Acute cerebral infarction in a patient with an epidural catheter after left upper lobectomy: a case report

Abstract

Background

There are several recent reports that left upper lobe lung resection is a risk factor for the development of postoperative thromboembolism. Although administering epidural analgesia is common in thoracic surgery, anesthesiologists should be alert when administering epidural analgesia to a patient undergoing left upper lobectomy, considering the increased risk of postoperative thromboembolism and the potential need for anticoagulation or fibrinolytic therapy in the immediate postoperative period.

Case presentation

A seventy-one-year-old female with a metastatic lung lesion developed a cerebral infarction approximately 30 h after video-assisted thoracoscopic left upper lobectomy. Cerebral intravascular therapy was indicated and the epidural catheter was removed immediately to avoid formation of an epidural hematoma. Approximately four hours after onset, reperfusion was successfully established by aspiration of endovascular thrombi. She recovered with mild residual paralysis of the left upper extremity and was transferred to a rehabilitation facility.

Conclusions

We present a patient with a cerebral infarction after left upper lobectomy. Left upper lobectomy is associated with an increased risk of postoperative thromboembolism. Although the exact mechanism of thrombosis after left upper lobectomy is unclear, a judicious decision should be made regarding epidural catheter placement for postoperative analgesia.

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Standardised concentrations of morphine infusions for nurse/patient-controlled analgesia use in children

Abstract

Background

Standardizing concentrations of intravenous infusions enables pre-preparation and is effective in improving patient safety by avoiding large deviations from the prescribed concentration that can occur when infusions are made individually in wards and theatres. The use of pre-prepared morphine standardized concentration infusions for paediatric nurse/patient-controlled analgesia (N/PCA) has not been previously investigated. We aimed to establish, implement and evaluate standardized concentrations of morphine in pre-filled syringes (PFS) for use in paediatric N/PCA.

Methods

Concentrations of morphine in PFS for N/PCA were identified that accommodated dosage variation across a 1–50 kg weight range. The use of infusions in PFS was implemented and evaluated using mixed methods involved direct observation of healthcare professionals (HCPs), focus groups and failure mode and effects analysis, a HCP survey and medication incident reports analysis.

Results

Standardized concentrations, 3 mg, 10 mg and 50 mg morphine in 50 mL sodium chloride 0.9%, delivered prescribed continuous and bolus doses using programmable smart pumps with variable infusion rates. During the implementation, 175 morphine pre-prepared infusions were administered to 157 children (9.4 ± 5.1 years) in theatres and wards. Time taken to set up a N/PCA was 3.7 ± 1.7 min, a reduction of one third compared with the previous system. The number of incidents associated with N/PCA infusions was reduced by 41.2%, and preparation errors were eliminated. HCPs reported using morphine PFS was an easier and safer system.

Conclusion

A system using pre-prepared standardized concentrations of morphine for paediatric N/PCA was implemented successfully and sustainably.

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Acute cerebral infarction in a patient with an epidural catheter after left upper lobectomy: a case report

Abstract

Background

There are several recent reports that left upper lobe lung resection is a risk factor for the development of postoperative thromboembolism. Although administering epidural analgesia is common in thoracic surgery, anesthesiologists should be alert when administering epidural analgesia to a patient undergoing left upper lobectomy, considering the increased risk of postoperative thromboembolism and the potential need for anticoagulation or fibrinolytic therapy in the immediate postoperative period.

Case presentation

A seventy-one-year-old female with a metastatic lung lesion developed a cerebral infarction approximately 30 h after video-assisted thoracoscopic left upper lobectomy. Cerebral intravascular therapy was indicated and the epidural catheter was removed immediately to avoid formation of an epidural hematoma. Approximately four hours after onset, reperfusion was successfully established by aspiration of endovascular thrombi. She recovered with mild residual paralysis of the left upper extremity and was transferred to a rehabilitation facility.

Conclusions

We present a patient with a cerebral infarction after left upper lobectomy. Left upper lobectomy is associated with an increased risk of postoperative thromboembolism. Although the exact mechanism of thrombosis after left upper lobectomy is unclear, a judicious decision should be made regarding epidural catheter placement for postoperative analgesia.

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Standardised concentrations of morphine infusions for nurse/patient-controlled analgesia use in children

Abstract

Background

Standardizing concentrations of intravenous infusions enables pre-preparation and is effective in improving patient safety by avoiding large deviations from the prescribed concentration that can occur when infusions are made individually in wards and theatres. The use of pre-prepared morphine standardized concentration infusions for paediatric nurse/patient-controlled analgesia (N/PCA) has not been previously investigated. We aimed to establish, implement and evaluate standardized concentrations of morphine in pre-filled syringes (PFS) for use in paediatric N/PCA.

Methods

Concentrations of morphine in PFS for N/PCA were identified that accommodated dosage variation across a 1–50 kg weight range. The use of infusions in PFS was implemented and evaluated using mixed methods involved direct observation of healthcare professionals (HCPs), focus groups and failure mode and effects analysis, a HCP survey and medication incident reports analysis.

Results

Standardized concentrations, 3 mg, 10 mg and 50 mg morphine in 50 mL sodium chloride 0.9%, delivered prescribed continuous and bolus doses using programmable smart pumps with variable infusion rates. During the implementation, 175 morphine pre-prepared infusions were administered to 157 children (9.4 ± 5.1 years) in theatres and wards. Time taken to set up a N/PCA was 3.7 ± 1.7 min, a reduction of one third compared with the previous system. The number of incidents associated with N/PCA infusions was reduced by 41.2%, and preparation errors were eliminated. HCPs reported using morphine PFS was an easier and safer system.

Conclusion

A system using pre-prepared standardized concentrations of morphine for paediatric N/PCA was implemented successfully and sustainably.

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Pre-operative biomarkers and imaging tests as predictors of post-operative delirium in non-cardiac surgical patients: a systematic review

Abstract

Background

Post-operative delirium (POD) is a common post-operative complication in elderly individuals and imposes a significant health and financial burden. Identifying predictive biomarkers may help understand the pathophysiology of POD. Our objective is to summarize the evidence of pre-operative biomarkers and imaging tests to predict POD in patients undergoing non-cardiac surgery.

Methods

A systematic search of English language articles in MEDLINE, EMBASE, Cochrane Database, PsychINFO, PubMed and ClinicalTrials. Gov up to January 2018 was performed. Studies that used biomarkers or imaging tests to predict POD and a validated POD assessment tool were included. Animal studies, paediatric, cardiac and intracranial surgery were excluded. Risk of bias was assessed using the Quality In Prognosis Study tool.

Results

Thirty-four prospective cohort studies involving 4424 patients were included. Nineteen studies described serum tests [Interleukin-6, Insulin-like Growth Factor 1, C-Reactive Protein (CRP), cholinesterases, apolipoprotein-E genotype, leptin, hypovitaminosis, hypoalbuminaemia, gamma-amino butyric acid], 10 described cerebral-spinal fluid tests (monoamine precursor, melatonin, acute phase proteins, S100B and neurofibrillary tangles), and 5 described imaging tests. Two studies had high risk of bias due to unclear outcome measurement and study participation. CRP was significantly associated with POD in 5 studies. Other biomarkers were either examined by only a single study or two or more studies with conflicting results.

Conclusion

CRP is the most promising biomarker associated with POD. However, we are still in the early stages in identifying biomarkers and imaging tests that may further understanding of the pathophysiology of POD.

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Pre-operative biomarkers and imaging tests as predictors of post-operative delirium in non-cardiac surgical patients: a systematic review

Abstract

Background

Post-operative delirium (POD) is a common post-operative complication in elderly individuals and imposes a significant health and financial burden. Identifying predictive biomarkers may help understand the pathophysiology of POD. Our objective is to summarize the evidence of pre-operative biomarkers and imaging tests to predict POD in patients undergoing non-cardiac surgery.

Methods

A systematic search of English language articles in MEDLINE, EMBASE, Cochrane Database, PsychINFO, PubMed and ClinicalTrials. Gov up to January 2018 was performed. Studies that used biomarkers or imaging tests to predict POD and a validated POD assessment tool were included. Animal studies, paediatric, cardiac and intracranial surgery were excluded. Risk of bias was assessed using the Quality In Prognosis Study tool.

Results

Thirty-four prospective cohort studies involving 4424 patients were included. Nineteen studies described serum tests [Interleukin-6, Insulin-like Growth Factor 1, C-Reactive Protein (CRP), cholinesterases, apolipoprotein-E genotype, leptin, hypovitaminosis, hypoalbuminaemia, gamma-amino butyric acid], 10 described cerebral-spinal fluid tests (monoamine precursor, melatonin, acute phase proteins, S100B and neurofibrillary tangles), and 5 described imaging tests. Two studies had high risk of bias due to unclear outcome measurement and study participation. CRP was significantly associated with POD in 5 studies. Other biomarkers were either examined by only a single study or two or more studies with conflicting results.

