen. Treatment with a variety of surgical and non-surgical systems has been reported. Recently, intradermal microneedle radiofrequency has attracted favorable attention.

Methods

Seventy-four armpits in 37 patients (9 males, 28 females, average age 28 years [range 15–68 years]) diagnosed as having axillary hyperhidrosis who were performed intradermal microneedling fractional radiofrequency (MRF) in three deeps 2 mm, 3 mm, and 3.5 mm. The study was performed from July 2014 until July 2016. All patients completed control and follow-up sessions for 6 months.

Results

A permanent decrease in sweating of over 50% was achieved in 30 patients (80%); intermediate results in 2 (7%) and little or no results in 5 patients (13% of patients).

Conclusions

results suggest that MFR is a novel, safe, effective, permanent, and minimally invasive method to treat AHH with tolerable side effects.

Level of Evidence: Level IV, therapeutic study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sul6LL

Voice outcome after unilateral ELS type III or bilateral type II resections for T1‐T2 glottic carcinoma: Results after 1 year

Abstract

Background

Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification.

Methods

Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self‐assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure.

Results

The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5.

Conclusion

Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self‐reported voice impairment.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QU2kXF

Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

Abstract

Background

Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non‐aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior.

Methods

Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004‐2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC.

Results

Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28‐1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82‐0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86‐0.92 and aOR = 0.81, 95% CI: 0.79‐0.84) and higher odds of LNM and ETE than whites (P < .001).

Conclusions

Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

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

Pilot study for permanent resolution of axillary hyperhidrosis: elimination of sweat glands with intradermal microneedle radiofrequency

Abstract

Background

Hyperhidrosis is a disorder of the autonomic nervous system that creates severe social and work problems through the production of excess uncontrolled perspiration. This disease affects about 1 to 3% of the world's population. Essential or primary hyperhidrosis being most frequently seen. Treatment with a variety of surgical and non-surgical systems has been reported. Recently, intradermal microneedle radiofrequency has attracted favorable attention.

Methods

Seventy-four armpits in 37 patients (9 males, 28 females, average age 28 years [range 15–68 years]) diagnosed as having axillary hyperhidrosis who were performed intradermal microneedling fractional radiofrequency (MRF) in three deeps 2 mm, 3 mm, and 3.5 mm. The study was performed from July 2014 until July 2016. All patients completed control and follow-up sessions for 6 months.

Results

A permanent decrease in sweating of over 50% was achieved in 30 patients (80%); intermediate results in 2 (7%) and little or no results in 5 patients (13% of patients).

Conclusions

results suggest that MFR is a novel, safe, effective, permanent, and minimally invasive method to treat AHH with tolerable side effects.

Level of Evidence: Level IV, therapeutic study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sul6LL

Pilot study for permanent resolution of axillary hyperhidrosis: elimination of sweat glands with intradermal microneedle radiofrequency

Abstract

Background

Hyperhidrosis is a disorder of the autonomic nervous system that creates severe social and work problems through the production of excess uncontrolled perspiration. This disease affects about 1 to 3% of the world's population. Essential or primary hyperhidrosis being most frequently seen. Treatment with a variety of surgical and non-surgical systems has been reported. Recently, intradermal microneedle radiofrequency has attracted favorable attention.

Methods

Seventy-four armpits in 37 patients (9 males, 28 females, average age 28 years [range 15–68 years]) diagnosed as having axillary hyperhidrosis who were performed intradermal microneedling fractional radiofrequency (MRF) in three deeps 2 mm, 3 mm, and 3.5 mm. The study was performed from July 2014 until July 2016. All patients completed control and follow-up sessions for 6 months.

Results

A permanent decrease in sweating of over 50% was achieved in 30 patients (80%); intermediate results in 2 (7%) and little or no results in 5 patients (13% of patients).

Conclusions

results suggest that MFR is a novel, safe, effective, permanent, and minimally invasive method to treat AHH with tolerable side effects.

Level of Evidence: Level IV, therapeutic study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sul6LL

Voice outcome after unilateral ELS type III or bilateral type II resections for T1‐T2 glottic carcinoma: Results after 1 year

Abstract

Background

Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification.

Methods

Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self‐assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure.

Results

The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5.

Conclusion

Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self‐reported voice impairment.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QU2kXF

Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma

Abstract

Background

Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non‐aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior.

Methods

Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004‐2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC.

Results

Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28‐1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82‐0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86‐0.92 and aOR = 0.81, 95% CI: 0.79‐0.84) and higher odds of LNM and ETE than whites (P < .001).

Conclusions

Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

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

Pilot study for permanent resolution of axillary hyperhidrosis: elimination of sweat glands with intradermal microneedle radiofrequency

Abstract

Background

Hyperhidrosis is a disorder of the autonomic nervous system that creates severe social and work problems through the production of excess uncontrolled perspiration. This disease affects about 1 to 3% of the world's population. Essential or primary hyperhidrosis being most frequently seen. Treatment with a variety of surgical and non-surgical systems has been reported. Recently, intradermal microneedle radiofrequency has attracted favorable attention.

Methods

Seventy-four armpits in 37 patients (9 males, 28 females, average age 28 years [range 15–68 years]) diagnosed as having axillary hyperhidrosis who were performed intradermal microneedling fractional radiofrequency (MRF) in three deeps 2 mm, 3 mm, and 3.5 mm. The study was performed from July 2014 until July 2016. All patients completed control and follow-up sessions for 6 months.

Results

A permanent decrease in sweating of over 50% was achieved in 30 patients (80%); intermediate results in 2 (7%) and little or no results in 5 patients (13% of patients).

Conclusions

results suggest that MFR is a novel, safe, effective, permanent, and minimally invasive method to treat AHH with tolerable side effects.

Level of Evidence: Level IV, therapeutic study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sul6LL

The diaphragma sellae, diaphragm opening, and subdiaphragmatic cistern: an anatomical study using magnetic resonance imaging

Abstract

Purpose

Few studies have explored the detailed morphology of the diaphragma sellae (DS), diaphragm opening (DO) or stoma, and subdiaphragmatic cistern (SDC) using neuroimages. The aim of the present study was to characterize these structures using magnetic resonance imaging.

Methods

Thin-sliced, sagittal and coronal T2-weighted imaging was performed for a total of 84 outpatients.

Results

The DS, DO, SDC, and relevant structures were consistently delineated in all patients. In 66% of patients, all three structures appeared to be highly variable, and were classifiable as six distinct morphological types. In 4% of patients, the DS presented as a complete sheet lacking a discernible DO. In addition, 30% of the patients presented with undiscernible SDCs. In the coronal sections of 11% of patients, the pituitary glands extended laterally, reaching or extending beyond the center line on the sectional image of the cavernous internal carotid artery.

Conclusions

Thin-sliced, sagittal, and coronal T2-weighted sequences are useful for delineating the DS, DO, and SDC. Morphological variation of these structures among individuals may considerably influence the direction of pituitary tumor expansion.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fy7Gqi

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Abstract

The use of the term "brachioradial artery" was introduced for the high origin of the radial artery. Although the prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6%, the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate of 0.83%. Moreover, in just 0.6% of cases the loop of the median nerve may be placed near half of the length of the brachial artery, as in the case described in our report. A comprehensive understanding of anatomical variations of neurovascular structures in the upper limb is of great clinical significance. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (persistent, hypoplastic brachial segment of the superficial brachioradial artery), coexisting with atypical formation of the median and musculocutaneous nerves. Anatomical variations of vessels and nerves may coexist which should be taken into account when performing vascular, reconstructive or orthopedic surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJh4Hh

The diaphragma sellae, diaphragm opening, and subdiaphragmatic cistern: an anatomical study using magnetic resonance imaging

Abstract

Purpose

Few studies have explored the detailed morphology of the diaphragma sellae (DS), diaphragm opening (DO) or stoma, and subdiaphragmatic cistern (SDC) using neuroimages. The aim of the present study was to characterize these structures using magnetic resonance imaging.

Methods

Thin-sliced, sagittal and coronal T2-weighted imaging was performed for a total of 84 outpatients.