Conclusion

CRP is the most promising biomarker associated with POD. However, we are still in the early stages in identifying biomarkers and imaging tests that may further understanding of the pathophysiology of POD.

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Own Your Contribution

"Life is not about accumulation. It is about contribution." Stephen Covey's powerful words resonate on oh so many levels. In the work setting, it's not about accumulating personal performance accolades; it's about our contribution to the betterment of the entire organization. In the social sphere, it's not about the number of friends that we accumulate (know any "friend collectors"?), but about how we can meaningfully contribute to just one person's life. And in the neighborhood, it's never about how high a fence we can build, but about how leaving our gate open can foster a sense of camaraderie, community, and collective wellbeing. The cost of these contributions? Free. The implementation? Super easy. (Fact: It takes zero effort to be kind). The impact? Inf...

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The Revolving Door Spins Again: the Now Constant Coziness Between the Health Care Industry and US Government

Just because Washington DC is now crazy town does not mean the revolving door has stopped spinning.  We have been dutifully accumulating cases, so it is time to present our latest update.I will divide this into two sections 1) the incoming revolving door, through which come people from the health care industry to enter US government positions in which they may influence health care regulation or policy relevant to their former positions; and 2) the outgoing revolving door, through which go people from US government positions in which they influenced health care regulation or policy to industry positions which were relevant to the scope of their government work.  In each section, we will list cases chronologically according to when they were made public.Incoming Revolving Door Tra...

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Own Your Contribution

"Life is not about accumulation. It is about contribution." Stephen Covey's powerful words resonate on oh so many levels. In the work setting, it's not about accumulating personal performance accolades; it's about our contribution to the betterment of the entire organization. In the social sphere, it's not about the number of friends that we accumulate (know any "friend collectors"?), but about how we can meaningfully contribute to just one person's life. And in the neighborhood, it's never about how high a fence we can build, but about how leaving our gate open can foster a sense of camaraderie, community, and collective wellbeing. The cost of these contributions? Free. The implementation? Super easy. (Fact: It takes zero effort to be kind). The impact? Inf...

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Odysseus the traveler: Appropriation of a chronotope in a community of practice

Publication date: Available online 21 February 2019Source: Language & CommunicationAuthor(s): Anna De Fina, Giuseppe Paternostro, Marcello AmorusoAbstractIn this article we analyze the role of chronotopes in the formation and negotiation of identities. In particular, we consider the case of a superdiverse community of practice formed by minors asylum seekers and teachers in a school of Italian in Sicily, Italy. In our analysis we stress the role of reciprocity on the ways in which the chronotopic figure of Odysseus is reinterpreted and appropriated by members of this community. We look at how through a process of mutual engagement the indexical values associated with the figure of Odysseus are recontextualized by both teachers and students in light of their present experiences. Data for th...

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Editorial announcement

Publication date: Available online 22 February 2019Source: Language SciencesAuthor(s): Sune Vork Steffensen (Source: Language Sciences)

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Binding Interaction of Juglone with Lysozyme: Spectroscopic Studies Aided by In Silico Calculations

Publication date: Available online 21 February 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Saumen Saha, Joydeep ChowdhuryAbstractBinding interactions between the drug Juglone (JUG) and Lysozyme (LYZ) have been explored in details from spectroscopic studies aided by in silico calculations. UV–Vis, steady state and time resolved fluorescence spectroscopic studies indicate the formation of LYZ–JUG complex in the ground state. Quenching of corrected fluorescence spectra of LYZ in presence of JUG at varied concentrations in different temperature range have been estimated from Stern–Volmer (SV) plots. Time resolved fluorescence spectroscopic studies confirm the mechanism of quenching to be of static type. Binding constant associated with the LYZ–JUG comple...

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Phonological Motivation for the Acquisition of Onomatopoeia: An Analysis of Early Words

. (Source: Language Learning and Development)

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Brain responses to morphologically complex verbs: An electrophysiological study of Swedish regular and irregular past tense forms

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Andrea Schremm, Mikael Novén, Merle Horne, Mikael RollAbstractThe present electrophysiological study investigated irregular versus regular verb form processing in Swedish during reading. In line with previous results from other languages, overregularized verbs, i.e. incorrect irregular stem + regular past tense suffix combinations (e.g. *stjäl + de 'steal + past tense'), elicited a left-lateralized negativity (LAN) relative to correct irregulars (stal 'stole'), suggesting rule-based decomposition of regularly inflected words. Lack of a similar effect for misapplication of the irregular stem formation pattern on regular verbs (e.g. *löft 'lifted' instead of lyfte) suggests the involv...

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The impact of the Cognitive Pragmatic Treatment on the pragmatic and informative skills of individuals with traumatic brain injury (TBI)

ConclusionsThe study highlighted the efficacy of the CPT program in improving patients' informativeness, confirming previous reports of its effectiveness in the rehabilitation of communicative-pragmatic skills. (Source: Journal of Neurolinguistics)

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An electrophysiological investigation of translation and morphological priming in biscriptal bilinguals

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Wonil Chung, Myung-Kwan Park, Say Young KimAbstractThe current study used event-related potentials (ERPs) to investigate whether the pattern of cross-language masked translation priming reflects the asymmetric link between first language (L1) and second language (L2) and whether it occurs via morphological decomposition with unbalanced Korean-English bilinguals. In Experiment 1, the targets were Korean (L1) compound words (e.g., 꿀벌, "kkwu-pel", honeybee), and the primes were English (L2) words: either 1) translated compound words (e.g., honeybee), 2) translated constituents (e.g., bee), or 3) unrelated constituents (e.g., ear). Experiment 2 was the same as Experiment 1, except that the targets wer...

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Free the code, free the world: The chronotopic “worldness” of the virtual world of Ryzom

This article deploys Bakhtinian concepts of chronotopes operating at different scales to explore the worldness of one such online "world" (Ryzom's Atys). I will show that these different layered chronotopes become visible at moments of crisis. In each crisis, the chronotopic worldness of Atys affords developers and players not only a domain for potential conflict, but also political collaboration and engagement. (Source: Language and Communication)

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Neural correlates of processing emotions in words across cultures

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Peiyao Chen, Bingle Chen, Thomas F. Münte, Chunming Lu, Li Liu, Taomei GuoAbstractCulture influences its individuals' behaviors in a subtle yet effective way. While the physical experience of emotions is largely biologically determined, emotion perception and processing can still be culturally specific. The present study investigates the neural mechanisms that underlie emotion processing and experience in two cultures. Participants from Eastern and Western cultures performed a lexical decision task on positive and negative words, along with pseudowords. While the two groups' behavioral response to emotional words did not differ, Eastern participants showed greater activation in the left cerebellum and ...

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Backward licensing of Negative Polarity Items in Dutch: An ERP investigation

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Leticia Pablos, Jenny Doetjes, Bobby J. Ruijgrok, Lisa L.S. ChengAbstractThis Event-related Potential (ERP) study examines the licensing of NPIs in Dutch in a grammatical configuration where the NPI linearly precedes its licensor. It investigates how the addition of modifiers at two different structural positions in the sentence affects differently the process of actively searching for an upcoming licensor. We measured the ERPs elicited at the licensor position by comparing conditions with modifiers at two different structural positions, with a control condition where no modifier was added, where all the tested conditions were grammatical. In addition, we examined whether adding different number of modifi...

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Odysseus the traveler: Appropriation of a chronotope in a community of practice

Publication date: Available online 21 February 2019Source: Language & CommunicationAuthor(s): Anna De Fina, Giuseppe Paternostro, Marcello AmorusoAbstractIn this article we analyze the role of chronotopes in the formation and negotiation of identities. In particular, we consider the case of a superdiverse community of practice formed by minors asylum seekers and teachers in a school of Italian in Sicily, Italy. In our analysis we stress the role of reciprocity on the ways in which the chronotopic figure of Odysseus is reinterpreted and appropriated by members of this community. We look at how through a process of mutual engagement the indexical values associated with the figure of Odysseus are recontextualized by both teachers and students in light of their present experiences. Data for th...