Results

The DS, DO, SDC, and relevant structures were consistently delineated in all patients. In 66% of patients, all three structures appeared to be highly variable, and were classifiable as six distinct morphological types. In 4% of patients, the DS presented as a complete sheet lacking a discernible DO. In addition, 30% of the patients presented with undiscernible SDCs. In the coronal sections of 11% of patients, the pituitary glands extended laterally, reaching or extending beyond the center line on the sectional image of the cavernous internal carotid artery.

Conclusions

Thin-sliced, sagittal, and coronal T2-weighted sequences are useful for delineating the DS, DO, and SDC. Morphological variation of these structures among individuals may considerably influence the direction of pituitary tumor expansion.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fy7Gqi

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Abstract

The use of the term "brachioradial artery" was introduced for the high origin of the radial artery. Although the prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6%, the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate of 0.83%. Moreover, in just 0.6% of cases the loop of the median nerve may be placed near half of the length of the brachial artery, as in the case described in our report. A comprehensive understanding of anatomical variations of neurovascular structures in the upper limb is of great clinical significance. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (persistent, hypoplastic brachial segment of the superficial brachioradial artery), coexisting with atypical formation of the median and musculocutaneous nerves. Anatomical variations of vessels and nerves may coexist which should be taken into account when performing vascular, reconstructive or orthopedic surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJh4Hh

Pediatric ovarian volumes measured at ultrasound after contralateral unilateral oophorectomy

Abstract

Background

Changes that occur in the remaining ovary after contralateral oophorectomy are not well described.

Objective

To determine average ovarian volume in pediatric patients after contralateral oophorectomy compared to age-matched controls with two normal ovaries.

Materials and methods

We performed a retrospective review of ultrasound examinations and electronic medical records of patients ages 0–18 years who had unilateral oophorectomy from 2000 to 2017 (n=64). We used 384 consecutive normal age-matched ovaries for comparison, analyzing mean ovarian volumes.

Results

Higher mean ovarian volume (mL) was observed in patients who had oophorectomy compared to controls in the first decade of life (P<0.003) and second decade of life (P<0.0003). Higher mean ovarian volume was seen in both premenarchal and menstruating patients with prior oophorectomy when compared to controls (P<0.05 and P<0.0001, respectively). When comparing volume during menstrual cycle, we saw higher mean ovarian volumes in the oophorectomy group compared to the control group for the follicular (P<0.0001), pre-ovulatory (P=0.0005) and luteal phases (P<0.0003). We provide an updated reference of normal ovarian volumes for pediatric patients, with values similar to those already reported in the literature.

Conclusion

Ovarian volume is higher in pediatric patients with one normal ovary following contralateral oophorectomy. The provided normative volumes can be used in evaluating these patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fxh2mn

Pediatric ovarian volumes measured at ultrasound after contralateral unilateral oophorectomy

Abstract

Background

Changes that occur in the remaining ovary after contralateral oophorectomy are not well described.

Objective

To determine average ovarian volume in pediatric patients after contralateral oophorectomy compared to age-matched controls with two normal ovaries.

Materials and methods

We performed a retrospective review of ultrasound examinations and electronic medical records of patients ages 0–18 years who had unilateral oophorectomy from 2000 to 2017 (n=64). We used 384 consecutive normal age-matched ovaries for comparison, analyzing mean ovarian volumes.

Results

Higher mean ovarian volume (mL) was observed in patients who had oophorectomy compared to controls in the first decade of life (P<0.003) and second decade of life (P<0.0003). Higher mean ovarian volume was seen in both premenarchal and menstruating patients with prior oophorectomy when compared to controls (P<0.05 and P<0.0001, respectively). When comparing volume during menstrual cycle, we saw higher mean ovarian volumes in the oophorectomy group compared to the control group for the follicular (P<0.0001), pre-ovulatory (P=0.0005) and luteal phases (P<0.0003). We provide an updated reference of normal ovarian volumes for pediatric patients, with values similar to those already reported in the literature.

Conclusion

Ovarian volume is higher in pediatric patients with one normal ovary following contralateral oophorectomy. The provided normative volumes can be used in evaluating these patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fxh2mn

Patients Who Say They're Allergic to Penicillin Are Usually Wrong

(MedPage Today) -- All " allergic " patients should be evaluated, review concludes (Source: MedPage Today Allergy)

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/2AQnD7D

Morel-Lavellée lesions: MRI characteristics in the pediatric patient

Abstract

Background

A closed degloving injury is often referred to as a Morel-Lavellée lesion regardless of location despite traditionally being associated with the hip in adults. It results from a shearing injury that separates the subcutaneous layers from the fascia with fluid filling a potential space.

Objective

While the most common location and cause have been described in adults, there is limited literature in pediatric patients. We have seen pediatric Morel-Lavellée lesions commonly occurring at the knee after sports. We set out to describe the magnetic resonance imaging (MRI) characteristics.

Materials and methods

A retrospective analysis was performed. All patients with trauma to the pelvis and lower extremities with a subcutaneous fluid collection seen on MRI were evaluated. Age, gender, mechanism of injury, time interval to imaging, and treatment were recorded. The collections were evaluated for location, size, shape and signal characteristics including the presence of fat, blood and septations.

Results

Twenty-one patients ages 7 to 17 years old had findings of degloving injury on MRI. The most common etiology was sports related (18/21, 85.7%). The anterior knee was most often affected (18/21, 85.7%). Lesions were ovoid and centered over the medial retinaculum (8/18, 44.4%) or lateral retinaculum (7/18, 38.9%). A capsule was weakly associated with later presentation (P=0.12).

Conclusion

Pediatric Morel-Lavellée lesions commonly occur in a location not classically described, the anterior knee, and often after sports injury. Commonly, the collections are ovoid and always located at the subcutaneous fat/fascial interface. Recognition of specific imaging characteristics in a common location after sports injury allows for early identification. While most patients recover with conservative management, some need additional intervention with aspiration or debridement.

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

Morel-Lavellée lesions: MRI characteristics in the pediatric patient

Abstract

Background

A closed degloving injury is often referred to as a Morel-Lavellée lesion regardless of location despite traditionally being associated with the hip in adults. It results from a shearing injury that separates the subcutaneous layers from the fascia with fluid filling a potential space.

Objective

While the most common location and cause have been described in adults, there is limited literature in pediatric patients. We have seen pediatric Morel-Lavellée lesions commonly occurring at the knee after sports. We set out to describe the magnetic resonance imaging (MRI) characteristics.

Materials and methods

A retrospective analysis was performed. All patients with trauma to the pelvis and lower extremities with a subcutaneous fluid collection seen on MRI were evaluated. Age, gender, mechanism of injury, time interval to imaging, and treatment were recorded. The collections were evaluated for location, size, shape and signal characteristics including the presence of fat, blood and septations.

Results

Twenty-one patients ages 7 to 17 years old had findings of degloving injury on MRI. The most common etiology was sports related (18/21, 85.7%). The anterior knee was most often affected (18/21, 85.7%). Lesions were ovoid and centered over the medial retinaculum (8/18, 44.4%) or lateral retinaculum (7/18, 38.9%). A capsule was weakly associated with later presentation (P=0.12).

Conclusion

Pediatric Morel-Lavellée lesions commonly occur in a location not classically described, the anterior knee, and often after sports injury. Commonly, the collections are ovoid and always located at the subcutaneous fat/fascial interface. Recognition of specific imaging characteristics in a common location after sports injury allows for early identification. While most patients recover with conservative management, some need additional intervention with aspiration or debridement.

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Hearing outcomes in children with meningitis at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A silent crisis.

CONCLUSIONS: Less than a quarter of all children diagnosed with bacterial meningitis at RCWMCH over the 18-month study period were referred to audiology. Frequent delays in referrals for audiological assessment following meningitis were noted. This may indicate a lack of awareness on the part of doctors. Healthcare practitioners need to be made aware of the need for prompt audiological testing for children with meningitis. In SA, local guidelines for early diagnosis and monitoring of hearing in children who have had meningitis should be developed in order to improve hearing outcomes. PMID: 30645961 [PubMed - in process] (Source: South African Medical Journal)

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

Special edition on unilateral deafness and hearing loss: An introduction and overview.