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Editorial announcement

Publication date: Available online 22 February 2019Source: Language SciencesAuthor(s): Sune Vork Steffensen (Source: Language Sciences)

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Binding Interaction of Juglone with Lysozyme: Spectroscopic Studies Aided by In Silico Calculations

Publication date: Available online 21 February 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Saumen Saha, Joydeep ChowdhuryAbstractBinding interactions between the drug Juglone (JUG) and Lysozyme (LYZ) have been explored in details from spectroscopic studies aided by in silico calculations. UV–Vis, steady state and time resolved fluorescence spectroscopic studies indicate the formation of LYZ–JUG complex in the ground state. Quenching of corrected fluorescence spectra of LYZ in presence of JUG at varied concentrations in different temperature range have been estimated from Stern–Volmer (SV) plots. Time resolved fluorescence spectroscopic studies confirm the mechanism of quenching to be of static type. Binding constant associated with the LYZ–JUG comple...

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Phonological Motivation for the Acquisition of Onomatopoeia: An Analysis of Early Words

. (Source: Language Learning and Development)

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But mom! I’m not a Spanish Boy: Raciolinguistic socialization in a Two-Way Immersion bilingual program

This article is about the ways in which race and class impact socialization in a Two Way Immersion classroom - a process I refer to as raciolinguistic socialization. In line with the concept of raciolinguistic ideologies (Flores and Rosa, 2015), the term raciolinguistic socialization captures the ways in which race and class impact how language and literacy abilities are perceived and evaluated. I illustrate this process through the ethnographic stories of three Kindergarten students. Weaving together observations, recorded interactions, and parent interviews, I show the impact of raciolinguistic expectations on Latinx children; how class and race privilege influence how language development is evaluated positively, and how a disadvantaged socioeconomic position negatively impacts percepti...

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Brain responses to morphologically complex verbs: An electrophysiological study of Swedish regular and irregular past tense forms

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Andrea Schremm, Mikael Novén, Merle Horne, Mikael RollAbstractThe present electrophysiological study investigated irregular versus regular verb form processing in Swedish during reading. In line with previous results from other languages, overregularized verbs, i.e. incorrect irregular stem + regular past tense suffix combinations (e.g. *stjäl + de 'steal + past tense'), elicited a left-lateralized negativity (LAN) relative to correct irregulars (stal 'stole'), suggesting rule-based decomposition of regularly inflected words. Lack of a similar effect for misapplication of the irregular stem formation pattern on regular verbs (e.g. *löft 'lifted' instead of lyfte) suggests the involv...

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Does phonological rule of tone substitution modulate mismatch negativity?

This study examined whether the phonological substitution rule of tone sandhi modulates tone perception in the preattentive stage. Tone sandhi is commonly present in East Asian languages. An example from Mandarin is the Tone tone 3 sandhi rule: T3 is pronounced as T2 when followed by another T3 (33 → 23). Previous mismatch negativity (MMN) studies in Mandarin have reported a smaller amplitude or longer latency in standard-deviant pair consisting of T2 and T3 (T2-T3) than in T1-T3. The most widely accepted explanation for this is that T2 and T3 have steeper pitch slopes than T1. This study tested an alternative account based on the phonological rule that the frequent substitution that occurs between T2 and T3 results in reduced MMN. In Experiment 1, we first tried to replicate the fin...

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An electrophysiological investigation of translation and morphological priming in biscriptal bilinguals

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Wonil Chung, Myung-Kwan Park, Say Young KimAbstractThe current study used event-related potentials (ERPs) to investigate whether the pattern of cross-language masked translation priming reflects the asymmetric link between first language (L1) and second language (L2) and whether it occurs via morphological decomposition with unbalanced Korean-English bilinguals. In Experiment 1, the targets were Korean (L1) compound words (e.g., 꿀벌, "kkwu-pel", honeybee), and the primes were English (L2) words: either 1) translated compound words (e.g., honeybee), 2) translated constituents (e.g., bee), or 3) unrelated constituents (e.g., ear). Experiment 2 was the same as Experiment 1, except that the targets wer...

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Free the code, free the world: The chronotopic “worldness” of the virtual world of Ryzom

This article deploys Bakhtinian concepts of chronotopes operating at different scales to explore the worldness of one such online "world" (Ryzom's Atys). I will show that these different layered chronotopes become visible at moments of crisis. In each crisis, the chronotopic worldness of Atys affords developers and players not only a domain for potential conflict, but also political collaboration and engagement. (Source: Language and Communication)

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Neural correlates of processing emotions in words across cultures

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Peiyao Chen, Bingle Chen, Thomas F. Münte, Chunming Lu, Li Liu, Taomei GuoAbstractCulture influences its individuals' behaviors in a subtle yet effective way. While the physical experience of emotions is largely biologically determined, emotion perception and processing can still be culturally specific. The present study investigates the neural mechanisms that underlie emotion processing and experience in two cultures. Participants from Eastern and Western cultures performed a lexical decision task on positive and negative words, along with pseudowords. While the two groups' behavioral response to emotional words did not differ, Eastern participants showed greater activation in the left cerebellum and ...

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Altered hemispheric specialization for speech in adult dyslexic readers: An ERPs and dichotic listening study

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Shay MenasheAbstractThe aim of this study was to investigate the functional speech lateralization in adult dyslexic readers whose native language is Hebrew. Event-related potentials (ERPs) were recorded from 22 non-impaired readers and 18 dyslexic readers performing dichotic nonsense consonant-vowel (CV) syllables and dichotic vowels target detection tasks. Evidence of altered patterns of behavioral speech lateralization was found in the dyslexic group mainly for the CV syllables task. The latencies and amplitudes of the N1P2 ERPs complex produced by the dichotic CV syllables and dichotic vowels tasks were deviant as well. The findings suggest a differently organized auditory system with altered speech la...

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Backward licensing of Negative Polarity Items in Dutch: An ERP investigation

Publication date: August 2019Source: Journal of Neurolinguistics, Volume 51Author(s): Leticia Pablos, Jenny Doetjes, Bobby J. Ruijgrok, Lisa L.S. ChengAbstractThis Event-related Potential (ERP) study examines the licensing of NPIs in Dutch in a grammatical configuration where the NPI linearly precedes its licensor. It investigates how the addition of modifiers at two different structural positions in the sentence affects differently the process of actively searching for an upcoming licensor. We measured the ERPs elicited at the licensor position by comparing conditions with modifiers at two different structural positions, with a control condition where no modifier was added, where all the tested conditions were grammatical. In addition, we examined whether adding different number of modifi...

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Prosodic phrase priming during listening to Chinese ambiguous phrases in different experimental tasks

In conclusion, prosodic phrase structures are formulated in the brain and modulate the processing of the immediately subsequent item during speech comprehension, and this process is influenced by the type of task being performed. (Source: Journal of Neurolinguistics)

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Comparing invasive with MRI‐derived intracranial pressure measurements in healthy elderly and brain trauma cases: A pilot study

Background

Intracranial pressure (ICP) is an important physiological parameter in several neurological disorders. Considerable effort has been made to measure ICP noninvasively. MR‐based ICP (MR‐ICP) is a nonempirical method based on principles of cerebrospinal fluid (CSF) physiology, where ICP is obtained from measurements of blood and CSF flows to and from the cranium during the cardiac cycle.

Purpose

To compare MR‐ICP with invasive ICP measurements obtained using lumbar puncture (LP) or external ventricular drainage (EVD).

Study Type

Prospective, cross‐sectional, observational study.

Subjects

Ten cognitively healthy elderly subjects (age 69.6 ± 6.6 years; seven females) and six brain trauma patients (age 36.8 ± 19.7 years; two females).

Field Strength

Velocity encoding cine phase‐contrast at 1.5 T and 3 T.

Assessment

MR‐ICP and craniospinal compliance distribution were estimated from arterial inflow and venous outflow to and from cranium, and craniospinal CSF flow at the upper cervical region, measured using cine phase contrast MRI. LP (done 177 ± 163 days after scan) and EVD measurements (at the time of scan) were performed in lateral recumbent and supine positions, respectively.

Statistical Tests

Linear regression was used to assess the relationships of MR‐ICP with invasive ICP, and the dependency of these measurements on age, weight, height, and BMI. A Shapiro–Wilks test and Bland–Altman plot were respectively used to evaluate the normality and agreement between these two pressure distributions. Student's t‐test was used throughout the analysis to compare differences between the EVD and LP cohorts.

Results

In the combined cohort, MR‐ICP and invasive ICP were positively correlated (r = 0.95, P < 0.001), with invasive ICP being higher than MR‐ICP by 2.2 mmHg on average. In the healthy cohort, the cranial contribution to total craniospinal compliance was negatively correlated with MR‐ICP (r = −0.90, P < 0.001).

Data Conclusion

MR‐ICP provides a reliable estimate of ICP, with 14 out of 16 datapoints within the clinically acceptable error. Craniospinal compliance distribution plays a role in modulating ICP in supine position.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019.

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Comparing invasive with MRI‐derived intracranial pressure measurements in healthy elderly and brain trauma cases: A pilot study

Background

Intracranial pressure (ICP) is an important physiological parameter in several neurological disorders. Considerable effort has been made to measure ICP noninvasively. MR‐based ICP (MR‐ICP) is a nonempirical method based on principles of cerebrospinal fluid (CSF) physiology, where ICP is obtained from measurements of blood and CSF flows to and from the cranium during the cardiac cycle.

Purpose

To compare MR‐ICP with invasive ICP measurements obtained using lumbar puncture (LP) or external ventricular drainage (EVD).

Study Type

Prospective, cross‐sectional, observational study.

Subjects

Ten cognitively healthy elderly subjects (age 69.6 ± 6.6 years; seven females) and six brain trauma patients (age 36.8 ± 19.7 years; two females).

Field Strength

Velocity encoding cine phase‐contrast at 1.5 T and 3 T.

Assessment

MR‐ICP and craniospinal compliance distribution were estimated from arterial inflow and venous outflow to and from cranium, and craniospinal CSF flow at the upper cervical region, measured using cine phase contrast MRI. LP (done 177 ± 163 days after scan) and EVD measurements (at the time of scan) were performed in lateral recumbent and supine positions, respectively.

Statistical Tests

Linear regression was used to assess the relationships of MR‐ICP with invasive ICP, and the dependency of these measurements on age, weight, height, and BMI. A Shapiro–Wilks test and Bland–Altman plot were respectively used to evaluate the normality and agreement between these two pressure distributions. Student's t‐test was used throughout the analysis to compare differences between the EVD and LP cohorts.

Results

In the combined cohort, MR‐ICP and invasive ICP were positively correlated (r = 0.95, P < 0.001), with invasive ICP being higher than MR‐ICP by 2.2 mmHg on average. In the healthy cohort, the cranial contribution to total craniospinal compliance was negatively correlated with MR‐ICP (r = −0.90, P < 0.001).

Data Conclusion

MR‐ICP provides a reliable estimate of ICP, with 14 out of 16 datapoints within the clinically acceptable error. Craniospinal compliance distribution plays a role in modulating ICP in supine position.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019.

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Describing How School-Based SLPs Determine Eligibility for Children with Speech Sound Disorders

We report the results of a nation-wide survey of school-based SLPs, which further underscore this variability. Findings provide insight into which and how many factors SLPs report contributing to eligibility decisions, as well as which and how many components of an assessment are mandatory. Our discussion includes a call to advocacy for SLPs, but also a need for increased awareness of this problematic variability for school administrators. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Speech and Language)

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Speech Sound Disorder and Visual Biofeedback Intervention: A Preliminary Investigation of Treatment Intensity

Semin Speech Lang 2019; 40: 124-137 DOI: 10.1055/s-0039-1677763A growing body of research suggests that cases of speech sound errors that have not responded to previous intervention can sometimes be eliminated through speech therapy incorporating visual biofeedback. Aside from considerations related to the specific biofeedback type, acquisition and generalization of a motor plan may be linked to treatment intensity. Several researchers have raised the possibility that inadequate dosage levels may present a significant barrier to success. Thus, the current study aimed to assess the relationship between treatment intensity and treatment outcomes. Twenty-nine articles reporting the use of visual biofeedback intervention for speech sound disorder were identified and coded for treatment intensi...

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Innovative Service Delivery Models for Serving Children with Speech Sound Disorders

Semin Speech Lang 2019; 40: 113-123 DOI: 10.1055/s-0039-1677762Service delivery variables that may have an impact on the treatment outcomes of children with speech sound disorders include the number and duration of intervention sessions, distribution of the sessions over time, and the format (group intervention or individual intervention). In this article, we briefly review these variables and the recommendations for the most effective service delivery components for children with speech sound disorders. We then describe innovative, collaborative service delivery models for preschoolers and school-age children with speech sound disorder. The models include "Quick Articulation!" conducted in a local elementary school by clinical MS-SLP students from Purdue University, as well as Summer ...

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What Do Children with Speech Sound Disorders Think about Their Talking?

Semin Speech Lang 2019; 40: 094-104 DOI: 10.1055/s-0039-1677760Investigating children's feelings and attitudes toward talking assists speech–language pathologists (SLPs) to understand experiences of communication and the impact of speech sound disorders (SSD). This, in turn, can assist SLPs in identifying appropriate intervention for children with SSD that addresses the needs of children, and their communication partners. This paper draws on data from the Sound Start Study in Australia to explore the attitudes toward talking of 132 preschool-aged children with SSD and the relationship between children's attitudes, speech accuracy, and parent-reported intelligibility and participation. The study revealed most of the children with SSD had a positive attitude toward talking. There was a sig...

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Clinical Challenges: Assessing Toddler Speech Sound Productions

This article includes a discussion of these factors, an overview of key assessment tools for single-word and connected-speech sampling, advice for current evidence-based practice procedures, and a thorough but not exhaustive listing of opportunities to improve clinical practice in this area. Despite limitations, SLPs working with toddlers have some tools and resources available to facilitate diagnostic procedures that allow for authentic decision-making regarding access to therapeutic services. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Speech and Language)

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Speech Sound Disorders in Children

Semin Speech Lang 2019; 40: 079-080 DOI: 10.1055/s-0039-1677758 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Speech and Language)

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Self-Assessment Questions

Semin Speech Lang 2019; 40: C1-C9 DOI: 10.1055/s-0039-1678685 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Speech and Language)

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Phonological Treatment Options for Children with Expressive Language Impairment

Semin Speech Lang 2019; 40: 138-148 DOI: 10.1055/s-0039-1677764The vast majority of treatment efficacy research in the area of phonology focuses on issues relevant to children who have significant limitations in productive phonology but are "typically developing" in most other ways. The base of evidence to guide clinicians on planning intervention for children with phonological and cooccurring expressive language difficulties (PD + LI) is less well developed. Thus, the goal of this paper is to summarize the evidence on two treatment procedures designed to facilitate growth in phonological inventory for children who also require direct intervention to target other aspects of expressive language. We first review what is known about the delicate interaction between phonology and gramm...

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Sports-Related Concussion: Neurometabolic Aspects.

Authors: Banks RE, Domínguez DC Abstract Concussion is a transitory brain injury resulting from a blow to the head. Concussion is considered a mild traumatic brain injury (mTBI), which is self-limited. Repetitive mTBI has been associated with chronic, progressive neurological damage. Extreme biochemical changes occur in neuron cells as a result of mTBI. These metabolic disturbances may reflect the symptoms observed in patients who had suffered concussions. However, it has been difficult to correlate clinical signs and symptoms. Currently, there are no laboratory tests to diagnose concussion, though several biomarkers are being investigated. Further studies are needed to elucidate the biochemical details of the metabolic cascade and the associated time frame, which will help determ...

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

Speech Sound Disorder and Visual Biofeedback Intervention: A Preliminary Investigation of Treatment Intensity

Semin Speech Lang 2019; 40: 124-137 DOI: 10.1055/s-0039-1677763A growing body of research suggests that cases of speech sound errors that have not responded to previous intervention can sometimes be eliminated through speech therapy incorporating visual biofeedback. Aside from considerations related to the specific biofeedback type, acquisition and generalization of a motor plan may be linked to treatment intensity. Several researchers have raised the possibility that inadequate dosage levels may present a significant barrier to success. Thus, the current study aimed to assess the relationship between treatment intensity and treatment outcomes. Twenty-nine articles reporting the use of visual biofeedback intervention for speech sound disorder were identified and coded for treatment intensi...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GYZv6D

Innovative Service Delivery Models for Serving Children with Speech Sound Disorders

Semin Speech Lang 2019; 40: 113-123 DOI: 10.1055/s-0039-1677762Service delivery variables that may have an impact on the treatment outcomes of children with speech sound disorders include the number and duration of intervention sessions, distribution of the sessions over time, and the format (group intervention or individual intervention). In this article, we briefly review these variables and the recommendations for the most effective service delivery components for children with speech sound disorders. We then describe innovative, collaborative service delivery models for preschoolers and school-age children with speech sound disorder. The models include "Quick Articulation!" conducted in a local elementary school by clinical MS-SLP students from Purdue University, as well as Summer ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tAY85X

What Do Children with Speech Sound Disorders Think about Their Talking?