Special edition on unilateral deafness and hearing loss: An introduction and overview. Hear Res. 2019 Feb;372:1-2 Authors: Gordon KA, Papsin BC PMID: 30642608 [PubMed - in process] (Source: Hearing Research)

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The onset and post-onset auditory responses of cochlear nucleus neurons are modulated differently by cortical activation.

Authors: Liu X, Zhang O, Qi J, Chen A, Hu K, Yan J Abstract Auditory cortex exhibit a capacity of modulating the functions of subcortical auditory nuclei and even inner ear through descending pathways. The cochlear nucleus (CN), which acts as the gateway from the auditory periphery to the central auditory system, is also subjected to corticofugal modulation. Cortical modulation of subcortical nuclei is highly specific to the frequency tunings of cortical and subcortical neurons. It is unclear whether the high frequency-specificity of the cortical modulation of CN frequency tuning is implemented in the CN, in the auditory periphery, or in both. We analyzed the corticofugal effects on the frequency tuning, constructed from both onset (OS) and post-onset (pOS) response components of C...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2De0E87

Hearing outcomes in children with meningitis at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A silent crisis.

CONCLUSIONS: Less than a quarter of all children diagnosed with bacterial meningitis at RCWMCH over the 18-month study period were referred to audiology. Frequent delays in referrals for audiological assessment following meningitis were noted. This may indicate a lack of awareness on the part of doctors. Healthcare practitioners need to be made aware of the need for prompt audiological testing for children with meningitis. In SA, local guidelines for early diagnosis and monitoring of hearing in children who have had meningitis should be developed in order to improve hearing outcomes. PMID: 30645961 [PubMed - in process] (Source: South African Medical Journal)

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

Special edition on unilateral deafness and hearing loss: An introduction and overview.

Special edition on unilateral deafness and hearing loss: An introduction and overview. Hear Res. 2019 Feb;372:1-2 Authors: Gordon KA, Papsin BC PMID: 30642608 [PubMed - in process] (Source: Hearing Research)

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

The onset and post-onset auditory responses of cochlear nucleus neurons are modulated differently by cortical activation.

Authors: Liu X, Zhang O, Qi J, Chen A, Hu K, Yan J Abstract Auditory cortex exhibit a capacity of modulating the functions of subcortical auditory nuclei and even inner ear through descending pathways. The cochlear nucleus (CN), which acts as the gateway from the auditory periphery to the central auditory system, is also subjected to corticofugal modulation. Cortical modulation of subcortical nuclei is highly specific to the frequency tunings of cortical and subcortical neurons. It is unclear whether the high frequency-specificity of the cortical modulation of CN frequency tuning is implemented in the CN, in the auditory periphery, or in both. We analyzed the corticofugal effects on the frequency tuning, constructed from both onset (OS) and post-onset (pOS) response components of C...

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The Tralokinumab Story: Nothing is ever simple

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RUXI8k

Dominant-negative CARD11 mutations: beyond atopy

(Source: Journal of Allergy and Clinical Immunology)

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

Aberrant CARD14 function might cause defective barrier formation

We read with great interest the recent report by Peled et  al1 on how loss-of-function mutations in CARD14 (caspase recruitment domain family, member 14) are associated with a severe variant of atopic dermatitis (AD).1 CARD14 encodes a known regulator of nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), and dominant gain-of-function mutations in CARD14 cause psoriasis and related disorders.1,2 Peled et al1 revealed that dominant negative mutations in CARD14 result in severe AD and decreased NF-κB signaling. (Source: Journal of Allergy and Clinical Immunology)

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The Tralokinumab Story: Nothing is ever simple

(Source: Journal of Allergy and Clinical Immunology)

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Patients Who Say They're Allergic to Penicillin Are Usually Wrong

(MedPage Today) -- All " allergic " patients should be evaluated, review concludes (Source: MedPage Today Allergy)

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January is Thyroid Awareness Month

PDF file for Printing and Saving

The post January is Thyroid Awareness Month appeared first on American Thyroid Association.

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

Patients Who Say They're Allergic to Penicillin Are Usually Wrong

(MedPage Today) -- All " allergic " patients should be evaluated, review concludes (Source: MedPage Today Allergy)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AQnD7D

January is Thyroid Awareness Month

PDF file for Printing and Saving

The post January is Thyroid Awareness Month appeared first on American Thyroid Association.

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

Long-Term Outcomes of Vibroplasty Coupler Implantations to Treat Mixed/Conductive Hearing Loss

Conclusion: A significant improvement was seen with all couplers, and audiological performance did not significantly differ between 12 and 36 months after surgery.Audiol Neurotol 2018;23:316 –325 (Source: Audiology and Neurotology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hh2OYA

What do hearing healthcare professionals do to promote hearing aid use and benefit among adults? A systematic review

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RXx2UI

Influence of subcortical auditory processing and cognitive measures on cocktail party listening in younger and older adults

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hh2IjG

Long-Term Outcomes of Vibroplasty Coupler Implantations to Treat Mixed/Conductive Hearing Loss

Conclusion: A significant improvement was seen with all couplers, and audiological performance did not significantly differ between 12 and 36 months after surgery.Audiol Neurotol 2018;23:316 –325 (Source: Audiology and Neurotology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hh2OYA

What do hearing healthcare professionals do to promote hearing aid use and benefit among adults? A systematic review

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RXx2UI

Influence of subcortical auditory processing and cognitive measures on cocktail party listening in younger and older adults

. (Source: International Journal of Audiology)

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January is Thyroid Awareness Month

PDF file for Printing and Saving

The post January is Thyroid Awareness Month appeared first on American Thyroid Association.

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January is Thyroid Awareness Month

PDF file for Printing and Saving

The post January is Thyroid Awareness Month appeared first on American Thyroid Association.

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Hearing aid users often do not see doctors to ensure devices help

(Reuters Health) - In 2020, a new U.S. law will allow people to buy hearing aids over-the-counter, but that may not improve access to hearing care, a new study suggests. (Source: Reuters: Health)

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

Hearing aid users often do not see doctors to ensure devices help

(Reuters Health) - In 2020, a new U.S. law will allow people to buy hearing aids over-the-counter, but that may not improve access to hearing care, a new study suggests. (Source: Reuters: Health)

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

A retrospective study of the accuracy of template-guided vs. freehand implant placement: a non-radiological method

The aim of this retrospective case study was to evaluate the implant placement accuracy for inexperienced clinicians compared to the preoperatively planned implant position when using a surgical guide template vs. the freehand method.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hqig4q

Trends Associated with Debt Loads Amongst Oral and Maxillofacial Surgery Chief Residents

This survey-based study was undertaken to investigate how total debt loads are impacting the personal and professional decisions that graduating oral and maxillofacial (OMS) surgeons. The aim of this study was to evaluate differences in total debt load on graduating residents and analyze the effects of this debt on career, family, and lifestyle choices after graduation.

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

Efficacy of curcumin for management of oral submucous fibrosis: a systematic review of randomized clinical trials

Oral submucous fibrosis (OSF) is a chronic debilitating disease that has a high risk of malignant transformation. Management of OSF is quite challenging with no definitive cure. This systematic review assessed the available evidence for using curcumin in pain alleviation and clinical improvement in patients with OSF.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HgAyp0

Development of a Tongue-Tie Case Definition (TTCD) in Newborns using a Delphi Survey: the NYU-TTCD

The primary purpose of this study was to develop an operational definition of the oral condition of ankyloglossia (aka: tongue-tie) in newborns (i.e., birth-6 months) that could consistently be used in research studies.

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

Three-Dimensional Measurement and Registration Accuracy of a Third Generation Optical Tracking System for Navigational Maxillary Orthognathic Surgery

The purpose of this study was to evaluate the accuracy of an optical tracking system during reference point localization, measurement, and registration of skull models for navigational maxillary orthognathic surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HqhS5Y

A retrospective study of the accuracy of template-guided vs. freehand implant placement: a non-radiological method

The aim of this retrospective case study was to evaluate the implant placement accuracy for inexperienced clinicians compared to the preoperatively planned implant position when using a surgical guide template vs. the freehand method.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hqig4q

Trends Associated with Debt Loads Amongst Oral and Maxillofacial Surgery Chief Residents

This survey-based study was undertaken to investigate how total debt loads are impacting the personal and professional decisions that graduating oral and maxillofacial (OMS) surgeons. The aim of this study was to evaluate differences in total debt load on graduating residents and analyze the effects of this debt on career, family, and lifestyle choices after graduation.

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

Efficacy of curcumin for management of oral submucous fibrosis: a systematic review of randomized clinical trials

Oral submucous fibrosis (OSF) is a chronic debilitating disease that has a high risk of malignant transformation. Management of OSF is quite challenging with no definitive cure. This systematic review assessed the available evidence for using curcumin in pain alleviation and clinical improvement in patients with OSF.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HgAyp0

Development of a Tongue-Tie Case Definition (TTCD) in Newborns using a Delphi Survey: the NYU-TTCD

The primary purpose of this study was to develop an operational definition of the oral condition of ankyloglossia (aka: tongue-tie) in newborns (i.e., birth-6 months) that could consistently be used in research studies.

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

Three-Dimensional Measurement and Registration Accuracy of a Third Generation Optical Tracking System for Navigational Maxillary Orthognathic Surgery

The purpose of this study was to evaluate the accuracy of an optical tracking system during reference point localization, measurement, and registration of skull models for navigational maxillary orthognathic surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HqhS5Y

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mg2S9U

Heat shock protein 27 modulates autophagy and promotes cell survival after photodynamic therapy

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00536B, Paper

Matias Exequiel Rodriguez, Daniela Elisa Arévalo, Laura Natalia Milla Sanabria, Fernando Dario Cuello Carrion, Mariel Fanelli, Viviana Alicia Rivarola
Photodynamic therapy (PDT) is a clinically approved treatment that exerts a selective cytotoxic activity toward cancer cells. The procedure involves the administration of a photosensitizer drug followed by its activation...
The content of this RSS Feed (c) The Royal Society of Chemistry

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://rsc.li/2TXiAcF

In vitro evaluation of experimental light activated gels for tooth bleaching – The response of L-929 cells, 3T3 cells and gingival fibroblasts

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00223A, Paper

Christoph Kurzmann, Jeroen Verheyen, Michael Coto, Ramachandran Vasant Kumar, Giorgio Divitini, Hassan Shokoohi-Tabrizi, Peter Verheyen, Roeland De Moor, Andreas Moritz, Hermann Agis
Dental bleaching is an important part of aesthetic dentistry. Various strategies have been created to enhance the bleaching efficacy. As one such strategy, light-activated nanoparticles that enable localized generation of...
The content of this RSS Feed (c) The Royal Society of Chemistry

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://rsc.li/2DdoBMx

A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sv6vzJ

Heat shock protein 27 modulates autophagy and promotes cell survival after photodynamic therapy

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00536B, Paper

Matias Exequiel Rodriguez, Daniela Elisa Arévalo, Laura Natalia Milla Sanabria, Fernando Dario Cuello Carrion, Mariel Fanelli, Viviana Alicia Rivarola
Photodynamic therapy (PDT) is a clinically approved treatment that exerts a selective cytotoxic activity toward cancer cells. The procedure involves the administration of a photosensitizer drug followed by its activation...
The content of this RSS Feed (c) The Royal Society of Chemistry

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://rsc.li/2TXiAcF

In vitro evaluation of experimental light activated gels for tooth bleaching – The response of L-929 cells, 3T3 cells and gingival fibroblasts

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00223A, Paper

Christoph Kurzmann, Jeroen Verheyen, Michael Coto, Ramachandran Vasant Kumar, Giorgio Divitini, Hassan Shokoohi-Tabrizi, Peter Verheyen, Roeland De Moor, Andreas Moritz, Hermann Agis
Dental bleaching is an important part of aesthetic dentistry. Various strategies have been created to enhance the bleaching efficacy. As one such strategy, light-activated nanoparticles that enable localized generation of...
The content of this RSS Feed (c) The Royal Society of Chemistry

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://rsc.li/2DdoBMx

A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QS9jR1

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VV6mD0

Hearing aid users often do not see doctors to ensure devices help

(Reuters Health) - In 2020, a new U.S. law will allow people to buy hearing aids over-the-counter, but that may not improve access to hearing care, a new study suggests. (Source: Reuters: Health)

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A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sv6vzJ

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mg2S9U

A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QS9jR1

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VV6mD0

Hearing aid users often do not see doctors to ensure devices help

(Reuters Health) - In 2020, a new U.S. law will allow people to buy hearing aids over-the-counter, but that may not improve access to hearing care, a new study suggests. (Source: Reuters: Health)

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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A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sv6vzJ

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mg2S9U

“A morphometric study of age and sex dependent changes in eyebrow height and shape”

Rejuvenation procedures of the periorbital region and the forehead with the eyebrow as a key structure are often performed in plastic surgery. There is no common consent on the changes of aging in this region and the consecutive treatment options. This study was designed to support the body of literature with a broader data basis about the natural changes of eyebrow position and its shape.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2He7RJ1

A Comment on a Controversial Interpretation of an Apparent Thyroid Phenotype in the Paintings of Henri Matisse

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sv6vzJ

Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mg2S9U

“A morphometric study of age and sex dependent changes in eyebrow height and shape”

Rejuvenation procedures of the periorbital region and the forehead with the eyebrow as a key structure are often performed in plastic surgery. There is no common consent on the changes of aging in this region and the consecutive treatment options. This study was designed to support the body of literature with a broader data basis about the natural changes of eyebrow position and its shape.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2He7RJ1

Dominant-negative CARD11 mutations: beyond atopy

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

The Tralokinumab Story: Nothing is ever simple

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

Dominant-negative CARD11 mutations: beyond atopy

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

Aberrant CARD14 function might cause defective barrier formation

We read with great interest the recent report by Peled et al1 on how loss-of-function mutations in CARD14 (caspase recruitment domain family, member 14) are associated with a severe variant of atopic dermatitis (AD).1 CARD14 encodes a known regulator of nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), and dominant gain-of-function mutations in CARD14 cause psoriasis and related disorders.1,2 Peled et al1 revealed that dominant negative mutations in CARD14 result in severe AD and decreased NF-κB signaling.

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

The Tralokinumab Story: Nothing is ever simple

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

Aberrant CARD14 function might cause defective barrier formation

We read with great interest the recent report by Peled et al1 on how loss-of-function mutations in CARD14 (caspase recruitment domain family, member 14) are associated with a severe variant of atopic dermatitis (AD).1 CARD14 encodes a known regulator of nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), and dominant gain-of-function mutations in CARD14 cause psoriasis and related disorders.1,2 Peled et al1 revealed that dominant negative mutations in CARD14 result in severe AD and decreased NF-κB signaling.

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

Antibiotic allergy labels in hospitalized and critically ill adults: A review of current impacts of inaccurate labelling

This narrative review states that antibiotic allergy labels (AALs) are reported by a 20% of patients, yet>85% will be negative on formal allergy testing. Allergy testing to define AALs in the ICU may lead to significant changes in appropriate and preferred antibiotic use. (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/2TTNLpe

In a Children ’ s Theater Program, Drama Over a Peanut Allergy

The conflict over accommodating a child ' s allergy turned into a legal battle that highlights the isolation that people with food allergies often face. (Source: NYT Health)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ddw2DJ

Combatting brain infections in special issue of Viral Immunology

(Mary Ann Liebert, Inc./Genetic Engineering News) A special issue of Viral Immunology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers, contains a rich collection of the latest research and reviews focusing on Viral Neuroimmunology and the intricacies of viral brain infection. (Source: EurekAlert! - Medicine and Health)

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

Antibiotic allergy labels in hospitalized and critically ill adults: A review of current impacts of inaccurate labelling

This narrative review states that antibiotic allergy labels (AALs) are reported by a 20% of patients, yet>85% will be negative on formal allergy testing. Allergy testing to define AALs in the ICU may lead to significant changes in appropriate and preferred antibiotic use. (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/2TTNLpe