Semin Speech Lang 2019; 40: 094-104 DOI: 10.1055/s-0039-1677760Investigating children's feelings and attitudes toward talking assists speech–language pathologists (SLPs) to understand experiences of communication and the impact of speech sound disorders (SSD). This, in turn, can assist SLPs in identifying appropriate intervention for children with SSD that addresses the needs of children, and their communication partners. This paper draws on data from the Sound Start Study in Australia to explore the attitudes toward talking of 132 preschool-aged children with SSD and the relationship between children's attitudes, speech accuracy, and parent-reported intelligibility and participation. The study revealed most of the children with SSD had a positive attitude toward talking. There was a sig...

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

Clinical Challenges: Assessing Toddler Speech Sound Productions

This article includes a discussion of these factors, an overview of key assessment tools for single-word and connected-speech sampling, advice for current evidence-based practice procedures, and a thorough but not exhaustive listing of opportunities to improve clinical practice in this area. Despite limitations, SLPs working with toddlers have some tools and resources available to facilitate diagnostic procedures that allow for authentic decision-making regarding access to therapeutic services. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Speech and Language)

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Speech Sound Disorders in Children

Semin Speech Lang 2019; 40: 079-080 DOI: 10.1055/s-0039-1677758 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Speech and Language)

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

Self-Assessment Questions

Semin Speech Lang 2019; 40: C1-C9 DOI: 10.1055/s-0039-1678685 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Speech and Language)

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

Phonological Treatment Options for Children with Expressive Language Impairment

Semin Speech Lang 2019; 40: 138-148 DOI: 10.1055/s-0039-1677764The vast majority of treatment efficacy research in the area of phonology focuses on issues relevant to children who have significant limitations in productive phonology but are "typically developing" in most other ways. The base of evidence to guide clinicians on planning intervention for children with phonological and cooccurring expressive language difficulties (PD + LI) is less well developed. Thus, the goal of this paper is to summarize the evidence on two treatment procedures designed to facilitate growth in phonological inventory for children who also require direct intervention to target other aspects of expressive language. We first review what is known about the delicate interaction between phonology and gramm...

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

Sports-Related Concussion: Neurometabolic Aspects.

Authors: Banks RE, Domínguez DC Abstract Concussion is a transitory brain injury resulting from a blow to the head. Concussion is considered a mild traumatic brain injury (mTBI), which is self-limited. Repetitive mTBI has been associated with chronic, progressive neurological damage. Extreme biochemical changes occur in neuron cells as a result of mTBI. These metabolic disturbances may reflect the symptoms observed in patients who had suffered concussions. However, it has been difficult to correlate clinical signs and symptoms. Currently, there are no laboratory tests to diagnose concussion, though several biomarkers are being investigated. Further studies are needed to elucidate the biochemical details of the metabolic cascade and the associated time frame, which will help determ...

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Communication between the transverse cervical nerve (C2,3) and marginal mandibular branch of the facial nerve: a cadaveric and clinical study

Several branches of the facial nerve are known to anastomose with branches of the cervical plexus, other cranial nerves, and the trigeminal nerve. Communication between the sensory transverse cervical nerve (C2, 3) and marginal mandibular nerve is, however, less well known, and in a previous study of 86 neck dissections we reported a 2.3% incidence of anastomoses between them. In this prospective study, we meticulously searched for more examples using both formalin-fixed cadavers and neck dissections. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Communication between the transverse cervical nerve (C2,3) and marginal mandibular branch of the facial nerve: a cadaveric and clinical study

Several branches of the facial nerve are known to anastomose with branches of the cervical plexus, other cranial nerves, and the trigeminal nerve. Communication between the sensory transverse cervical nerve (C2, 3) and marginal mandibular nerve is, however, less well known, and in a previous study of 86 neck dissections we reported a 2.3% incidence of anastomoses between them. In this prospective study, we meticulously searched for more examples using both formalin-fixed cadavers and neck dissections. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Supernumerary teeth in the bilateral buccal space: a rare case

We report a rare case of a patient who presented with two supernumerary teeth in the bilateral buccal space. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Restoration of Spectral Resolution With Hearing-aid Amplification

Condition:   Hearing Loss Intervention:   Device: Hearing Aid Sponsors:   University of Nebraska Lincoln;   National Institute on Deafness and Other Communication Disorders (NIDCD) Not yet recruiting (Source: ClinicalTrials.gov)

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Subject ´s Preference Regarding Hearing Performance and Functionality Using a New Sound Processor

Conditions:   Deafness; Sensoneural Single Sided;   Conductive Hearing Loss;   Mixed Hearing Loss Intervention:   Device: Investigational device - Sound Processor Sponsor:   Cochlear Bone Anchored Solutions Recruiting (Source: ClinicalTrials.gov)

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Tubomanometry and EarPopper Devices for Eustachian Tube Function Testing

Condition:   Eustachian Tube Dysfunction Interventions:   Device: EarPopper;   Device: Tympanometry;   Device: Tubomanometry Sponsors:   University of Pittsburgh;   National Institute on Deafness and Other Communication Disorders (NIDCD) Not yet recruiting (Source: ClinicalTrials.gov)

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Restoration of Spectral Resolution With Hearing-aid Amplification

Condition:   Hearing Loss Intervention:   Device: Hearing Aid Sponsors:   University of Nebraska Lincoln;   National Institute on Deafness and Other Communication Disorders (NIDCD) Not yet recruiting (Source: ClinicalTrials.gov)

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Subject ´s Preference Regarding Hearing Performance and Functionality Using a New Sound Processor

Conditions:   Deafness; Sensoneural Single Sided;   Conductive Hearing Loss;   Mixed Hearing Loss Intervention:   Device: Investigational device - Sound Processor Sponsor:   Cochlear Bone Anchored Solutions Recruiting (Source: ClinicalTrials.gov)

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

Tubomanometry and EarPopper Devices for Eustachian Tube Function Testing

Condition:   Eustachian Tube Dysfunction Interventions:   Device: EarPopper;   Device: Tympanometry;   Device: Tubomanometry Sponsors:   University of Pittsburgh;   National Institute on Deafness and Other Communication Disorders (NIDCD) Not yet recruiting (Source: ClinicalTrials.gov)

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Peanut Allergy Patch Shows Middling Results in Trial

FRIDAY, Feb. 22, 2019 -- Delivering " exposure therapy " via a patch to help curb peanut allergy in kids is somewhat effective, but not as good as delivering the tiny amounts of peanut by mouth, new research shows. The international trial involved 356... (Source: Drugs.com - Daily MedNews)

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Peanut Allergy Patch Shows Middling Results in Trial

FRIDAY, Feb. 22, 2019 -- Delivering " exposure therapy " via a patch to help curb peanut allergy in kids is somewhat effective, but not as good as delivering the tiny amounts of peanut by mouth, new research shows. The international trial involved 356... (Source: Drugs.com - Daily MedNews)

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Peanut Allergy Patch Shows Middling Results in Trial

FRIDAY, Feb. 22, 2019 -- Delivering " exposure therapy " via a patch to help curb peanut allergy in kids is somewhat effective, but not as good as delivering the tiny amounts of peanut by mouth, new research shows. The international trial involved 356... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NmN45H

Peanut Allergy Patch Shows Middling Results in Trial

FRIDAY, Feb. 22, 2019 -- Delivering " exposure therapy " via a patch to help curb peanut allergy in kids is somewhat effective, but not as good as delivering the tiny amounts of peanut by mouth, new research shows. The international trial involved 356... (Source: Drugs.com - Daily MedNews)

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Validation of Combined Symptom Medication Score (cSMS) in Allergic Patients

Conditions:   Allergic Rhinoconjunctivitis;   Allergic Asthma Intervention:   Biological: Immunotherapy Sponsor:   Leti Pharma GmbH Recruiting (Source: ClinicalTrials.gov)

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Characteristics of Patients Diagnosed With NSAID Sensitivity in Thailand

Conditions:   Aspirin Sensitivity;   Aspirin-exacerbated Respiratory Disease;   Aspirin-Induced Angioedema-Urticaria;   Aspirin Allergy;   NSAID-Induced Asthma;   NSAID-Induced Angioedema-Urticaria;   NSAID-Induced Anaphylactoid Reaction;   Aspirin-Induced Anaphylactoid Reaction Intervention:   Drug: aspirin, NSAIDs, paracetamol Sponsor:   Chulalongkorn University Recruiting (Source: ClinicalTrials.gov)

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Validation of the HYPONUT Product

Condition:   Peanut Allergy Intervention:   Other: Hyponut Sponsor:   University Hospital, Montpellier Not yet recruiting (Source: ClinicalTrials.gov)

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Mucosal and Systemic Immunity After Viral Challenge of Healthy Volunteers Vaccinated With Inactivated Influenza Vaccine Via the Intranasal Versus Intramuscular Route