In a Children ’ s Theater Program, Drama Over a Peanut Allergy

The conflict over accommodating a child ' s allergy turned into a legal battle that highlights the isolation that people with food allergies often face. (Source: NYT Health)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ddw2DJ

Combatting brain infections in special issue of Viral Immunology

(Mary Ann Liebert, Inc./Genetic Engineering News) A special issue of Viral Immunology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers, contains a rich collection of the latest research and reviews focusing on Viral Neuroimmunology and the intricacies of viral brain infection. (Source: EurekAlert! - Medicine and Health)

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

Antibiotic allergy labels in hospitalized and critically ill adults: A review of current impacts of inaccurate labelling

This narrative review states that antibiotic allergy labels (AALs) are reported by a 20% of patients, yet>85% will be negative on formal allergy testing. Allergy testing to define AALs in the ICU may lead to significant changes in appropriate and preferred antibiotic use. (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/2TTNLpe

In a Children ’ s Theater Program, Drama Over a Peanut Allergy

The conflict over accommodating a child ' s allergy turned into a legal battle that highlights the isolation that people with food allergies often face. (Source: NYT Health)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ddw2DJ

Combatting brain infections in special issue of Viral Immunology

(Mary Ann Liebert, Inc./Genetic Engineering News) A special issue of Viral Immunology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers, contains a rich collection of the latest research and reviews focusing on Viral Neuroimmunology and the intricacies of viral brain infection. (Source: EurekAlert! - Medicine and Health)

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Antibiotic allergy labels in hospitalized and critically ill adults: A review of current impacts of inaccurate labelling

This narrative review states that antibiotic allergy labels (AALs) are reported by a 20% of patients, yet>85% will be negative on formal allergy testing. Allergy testing to define AALs in the ICU may lead to significant changes in appropriate and preferred antibiotic use. (Source: Current Awareness Service for Health (CASH))

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In a Children ’ s Theater Program, Drama Over a Peanut Allergy

The conflict over accommodating a child ' s allergy turned into a legal battle that highlights the isolation that people with food allergies often face. (Source: NYT Health)

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Combatting brain infections in special issue of Viral Immunology

(Mary Ann Liebert, Inc./Genetic Engineering News) A special issue of Viral Immunology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers, contains a rich collection of the latest research and reviews focusing on Viral Neuroimmunology and the intricacies of viral brain infection. (Source: EurekAlert! - Medicine and Health)

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Researchers Uncover Major Clue In Predicting Response To Immunotherapy

Researchers at Memorial Sloan Kettering Cancer Center in New York have discovered that cancer cells with high numbers of faults in […]

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Researchers Uncover Major Clue In Predicting Response To Immunotherapy

Researchers at Memorial Sloan Kettering Cancer Center in New York have discovered that cancer cells with high numbers of faults in […]

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Researchers Uncover Major Clue In Predicting Response To Immunotherapy

Researchers at Memorial Sloan Kettering Cancer Center in New York have discovered that cancer cells with high numbers of faults in […]

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Researchers Uncover Major Clue In Predicting Response To Immunotherapy

Researchers at Memorial Sloan Kettering Cancer Center in New York have discovered that cancer cells with high numbers of faults in […]

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Idiopathic, heritable and veno-occlusive pulmonary arterial hypertension in childhood: computed tomography angiography features in the initial assessment of the disease

Abstract

Background

In children, idiopathic and heritable pulmonary arterial hypertension present echocardiographic and heart catheterization findings similar to findings in pulmonary veno-occlusive disease.

Objective

To provide a systematic analysis of CT angiography anomalies in children with idiopathic or heritable pulmonary arterial hypertension, or pulmonary veno-occlusive disease. We also sought to identify correlations between CT findings and patients' baseline characteristics.

Materials and methods

We retrospectively analyzed CT features of children with idiopathic and heritable pulmonary arterial hypertension or pulmonary veno-occlusive disease and 30 age-matched controls between 2008 and 2014. We compared CT findings and patient characteristics, including gene mutation type, and disease outcome until 2017.

Results

The pulmonary arterial hypertension group included idiopathic (n=15) and heritable pulmonary arterial hypertension (n=11) and pulmonary veno-occlusive disease (n=4). Median age was 6.5 years. Children with pulmonary arterial hypertension showed enlargement of pulmonary artery and right cardiac chambers. A threshold for the ratio between the pulmonary artery and the ascending aorta of ≥1.2 had a sensitivity of 90% and a specificity of 100% for pulmonary arterial hypertension. All children with pulmonary veno-occlusive disease had thickened interlobular septa, centrilobular ground-glass opacities, and lymphadenopathy. In children with idiopathic and heritable pulmonary arterial hypertension, presence of intrapulmonary neovessels and enlargement of the right atrium were correlated with higher mean pulmonary artery pressure (P=0.011) and pulmonary vascular resistance (P=0.038), respectively. Mediastinal lymphadenopathy was associated with disease worsening within the first 2 years of follow-up (P=0.024).

Conclusion

CT angiography could contribute to early diagnosis and prediction of severity in children with pulmonary arterial hypertension.

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Idiopathic, heritable and veno-occlusive pulmonary arterial hypertension in childhood: computed tomography angiography features in the initial assessment of the disease

Abstract

Background

In children, idiopathic and heritable pulmonary arterial hypertension present echocardiographic and heart catheterization findings similar to findings in pulmonary veno-occlusive disease.

Objective

To provide a systematic analysis of CT angiography anomalies in children with idiopathic or heritable pulmonary arterial hypertension, or pulmonary veno-occlusive disease. We also sought to identify correlations between CT findings and patients' baseline characteristics.

Materials and methods

We retrospectively analyzed CT features of children with idiopathic and heritable pulmonary arterial hypertension or pulmonary veno-occlusive disease and 30 age-matched controls between 2008 and 2014. We compared CT findings and patient characteristics, including gene mutation type, and disease outcome until 2017.

Results

The pulmonary arterial hypertension group included idiopathic (n=15) and heritable pulmonary arterial hypertension (n=11) and pulmonary veno-occlusive disease (n=4). Median age was 6.5 years. Children with pulmonary arterial hypertension showed enlargement of pulmonary artery and right cardiac chambers. A threshold for the ratio between the pulmonary artery and the ascending aorta of ≥1.2 had a sensitivity of 90% and a specificity of 100% for pulmonary arterial hypertension. All children with pulmonary veno-occlusive disease had thickened interlobular septa, centrilobular ground-glass opacities, and lymphadenopathy. In children with idiopathic and heritable pulmonary arterial hypertension, presence of intrapulmonary neovessels and enlargement of the right atrium were correlated with higher mean pulmonary artery pressure (P=0.011) and pulmonary vascular resistance (P=0.038), respectively. Mediastinal lymphadenopathy was associated with disease worsening within the first 2 years of follow-up (P=0.024).

Conclusion

CT angiography could contribute to early diagnosis and prediction of severity in children with pulmonary arterial hypertension.

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Mitteilungen des Berufsverbandes der Deutschen Radiologen

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Jugend ohne Alter und Leben ohne Tod

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Mitteilungen des Berufsverbandes der Deutschen Radiologen

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Jugend ohne Alter und Leben ohne Tod

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In vitro lifetime of zirconium dioxide‐based crowns veneered using Rapid Layer Technology

Rapid Layer Technology (RLT) uses computer‐aided design/computer‐aided manufacturing (CAD/CAM) to manufacture a veneer layer that is adhesively bonded to the zirconia framework, avoiding firing steps during the fabrication process and thus preventing build‐up of residual stresses. This work studied, using sliding contact fatigue, the in vitro lifetime of restorations produced using RLT compared with restorations produced using conventional veneering techniques. Zirconia copings were veneered with a conventional hand‐layering method (VM9) using a fast (n = 16) or a slow (n = 16) cooling protocol, or with RLT. For the latter, the veneers were CAD/CAM fabricated using a feldspathic reinforced‐glass (Vitablocs Mark II; n = 16) or a polymer‐infiltrated reinforced‐glass network (Enamic; n = 16) and adhesively bonded to the zirconia frameworks. Crowns thus obtained were submitted to sliding contact fatigue against a steatite indenter in a chewing simulator until failure. A Kaplan–Meier survival analysis was conducted. None of the hand‐layered restorations survived after a 2 × 10⁶‐cycle interval, whereas no fractures in the RLT groups were observed. Vitablocs Mark II veneers survived for a longer testing period (3.5 × 10⁶ cycles) than their Enamic counterparts (2.5 × 10⁶ cycles) owing to their superior wear behavior. The RLT represents an efficient method to veneer zirconia frameworks by reducing processing steps and, more importantly, increasing the lifetime of the restorations.

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Socio‐economic status, social support, social network, dental status, and oral health reported outcomes in adolescents

This study explored the relationships between sex, socio‐economic status, social support, social network, dental clinical status, dental pain, oral health‐related quality of life (OHRQoL), and self‐rated oral health (SROH) in adolescents. A cross‐sectional study involving 542 adolescents, aged 12–14 yr, was conducted in Dourados, Brazil, to collect dental clinical measures (dental caries, missing teeth, and dental trauma), as well as measures of social support, social network, dental pain, OHRQoL, and SROH. Information on family income and parental education were collected from participant's parents. Structural equation modeling showed that higher income predicted better dental status and better SROH. Greater social support was linked to better dental status and better OHRQoL. Having more social networks was directly linked to better dental status. Poor dental status was linked to dental pain and poor OHRQoL. Dental pain predicted poor OHRQoL and worse SROH. Poor OHRQoL predicted worse SROH. Family income, social support, and social networks indirectly predicted dental pain via dental status. The latter was indirectly linked to OHRQoL and SROH via dental pain. Social support and social networks indirectly predicted OHRQoL and SROH via dental status and dental pain. Socio‐economic factors and social relationships should be considered when planning health promotion and dental care provision to improve an adolescent's oral health.

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

In vitro lifetime of zirconium dioxide‐based crowns veneered using Rapid Layer Technology

Rapid Layer Technology (RLT) uses computer‐aided design/computer‐aided manufacturing (CAD/CAM) to manufacture a veneer layer that is adhesively bonded to the zirconia framework, avoiding firing steps during the fabrication process and thus preventing build‐up of residual stresses. This work studied, using sliding contact fatigue, the in vitro lifetime of restorations produced using RLT compared with restorations produced using conventional veneering techniques. Zirconia copings were veneered with a conventional hand‐layering method (VM9) using a fast (n = 16) or a slow (n = 16) cooling protocol, or with RLT. For the latter, the veneers were CAD/CAM fabricated using a feldspathic reinforced‐glass (Vitablocs Mark II; n = 16) or a polymer‐infiltrated reinforced‐glass network (Enamic; n = 16) and adhesively bonded to the zirconia frameworks. Crowns thus obtained were submitted to sliding contact fatigue against a steatite indenter in a chewing simulator until failure. A Kaplan–Meier survival analysis was conducted. None of the hand‐layered restorations survived after a 2 × 10⁶‐cycle interval, whereas no fractures in the RLT groups were observed. Vitablocs Mark II veneers survived for a longer testing period (3.5 × 10⁶ cycles) than their Enamic counterparts (2.5 × 10⁶ cycles) owing to their superior wear behavior. The RLT represents an efficient method to veneer zirconia frameworks by reducing processing steps and, more importantly, increasing the lifetime of the restorations.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2AQIt6z

Socio‐economic status, social support, social network, dental status, and oral health reported outcomes in adolescents

This study explored the relationships between sex, socio‐economic status, social support, social network, dental clinical status, dental pain, oral health‐related quality of life (OHRQoL), and self‐rated oral health (SROH) in adolescents. A cross‐sectional study involving 542 adolescents, aged 12–14 yr, was conducted in Dourados, Brazil, to collect dental clinical measures (dental caries, missing teeth, and dental trauma), as well as measures of social support, social network, dental pain, OHRQoL, and SROH. Information on family income and parental education were collected from participant's parents. Structural equation modeling showed that higher income predicted better dental status and better SROH. Greater social support was linked to better dental status and better OHRQoL. Having more social networks was directly linked to better dental status. Poor dental status was linked to dental pain and poor OHRQoL. Dental pain predicted poor OHRQoL and worse SROH. Poor OHRQoL predicted worse SROH. Family income, social support, and social networks indirectly predicted dental pain via dental status. The latter was indirectly linked to OHRQoL and SROH via dental pain. Social support and social networks indirectly predicted OHRQoL and SROH via dental status and dental pain. Socio‐economic factors and social relationships should be considered when planning health promotion and dental care provision to improve an adolescent's oral health.

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

Happy ears for many years: selected papers from the 2018 Annual Conference of the National Hearing Conservation Association

. (Source: International Journal of Audiology)

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Whole-genome sequencing reveals a large deletion in the MITF gene in horses with white spotted coat colour and increased risk of deafness.

Authors: Henkel J, Lafayette C, Brooks SA, Martin K, Patterson-Rosa L, Cook D, Jagannathan V, Leeb T Abstract White spotting phenotypes in horses are highly valued in some breeds. They are quite variable and may range from the common white markings up to completely white horses. EDNRB, KIT, MITF, PAX3 and TRPM1 represent known candidate genes for white spotting phenotypes in horses. For the present study, we investigated an American Paint Horse family segregating a phenotype involving white spotting and blue eyes. Six of eight horses with the white-spotting phenotype were deaf. We obtained whole-genome sequence data from an affected horse and specifically searched for structural variants in the known candidate genes. This analysis revealed a heterozygous ~63-kb deletion spanning ex...

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Happy ears for many years: selected papers from the 2018 Annual Conference of the National Hearing Conservation Association

. (Source: International Journal of Audiology)

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Whole-genome sequencing reveals a large deletion in the MITF gene in horses with white spotted coat colour and increased risk of deafness.

Authors: Henkel J, Lafayette C, Brooks SA, Martin K, Patterson-Rosa L, Cook D, Jagannathan V, Leeb T Abstract White spotting phenotypes in horses are highly valued in some breeds. They are quite variable and may range from the common white markings up to completely white horses. EDNRB, KIT, MITF, PAX3 and TRPM1 represent known candidate genes for white spotting phenotypes in horses. For the present study, we investigated an American Paint Horse family segregating a phenotype involving white spotting and blue eyes. Six of eight horses with the white-spotting phenotype were deaf. We obtained whole-genome sequence data from an affected horse and specifically searched for structural variants in the known candidate genes. This analysis revealed a heterozygous ~63-kb deletion spanning ex...

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Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers

Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence ...

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Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers

Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence ...

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Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Background

Chronic rhinosinusitis (CRS) patients who fail medical management have few treatment options other than endoscopic sinus surgery (ESS). A novel biodegradable mometasone furoate drug delivery system (LYR‐210) providing continuous topical steroid therapy to sinonasal mucosa over 24 weeks was developed to treat unoperated CRS patients who have failed medical management prior to ESS. LYR‐210 was designed to slowly expand in the middle meatus, ensuring efficient drug delivery as mucosal swelling reduces.

Methods

A prospective, multicenter, open‐label study was conducted in 20 CRS subjects who were determined to be candidates for ESS. Under endoscopic guidance and topical anesthesia, LYR‐210 was placed in both middle meatuses. The primary endpoint was product‐related serious adverse events (SAEs) at 4 weeks. Additional assessments included plasma drug concentration, morning serum cortisol levels, intraocular pressures (IOPs), and Sino‐Nasal Outcome Test (SNOT‐22) scores.

Results

LYR‐210 was successfully placed bilaterally in 20 subjects (12 without nasal polyps and 8 with polyps) in an office setting. There were no product‐related SAEs through 24 weeks, at which point 86% of LYR‐210 depots were still retained in the middle meatus. Serum cortisol, IOP, and plasma drug concentrations supported systemic safety at all time points tested. Subjects experienced significant reductions in their SNOT‐22 scores as early as week 1, and this reduction persisted through week 24 (p < 0.01). Significant symptom improvement was achieved in the SNOT‐22 rhinologic, extranasal rhinologic, ear‐facial, psychological, and sleep dysfunction subdomains at 24 weeks (p < 0.05).