Condition:   Influenza Interventions:   Biological: Flucelvax Quadrivalent inactivated influenza vaccine;   Other: A/Bethesda/MM2/H1N1 Passage 6 virus Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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A Prospective Multicenter Clinical Trial of MRD-based Treatment Strategy in Children and Young Adults With AML

Condition:   Acute Myeloid Leukemia, Childhood Intervention:   Other: HSCT Sponsors:   Federal Research Institute of Pediatric Hematology, Oncology and Immunology;   Physicians, Innovations, Science for Children Fund Not yet recruiting (Source: ClinicalTrials.gov)

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Experimental Human Infection With Neisseria Gonorrhoeae

Condition:   Gonococcal Infection Interventions:   Drug: Cefixime;   Drug: Ceftriaxone;   Drug: Ciprofloxacin;   Biological: Neisseria gonorrhoeae strain FA1090 A26;   Biological: Neisseria gonorrhoeae strain FA7537 Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Combining TLR9 Agonist With bNAbs for Reservoir Reduction and Immunological Control of HIV

Condition:   HIV-1-infection Interventions:   Drug: Saline;   Drug: Lefitolimod;   Drug: 3BNC117 and 10-1074 Sponsors:   University of Aarhus;   Aalborg Universitetshospital;   Odense University Hospital;   Rigshospitalet, Denmark;   Hvidovre University Hospital;   The Peter Doherty Institute for Infection and Immunity;   University of Utah Not yet recruiting (Source: ClinicalTrials.gov)

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Study in Cat-Allergic Patients With Asthma to Evaluate the Efficacy of a Single Dose of REGN1908-1909 to Reduce Bronchoconstriction Upon Cat Allergen Challenge

Conditions:   Cat Allergy;   Mild Asthma Interventions:   Drug: REGN1908-1909;   Drug: Placebo Sponsor:   Regeneron Pharmaceuticals Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GDHr2t

Validation of Combined Symptom Medication Score (cSMS) in Allergic Patients

Conditions:   Allergic Rhinoconjunctivitis;   Allergic Asthma Intervention:   Biological: Immunotherapy Sponsor:   Leti Pharma GmbH Recruiting (Source: ClinicalTrials.gov)

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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Validation of the HYPONUT Product

Condition:   Peanut Allergy Intervention:   Other: Hyponut Sponsor:   University Hospital, Montpellier Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NogCj6

A Prospective Multicenter Clinical Trial of MRD-based Treatment Strategy in Children and Young Adults With AML

Condition:   Acute Myeloid Leukemia, Childhood Intervention:   Other: HSCT Sponsors:   Federal Research Institute of Pediatric Hematology, Oncology and Immunology;   Physicians, Innovations, Science for Children Fund Not yet recruiting (Source: ClinicalTrials.gov)

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

Impact of MEditerranean Diet, Inflammation and Microbiome After an Acute Coronary Syndrome

Condition:   Acute Coronary Syndrome Interventions:   Other: Microbiota analysis;   Other: Immunological analysis;   Other: Proteome analysis;   Other: Metabolome analysis;   Other: Clinical evaluation;   Other: Diet evaluation;   Other: MedDiet Sponsors:   Consorcio Centro de Investigación Biomédica en Red, M.P.;   Hospital General Universitario Gregorio Marañon;   Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana;   University of Navarra;   Institut National de la Santé Et de la Recher che Médicale, France;   Tel Aviv University;   Göteborg University Not yet recruiting (Source: ClinicalTrials.gov)

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Experimental Human Infection With Neisseria Gonorrhoeae

Condition:   Gonococcal Infection Interventions:   Drug: Cefixime;   Drug: Ceftriaxone;   Drug: Ciprofloxacin;   Biological: Neisseria gonorrhoeae strain FA1090 A26;   Biological: Neisseria gonorrhoeae strain FA7537 Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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

Combining TLR9 Agonist With bNAbs for Reservoir Reduction and Immunological Control of HIV

Condition:   HIV-1-infection Interventions:   Drug: Saline;   Drug: Lefitolimod;   Drug: 3BNC117 and 10-1074 Sponsors:   University of Aarhus;   Aalborg Universitetshospital;   Odense University Hospital;   Rigshospitalet, Denmark;   Hvidovre University Hospital;   The Peter Doherty Institute for Infection and Immunity;   University of Utah Not yet recruiting (Source: ClinicalTrials.gov)

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Effect of Migalastat on Cardiac Involvement in Fabry Disease

Conditions:   Fabry Disease;   Heart Diseases Intervention:   Diagnostic Test: Cardiological evaluation Sponsors:   Ospedale San Donato;   Amicus Therapeutics;   Institute of Biomedicine and Molecular Immunology - CNR Recruiting (Source: ClinicalTrials.gov)

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

Study in Cat-Allergic Patients With Asthma to Evaluate the Efficacy of a Single Dose of REGN1908-1909 to Reduce Bronchoconstriction Upon Cat Allergen Challenge

Conditions:   Cat Allergy;   Mild Asthma Interventions:   Drug: REGN1908-1909;   Drug: Placebo Sponsor:   Regeneron Pharmaceuticals Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GDHr2t

A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty

Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application. (Source: International Journal of Oral and Maxillofacial Surgery)

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Equivocal Results for Peanut Allergy Skin Patch Equivocal Results for Peanut Allergy Skin Patch

Epicutaneous immunotherapy for peanut allergy resulted in significantly more responses than placebo, but failed to meet a primary trial endpoint; the clinical meaning of the findings is unclear.Medscape Medical News (Source: Medscape Medical News Headlines)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E8bqM8

Equivocal Results for Peanut Allergy Skin Patch Equivocal Results for Peanut Allergy Skin Patch

Epicutaneous immunotherapy for peanut allergy resulted in significantly more responses than placebo, but failed to meet a primary trial endpoint; the clinical meaning of the findings is unclear.Medscape Medical News (Source: Medscape Medical News Headlines)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E8bqM8

A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty

Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application. (Source: International Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Vh42VP

Equivocal Results for Peanut Allergy Skin Patch Equivocal Results for Peanut Allergy Skin Patch

Epicutaneous immunotherapy for peanut allergy resulted in significantly more responses than placebo, but failed to meet a primary trial endpoint; the clinical meaning of the findings is unclear.Medscape Medical News (Source: Medscape Medical News Headlines)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E8bqM8

Equivocal Results for Peanut Allergy Skin Patch Equivocal Results for Peanut Allergy Skin Patch

Epicutaneous immunotherapy for peanut allergy resulted in significantly more responses than placebo, but failed to meet a primary trial endpoint; the clinical meaning of the findings is unclear.Medscape Medical News (Source: Medscape Medical News Headlines)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E8bqM8

Application of auditory cortical evoked potentials for auditory assessment in people using auditory prosthesis.

Authors: Deng JH, Du JH, Ma XR, Zhang PF Abstract The present study explored the application of auditory cortical evoked potentials (ACEP) in the auditory assessment of people using an auditory prosthesis. There were 126 patients with prelingual deafness who were selected from January 2012-June 2017 from the First People's Hospital of Kunshan (Kunshan, China). HEARLab™ system was used to induce a P1-N1-P2 waveform under the condition of 60 dB sound pressure level at /m/, /g/ and /t/ acoustic stimulations. Speech production ability and auditory perception ability of patients were evaluated by speech intelligibility rating (SIR) and categories of auditory performance (CAP). Extraction rate of P1 waves of patients with auditory prosthesis was higher than that of N1 and P2 waves unde...

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Factors influencing the quality of life of children with cochlear implants

ConclusionThe influencing factors that correlated with the quality of life of the implanted children were the child's older age at the evaluation, the better hearing and language skills, the mother's level of schooling and the family receptiveness.ResumoIntroduçãoO impacto multidimensional da deficiência auditiva nas várias demandas da vida das crianças usuárias de implante coclear é representado por variáveis que podem influenciar os resultados de audição, linguagem e qualidade de vida desta população.ObjetivoAvaliar os fatores influenciadores na qualidade de vida de crianças com implante coclear, considerando a idade na cirurgia, a idade auditiva, a idade na avaliação, as habilidades auditivas, a linguagem falada, o grau de permeabilidade familiar, a escolaridade e o níve...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2XkJ6ik

Application of auditory cortical evoked potentials for auditory assessment in people using auditory prosthesis.

Authors: Deng JH, Du JH, Ma XR, Zhang PF Abstract The present study explored the application of auditory cortical evoked potentials (ACEP) in the auditory assessment of people using an auditory prosthesis. There were 126 patients with prelingual deafness who were selected from January 2012-June 2017 from the First People's Hospital of Kunshan (Kunshan, China). HEARLab™ system was used to induce a P1-N1-P2 waveform under the condition of 60 dB sound pressure level at /m/, /g/ and /t/ acoustic stimulations. Speech production ability and auditory perception ability of patients were evaluated by speech intelligibility rating (SIR) and categories of auditory performance (CAP). Extraction rate of P1 waves of patients with auditory prosthesis was higher than that of N1 and P2 waves unde...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Sh25Xz

Choroidal Melanoma With Optic Nerve Infiltration Presenting as Orbital Pseudocellulitis

No abstract available

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Surgical Timing for Congenital Ptosis Should Not Be Determined Solely by the Presence of Anisometropia

Purpose: Timing of surgery in children with congenital ptosis is a critical component of care, and anisometropia is frequently cited as an indication for early intervention. The purpose of this study is to evaluate the change in refractive error following surgery for congenital ptosis to better inform decisions regarding the timing of surgery. Methods: A retrospective review of clinical records was performed on patients who underwent surgical correction of congenital ptosis in an academic oculoplastic surgery practice from 2002 to 2017. Patients with complete preoperative and postoperative refractive data were included in the study. Changes in refractive error following surgery were analyzed. Results: Among 184 pediatric patients who underwent ptosis surgery during the study period, 56 patients (71 eyes) met inclusion criteria. The mean age at surgery was 5.1 years. Mean refractive error change in all the operated eyes was a 0.82 D decrease in spherical equivalent (p = 0.1920) and a 0.40 D increase in cylinder (p = 0.0255). There were no statistically significant changes in spherical equivalent or cylinder in the control eyes. Conclusions: The authors data did not show movement toward normalization of refractive error following ptosis surgery. In fact, it showed a statistically significant worsening of astigmatism following surgery. Because refractive error does not improve following surgery, anisometropia should not be the sole indication for early surgery in congenital ptosis. Accepted for publication October 17, 2018. The authors have no financial or conflicts of interest to disclose. Meeting presentation: This data was reported at the Fall 2018 American Society of Ophthalmic Plastic and Reconstructive Surgery Conference in Chicago, IL. Address correspondence and reprint requests to Smith Ann M. Chisholm, M.D., 925 North 87th Street, Milwaukee, WI 53226. E-mail: sachisholm@mcw.edu © 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E3mMkG

Steatocystoma Simplex of the Caruncle: Case Report and Immunohistologic Study

A yellow cystic lesion of the caruncle in a 23-year-old woman proved to be a solitary steatocystoma, a rare occurrence in that location. While the histopathologic diagnosis was evident from clusters of sebaceous cells within the cyst wall, a panel of immunohistochemical stains further distinguished the lesion from a keratinous cyst. The most useful stains for differentiating the two conditions were carcinoembryonic antigen, epithelial membrane antigen, cytokeratins 17 and 19, and calretinin. Only three previous cases of caruncular steatocystoma simplex have been reported, none of which included immunohistochemical studies. The current findings support the origin of the cyst from the small duct that connects the unilobular sebaceous gland associated with vellus hairs to the follicular canal. Accepted for publication December 18, 2018. The authors have no conflicts of interests to disclose. Address correspondence and reprint requests to Norman C. Charles, M.D., Department of Ophthalmology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016. E-mail: norman.charles@nyumc.org © 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2STtu6Z

Or bital Spread of Fungal Granuloma Post Dacryocystorhinostomy

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EaAAK2

Choroidal Melanoma With Optic Nerve Infiltration Presenting as Orbital Pseudocellulitis

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2STtwf7

Surgical Timing for Congenital Ptosis Should Not Be Determined Solely by the Presence of Anisometropia

Purpose: Timing of surgery in children with congenital ptosis is a critical component of care, and anisometropia is frequently cited as an indication for early intervention. The purpose of this study is to evaluate the change in refractive error following surgery for congenital ptosis to better inform decisions regarding the timing of surgery. Methods: A retrospective review of clinical records was performed on patients who underwent surgical correction of congenital ptosis in an academic oculoplastic surgery practice from 2002 to 2017. Patients with complete preoperative and postoperative refractive data were included in the study. Changes in refractive error following surgery were analyzed. Results: Among 184 pediatric patients who underwent ptosis surgery during the study period, 56 patients (71 eyes) met inclusion criteria. The mean age at surgery was 5.1 years. Mean refractive error change in all the operated eyes was a 0.82 D decrease in spherical equivalent (p = 0.1920) and a 0.40 D increase in cylinder (p = 0.0255). There were no statistically significant changes in spherical equivalent or cylinder in the control eyes. Conclusions: The authors data did not show movement toward normalization of refractive error following ptosis surgery. In fact, it showed a statistically significant worsening of astigmatism following surgery. Because refractive error does not improve following surgery, anisometropia should not be the sole indication for early surgery in congenital ptosis. Accepted for publication October 17, 2018. The authors have no financial or conflicts of interest to disclose. Meeting presentation: This data was reported at the Fall 2018 American Society of Ophthalmic Plastic and Reconstructive Surgery Conference in Chicago, IL. Address correspondence and reprint requests to Smith Ann M. Chisholm, M.D., 925 North 87th Street, Milwaukee, WI 53226. E-mail: sachisholm@mcw.edu © 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E3mMkG

Steatocystoma Simplex of the Caruncle: Case Report and Immunohistologic Study

A yellow cystic lesion of the caruncle in a 23-year-old woman proved to be a solitary steatocystoma, a rare occurrence in that location. While the histopathologic diagnosis was evident from clusters of sebaceous cells within the cyst wall, a panel of immunohistochemical stains further distinguished the lesion from a keratinous cyst. The most useful stains for differentiating the two conditions were carcinoembryonic antigen, epithelial membrane antigen, cytokeratins 17 and 19, and calretinin. Only three previous cases of caruncular steatocystoma simplex have been reported, none of which included immunohistochemical studies. The current findings support the origin of the cyst from the small duct that connects the unilobular sebaceous gland associated with vellus hairs to the follicular canal. Accepted for publication December 18, 2018. The authors have no conflicts of interests to disclose. Address correspondence and reprint requests to Norman C. Charles, M.D., Department of Ophthalmology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016. E-mail: norman.charles@nyumc.org © 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Or bital Spread of Fungal Granuloma Post Dacryocystorhinostomy

No abstract available

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EaAAK2

Supernumerary teeth in the bilateral buccal space: a rare case

Supernumerary teeth are usually found in the alveolus, but may occasionally be sited in unusual places. We report a rare case of a patient who presented with two supernumerary teeth in the bilateral buccal space.

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Communication between the transverse cervical nerve (C2,3) and marginal mandibular branch of the facial nerve: a cadaveric and clinical study

Several branches of the facial nerve are known to anastomose with branches of the cervical plexus, other cranial nerves, and the trigeminal nerve. Communication between the sensory transverse cervical nerve (C2, 3) and marginal mandibular nerve is, however, less well known, and in a previous study of 86 neck dissections we reported a 2.3% incidence of anastomoses between them. In this prospective study, we meticulously searched for more examples using both formalin-fixed cadavers and neck dissections.

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Supernumerary teeth in the bilateral buccal space: a rare case

Supernumerary teeth are usually found in the alveolus, but may occasionally be sited in unusual places. We report a rare case of a patient who presented with two supernumerary teeth in the bilateral buccal space.

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Communication between the transverse cervical nerve (C2,3) and marginal mandibular branch of the facial nerve: a cadaveric and clinical study

Several branches of the facial nerve are known to anastomose with branches of the cervical plexus, other cranial nerves, and the trigeminal nerve. Communication between the sensory transverse cervical nerve (C2, 3) and marginal mandibular nerve is, however, less well known, and in a previous study of 86 neck dissections we reported a 2.3% incidence of anastomoses between them. In this prospective study, we meticulously searched for more examples using both formalin-fixed cadavers and neck dissections.

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

Normalization of breathing with adenotonsillectomy in Japanese pediatric OSA

Since reports on surgical results for pediatric obstructive sleep apnea (OSA) in Japan are insufficient for debate, this study aimed to evaluate the feature of Japanese OSA children and surgical result and document whether is obesity and affecting factor similar to non-Asian countries.

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

Identification of NSDHL Mutations Associated with CHILD Syndrome in Oral Verruciform Xanthoma

To perform a systematic analysis of the NAD(P)-dependent steroid dehydrogenase-like (NSDHL) gene in cases of oral verruciform xanthoma (VX) and test for the presence of mutations associated with Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects (CHILD) Syndrome patients.

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

Diagnostic delay and sub-optimal management in persistent idiopathic facial pain and persistent dento-alveolar pain; a cross sectional study

To explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP), and to investigate factors influencing its delayed diagnosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E6Z9aP

Upregulation of eIF3a promotes cell survival in ameloblastoma

This study aimed to detect the expression of eIF3a in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate the roles of eIF3a in AM-1 cell proliferation and apoptosis.