Conclusion

LYR‐210 is safe and well‐tolerated in ESS‐naive CRS patients and leads to sustained symptom improvement in patients.

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Adenoid cystic carcinoma of the sinonasal tract: a review of the national cancer database

Background

Sinonasal adenoid cystic carcinoma (SNACC) is a rare malignancy with a propensity for distant metastasis. In this study we describe the incidence and determinants of survival among patients with SNACC between the years 2004 and 2012 using the National Cancer Database (NCDB).

Methods

This was a retrospective, population‐based cohort study performed at a tertiary academic medical center. All participants were diagnosed with SNACC between 2004 and 2012 within the NCDB. The main outcome was overall survival (OS).

Results

A total of 793 patients were identified. The cohort was composed of 46.9% males. Mean age at diagnosis was 59.6 years. The maxillary sinus was the most common primary site (49.7%). Nodal disease was seen in 3.6% of the patients, whereas 3.7% had distant metastases. Stage IV disease was seen in 49.1% of cases. In total, 77.4% of patients underwent surgery, 68.2% received radiation therapy, and 16.4% had chemotherapy. Median OS was 78.5 months; OS at 1, 2, and 5 years was 91%, 83%, and 61%, respectively. On multivariate analysis, advanced age (p = 0.001), frontal sinus primary site (p < 0.001), positive margins (p < 0.001), Charlson comorbidity index >0 (p = 0.01), residing in an urban setting (p = 0.04), poorly differentiated or undifferentiated tumor grade (p = 0.003), and advanced tumor stage (p = 0.01) were associated with worse OS, whereas surgery (p < 0.001), but not radiation therapy (p = 0.52) or chemotherapy (p = 0.57), predicted improved OS.

Conclusion

Predictors of survival in SNACC include age, comorbidity status, grade, and stage. Surgery is associated with improved survival and remains the mainstay of therapy, whereas the roles of radiation therapy and chemotherapy require future investigation.

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

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Background

Chronic rhinosinusitis (CRS) patients who fail medical management have few treatment options other than endoscopic sinus surgery (ESS). A novel biodegradable mometasone furoate drug delivery system (LYR‐210) providing continuous topical steroid therapy to sinonasal mucosa over 24 weeks was developed to treat unoperated CRS patients who have failed medical management prior to ESS. LYR‐210 was designed to slowly expand in the middle meatus, ensuring efficient drug delivery as mucosal swelling reduces.

Methods

A prospective, multicenter, open‐label study was conducted in 20 CRS subjects who were determined to be candidates for ESS. Under endoscopic guidance and topical anesthesia, LYR‐210 was placed in both middle meatuses. The primary endpoint was product‐related serious adverse events (SAEs) at 4 weeks. Additional assessments included plasma drug concentration, morning serum cortisol levels, intraocular pressures (IOPs), and Sino‐Nasal Outcome Test (SNOT‐22) scores.

Results

LYR‐210 was successfully placed bilaterally in 20 subjects (12 without nasal polyps and 8 with polyps) in an office setting. There were no product‐related SAEs through 24 weeks, at which point 86% of LYR‐210 depots were still retained in the middle meatus. Serum cortisol, IOP, and plasma drug concentrations supported systemic safety at all time points tested. Subjects experienced significant reductions in their SNOT‐22 scores as early as week 1, and this reduction persisted through week 24 (p < 0.01). Significant symptom improvement was achieved in the SNOT‐22 rhinologic, extranasal rhinologic, ear‐facial, psychological, and sleep dysfunction subdomains at 24 weeks (p < 0.05).

Conclusion

LYR‐210 is safe and well‐tolerated in ESS‐naive CRS patients and leads to sustained symptom improvement in patients.

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Adenoid cystic carcinoma of the sinonasal tract: a review of the national cancer database

Background

Sinonasal adenoid cystic carcinoma (SNACC) is a rare malignancy with a propensity for distant metastasis. In this study we describe the incidence and determinants of survival among patients with SNACC between the years 2004 and 2012 using the National Cancer Database (NCDB).

Methods

This was a retrospective, population‐based cohort study performed at a tertiary academic medical center. All participants were diagnosed with SNACC between 2004 and 2012 within the NCDB. The main outcome was overall survival (OS).

Results

A total of 793 patients were identified. The cohort was composed of 46.9% males. Mean age at diagnosis was 59.6 years. The maxillary sinus was the most common primary site (49.7%). Nodal disease was seen in 3.6% of the patients, whereas 3.7% had distant metastases. Stage IV disease was seen in 49.1% of cases. In total, 77.4% of patients underwent surgery, 68.2% received radiation therapy, and 16.4% had chemotherapy. Median OS was 78.5 months; OS at 1, 2, and 5 years was 91%, 83%, and 61%, respectively. On multivariate analysis, advanced age (p = 0.001), frontal sinus primary site (p < 0.001), positive margins (p < 0.001), Charlson comorbidity index >0 (p = 0.01), residing in an urban setting (p = 0.04), poorly differentiated or undifferentiated tumor grade (p = 0.003), and advanced tumor stage (p = 0.01) were associated with worse OS, whereas surgery (p < 0.001), but not radiation therapy (p = 0.52) or chemotherapy (p = 0.57), predicted improved OS.

Conclusion

Predictors of survival in SNACC include age, comorbidity status, grade, and stage. Surgery is associated with improved survival and remains the mainstay of therapy, whereas the roles of radiation therapy and chemotherapy require future investigation.

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Issue Information

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Torus mandibularis affects the severity and position‐dependent sleep apnea in non‐obese patients

Abstract

Objective

Various anatomical structures of upper airway and physical differences are known to be risk factors for obstructive sleep apnea (OSA). Torus mandibularis is a structure that can appear on the inside of the mandible. Therefore, it is possible for tori to influence airway volume by occupying the space for tongue, and cause sleep apnea. The purpose of this study is to investigate the effect of torus mandibularis on the severity of OSA as one of the craniofacial risk factors.

Design

Retrospective case‐control study.

Setting

University‐based tertiary medical center.

Participants

Adult patients over 19‐years‐old who visited out‐patient clinics with complaints of sleep‐disordered breathing symptoms between January 2010 and December 2017 were investigated.

Main outcome measures

The presence of torus mandibularis in oral cavity was confirmed by physical examination or CT image. We analyzed demographic findings including age, sex, medical history, previous operation history, physical findings of upper airway, and result of polysomnography. To evaluate the effect of torus mandibularis on OSA, polysomnography data of the two groups according to presence or absence of torus mandibularis were compared and analyzed.

Results

232 OSA patients with BMI less than 25 were divided into two groups, according to either the presence or absence of torus mandibularis. We analyzed 138 patients of control group and 94 of torus mandibularis group. AHI was 18.8 ± 14.9 in control group and 25.1 ± 18.4 in torus mandibularis group (p=0.006). RDI was 23.1 ± 14.7 in control group and 27.9 ± 18.4 in torus mandibularis group (p=0.035). Supine AHI showed 26.6 ± 20.3 in control group and 32.5 ± 22.6 in torus mandibularis group (p=0.039). Patients with torus mandibularis had a trend of increase in proportion according to the severity of sleep apnea, such as AHI (p=0.007) or RDI (p=0.034).

Conclusions

We newly found that the presence of torus mandibularis affects not only severity of OSA and also position dependent OSA. These results support the necessity of torus mandibularis evaluation in OSA patients, and further study is also required to investigate its consequence in the surgical outcome.

This article is protected by copyright. All rights reserved.

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Issue Information

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Our Experience with a Novel CSF Leak Repair Material in 14 Patients Following Anterior Skull Base Surgery

Abstract

Hemopatch (HE) advanced hemostatic pad composed of collagen and a synthetic, protein‐reactive monomer which polymerises on contact with protein containing body fluids such as blood and CSF to seal tissues.

HE is readily available which shortens the operating time, and may be manipulated intra‐nasally to reconstruct defects of the anterior skull base.

Reconstruction using HE reduces the morbidity compared with traditional facia lata graft harvesting techniques.

Length of stay and operative times might be decreased due to lower morbidity from donor site complications.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2stVL4j

Torus mandibularis affects the severity and position‐dependent sleep apnea in non‐obese patients

Abstract

Objective

Various anatomical structures of upper airway and physical differences are known to be risk factors for obstructive sleep apnea (OSA). Torus mandibularis is a structure that can appear on the inside of the mandible. Therefore, it is possible for tori to influence airway volume by occupying the space for tongue, and cause sleep apnea. The purpose of this study is to investigate the effect of torus mandibularis on the severity of OSA as one of the craniofacial risk factors.

Design

Retrospective case‐control study.

Setting

University‐based tertiary medical center.

Participants

Adult patients over 19‐years‐old who visited out‐patient clinics with complaints of sleep‐disordered breathing symptoms between January 2010 and December 2017 were investigated.

Main outcome measures

The presence of torus mandibularis in oral cavity was confirmed by physical examination or CT image. We analyzed demographic findings including age, sex, medical history, previous operation history, physical findings of upper airway, and result of polysomnography. To evaluate the effect of torus mandibularis on OSA, polysomnography data of the two groups according to presence or absence of torus mandibularis were compared and analyzed.

Results

232 OSA patients with BMI less than 25 were divided into two groups, according to either the presence or absence of torus mandibularis. We analyzed 138 patients of control group and 94 of torus mandibularis group. AHI was 18.8 ± 14.9 in control group and 25.1 ± 18.4 in torus mandibularis group (p=0.006). RDI was 23.1 ± 14.7 in control group and 27.9 ± 18.4 in torus mandibularis group (p=0.035). Supine AHI showed 26.6 ± 20.3 in control group and 32.5 ± 22.6 in torus mandibularis group (p=0.039). Patients with torus mandibularis had a trend of increase in proportion according to the severity of sleep apnea, such as AHI (p=0.007) or RDI (p=0.034).

Conclusions

We newly found that the presence of torus mandibularis affects not only severity of OSA and also position dependent OSA. These results support the necessity of torus mandibularis evaluation in OSA patients, and further study is also required to investigate its consequence in the surgical outcome.

This article is protected by copyright. All rights reserved.

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

Our Experience with a Novel CSF Leak Repair Material in 14 Patients Following Anterior Skull Base Surgery

Abstract

Hemopatch (HE) advanced hemostatic pad composed of collagen and a synthetic, protein‐reactive monomer which polymerises on contact with protein containing body fluids such as blood and CSF to seal tissues.

HE is readily available which shortens the operating time, and may be manipulated intra‐nasally to reconstruct defects of the anterior skull base.

Reconstruction using HE reduces the morbidity compared with traditional facia lata graft harvesting techniques.

Length of stay and operative times might be decreased due to lower morbidity from donor site complications.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2stVL4j

Wall enhancement ratio determined by vessel wall MRI associated with symptomatic intracranial aneurysms

Publication date: Available online 15 January 2019

Source: European Journal of Radiology

Author(s): Guang-xian Wang, Ming-fu Gong, Dong Zhang, Sheng Lei, Jin-bo Yin, Zi-li Gong, Li Wen

Abstract

Purpose

To study the association of the enhancement ratio (ER) of aneurysmal wall enhancement (AWE) with symptomatic intracranial aneurysms (IAs), we hypothesized that the ER of AWE would be stronger in symptomatic IAs than in asymptomatic IAs, as assessed by high-resolution magnetic resonance imaging (HRMRI).

Materials and Methods

Between February 2016 and February 2018, 80 consecutive patients with 89 unruptured IAs were reviewed. Patients and IAs were divided into symptomatic and asymptomatic groups. In addition to the clinical characteristics, the IA features (e.g., size, shape) were evaluated via computed tomography angiography, while the ER and enhanced patterns were evaluated by HRMRI. Multiple logistic regression analysis was performed to determine the independent risk factors for symptomatic IAs. Receiver operating characteristic curve analysis was used for the final model to obtain the optimal thresholds.

Results

Multiple logistic regression analysis indicated that only the ER was associated with symptomatic IAs. The threshold value of the ER was 60.5%.

Conclusions

A higher ER was more frequently identified in symptomatic IAs. More attention should be paid to this factor in the management of IAs.

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Detection of Occult Neoplastic Infiltration in the Corpus Callosum and Prediction of Overall Survival in Patients with Glioblastoma using Diffusion Tensor Imaging

Publication date: Available online 15 January 2019

Source: European Journal of Radiology

Author(s): Suyash Mohan, Sumei Wang, Gokcen Coban, Feride Kural, Sanjeev Chawla, Donald O'Rourke, Harish Poptani

Abstract

Objective

Corpus callosum (CC) involvement is a poor prognostic factor in patients with glioblastoma (GBM). The purpose of this study was to determine whether diffusion tensor imaging (DTI) can quantify occult tumor infiltration in the CC and predict for overall survival in GBM patients.

Methods

Forty-eight patients with pathologically proven GBM and 17 normal subjects were included in this retrospective study. Patients were divided into four groups based on CC invasion and overall survival: long survivors without CC invasion; short survivors without CC invasion; long survivors with CC invasion; short survivors with CC invasion. All patients underwent DTI at 3 T MRI scanner. Fractional anisotropy (FA) and mean diffusivity (MD) values were measured from genu, mid-body, and splenium of the CC. The mean values of these parameters were compared between different groups and Kaplan Meier curves were used for prediction of overall survival.

Results

Patients with short survival and CC invasion had the lowest FA values (0.64 ± 0.05) from the CC compared with other groups (p < 0.05). Receiver operator characteristic curve (ROC) analysis indicated that a FA cutoff value of 0.70 was the best predictor for overall survival with an area under the curve (AUC) of 0.77, sensitivity 1, specificity 0.59. Kaplan-Meier survival curves demonstrated that the mean survival time was significantly longer for patients with high FA (>0.70) compared with those with low FA (<0.70) (p < 0.001).

Conclusions

FA values from the CC can quantify occult tumor infiltration and serve as a sensitive prognostic marker for prediction of overall survival in GBM patients.

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Diffusion kurtosis imaging histogram parameter metrics predicting survival in integrated molecular subtypes of diffuse glioma: An observational cohort study

Publication date: Available online 15 January 2019

Source: European Journal of Radiology

Author(s): Johann-Martin Hempel, Cornelia Brendle, Benjamin Bender, Georg Bier, Mareen Sarah Kraus, Marco Skardelly, Hardy Richter, Franziska Eckert, Jens Schittenhelm, Ulrike Ernemann, Uwe Klose

Abstract

Purpose

The aim of the study was to assess the predictive value of preoperatively assessed diffusion kurtosis imaging (DKI) metrics as prognostic factors in the 2016 World Health Organization Classification of Tumors of the Central Nervous System integrated glioma groups.

Material and Methods

Seventy-seven patients with histopathologically confirmed treatment-naïve glioma were retrospectively assessed between 08/2013 and 10/2017 using mean kurtosis (MK) and mean diffusivity (MD) histogram parameters from DKI, overall and progression-free survival, and relevant prognostic molecular data (isocitrate dehydrogenase, [IDH]; alpha-thalassemia/mental retardation syndrome X-linked, [ATRX]; chromosome 1p/19q loss of heterozygosity). Receiver operating characteristic (ROC) analysis was performed on metric variables to determine the optimal cutoff-values. The Kaplan-Meier method was used to assess univariate survival data. A multivariate Cox proportional hazards model was performed on significant results from the univariate analysis.

Results

There were significant differences in overall and progression-free survival between patient age (p = 0.001), resection statuses (p = 0.002), WHO glioma grades (p < 0.0001), and integrated molecular profiles (p < 0.0001). Survival was significantly better in patients with lower MK and higher MD values globally (p = 0.009), in gliomas without chromosome 1p/19q LOH (p < 0.0001), and those with retained ATRX expression (p = 0.008).

Conclusions

Patient age and MK from DKI from DKI are relevant factors for preoperatively predicting overall and progression-free survival. Regarding the molecular subgroups, they seem to be predictive in gliomas with ATRX retention, representing a feature of IDH wild-type gliomas.

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