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Acinetobacter baumannii orofacial cellulitis: report of two cases

Acinetobacter baumannii infection of skin and soft tissues is uncommon and usually associated with trauma. The present report describes two cases of cellulitis in the orofacial region, caused by an A. baumannii infection in paediatric patients, and with fatal outcome. A twelve-year-old male patient, diagnosed with acute promyelocytic leukemia, presented an ulcerated lesion on the lip suggestive of local trauma. The condition evolved with cellulitis, epithelial necrosis and non-specific vesicles and blisters.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E30PlQ

Normalization of breathing with adenotonsillectomy in Japanese pediatric OSA

Since reports on surgical results for pediatric obstructive sleep apnea (OSA) in Japan are insufficient for debate, this study aimed to evaluate the feature of Japanese OSA children and surgical result and document whether is obesity and affecting factor similar to non-Asian countries.

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

Identification of NSDHL Mutations Associated with CHILD Syndrome in Oral Verruciform Xanthoma

To perform a systematic analysis of the NAD(P)-dependent steroid dehydrogenase-like (NSDHL) gene in cases of oral verruciform xanthoma (VX) and test for the presence of mutations associated with Congenital Hemidysplasia with Ichthyosiform nevus and Limb Defects (CHILD) Syndrome patients.

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

Diagnostic delay and sub-optimal management in persistent idiopathic facial pain and persistent dento-alveolar pain; a cross sectional study

To explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP), and to investigate factors influencing its delayed diagnosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E6Z9aP

Upregulation of eIF3a promotes cell survival in ameloblastoma

This study aimed to detect the expression of eIF3a in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate the roles of eIF3a in AM-1 cell proliferation and apoptosis.

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

Acinetobacter baumannii orofacial cellulitis: report of two cases

Acinetobacter baumannii infection of skin and soft tissues is uncommon and usually associated with trauma. The present report describes two cases of cellulitis in the orofacial region, caused by an A. baumannii infection in paediatric patients, and with fatal outcome. A twelve-year-old male patient, diagnosed with acute promyelocytic leukemia, presented an ulcerated lesion on the lip suggestive of local trauma. The condition evolved with cellulitis, epithelial necrosis and non-specific vesicles and blisters.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2E30PlQ

A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty

Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T7KvtE

A reversed approach for simultaneous mandibular symphyseal split osteotomy and genioplasty

Performing a mandibular symphyseal split and genioplasty simultaneously and accurately is a technical challenge for the surgeon. The aim of this study was to validate a reversed approach for simultaneous symphyseal split and genioplasty. A cutting guide and a repositioning guide were designed and printed three-dimensionally in titanium. The symphyseal split and genioplasty were performed successfully. The accuracy of the technique appears to be appropriate for clinical application.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T7KvtE

Detection and measurements of apical lesions in the upper jaw by cone beam computed tomography and panoramic radiography as a function of cortical bone thickness

Abstract

Objectives

In the current literature, cone beam computed tomography (CBCT) seems to be more accurate in detecting apical lesions (AL) than two-dimensional radiographs. Cortical bone thickness might have an influence on AL visibility. Therefore, the purpose of the study was to directly compare the diagnostic accuracy of panoramic radiography (PANO) and CBCT in detecting AL in the upper jaw and determine the influence of cortical bone thickness on AL visibility.

Materials and methods

Anonymised digital images of 351 patients who received a CBCT image and a panoramic radiograph within 90 days were examined for AL in the upper jaw. The analysis was conducted by a trained examiner and reviewed by an expert in dental radiology. Further, the dimensions of AL and cortical bone thickness in the region affected by AL were measured to determine their influence on visibility. Statistical analysis was carried out by means of statistical software (IBM SPSS 25; Armonk, NY, USA).

Results

The mean age of the patients was 58.9 years with an almost equal gender distribution. A total of 2223 teeth in the upper jaw were included in the final analysis. CBCT detected AL on 144 teeth (6.5%), of which only 23 were also visible on a PANO. The difference between both methods was significant (p < 0.001). The dimensions of AL measured within a PANO were approximately twice as high as those measured by CBCT. However, the difference was not significant (p ≥ 0.005). Cortical bone thickness had no influence on AL visibility.

Conclusions and clinical relevance

Panoramic radiographs are unsuitable for a reliable diagnosis of AL in the upper jaw, while CBCT leads to a better visualisation of AL. Bone thickness has no significant influence on AL visibility with either imaging method.

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

Detection and measurements of apical lesions in the upper jaw by cone beam computed tomography and panoramic radiography as a function of cortical bone thickness

Abstract

Objectives

In the current literature, cone beam computed tomography (CBCT) seems to be more accurate in detecting apical lesions (AL) than two-dimensional radiographs. Cortical bone thickness might have an influence on AL visibility. Therefore, the purpose of the study was to directly compare the diagnostic accuracy of panoramic radiography (PANO) and CBCT in detecting AL in the upper jaw and determine the influence of cortical bone thickness on AL visibility.

Materials and methods

Anonymised digital images of 351 patients who received a CBCT image and a panoramic radiograph within 90 days were examined for AL in the upper jaw. The analysis was conducted by a trained examiner and reviewed by an expert in dental radiology. Further, the dimensions of AL and cortical bone thickness in the region affected by AL were measured to determine their influence on visibility. Statistical analysis was carried out by means of statistical software (IBM SPSS 25; Armonk, NY, USA).

Results

The mean age of the patients was 58.9 years with an almost equal gender distribution. A total of 2223 teeth in the upper jaw were included in the final analysis. CBCT detected AL on 144 teeth (6.5%), of which only 23 were also visible on a PANO. The difference between both methods was significant (p < 0.001). The dimensions of AL measured within a PANO were approximately twice as high as those measured by CBCT. However, the difference was not significant (p ≥ 0.005). Cortical bone thickness had no influence on AL visibility.

Conclusions and clinical relevance

Panoramic radiographs are unsuitable for a reliable diagnosis of AL in the upper jaw, while CBCT leads to a better visualisation of AL. Bone thickness has no significant influence on AL visibility with either imaging method.

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Overheard: Using Respiratory Muscle Strength Training in Dysphagia

The objective data comes from what you measure as an outcome. The device is the trainer. Again, use pressure threshold and then set out to measure the outcomes, a scale, a swallow exam, a cough flow rate, a voice quality, etc. Participant: How do you establish goals? There are norms for peak cough, is this what you use? Kiourkas: Respiratory uses cough peak flow to qualify for noninvasive ventilation for ALS and neuromuscular patients. The norms are different for each person. Suggested ranges are used as a guide to assist in determining if the patient is getting worse at subsequent visits. We also use a SNIP (sniffing pressure) when they are extremely weak as a trending tool. Participant: Would you recommend using RMST in the pediatric population? Kiourkas: I would. Children are very resou...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Xf26z3

Overheard: Using Respiratory Muscle Strength Training in Dysphagia

The objective data comes from what you measure as an outcome. The device is the trainer. Again, use pressure threshold and then set out to measure the outcomes, a scale, a swallow exam, a cough flow rate, a voice quality, etc. Participant: How do you establish goals? There are norms for peak cough, is this what you use? Kiourkas: Respiratory uses cough peak flow to qualify for noninvasive ventilation for ALS and neuromuscular patients. The norms are different for each person. Suggested ranges are used as a guide to assist in determining if the patient is getting worse at subsequent visits. We also use a SNIP (sniffing pressure) when they are extremely weak as a trending tool. Participant: Would you recommend using RMST in the pediatric population? Kiourkas: I would. Children are very resou...

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The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson ’s Disease

AbstractDysphagia increases risk of pneumonia in patients with Parkinson 's disease (PD). However, no studies have investigated the association between objective measures of swallowing dysfunction and clinical outcomes. Therefore, we aimed to study the link between scores obtained on the modified barium swallow impairment scale profile (MBSImP) and hospital admissions for pneumonia and choking, in groups of patients with PD on different feeding modes. 157 patients who completed MBS studies were divided into three groups based on their feeding modes (oral, enteral, and rejected enteral feeding with oral feeding at own risk). Videos were analysed using the MBSImP. We evaluated the association of the oral, pharyngeal, and combined scores, with risk of admission for pneumonia and choking. Ka...

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

The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson ’s Disease

AbstractDysphagia increases risk of pneumonia in patients with Parkinson 's disease (PD). However, no studies have investigated the association between objective measures of swallowing dysfunction and clinical outcomes. Therefore, we aimed to study the link between scores obtained on the modified barium swallow impairment scale profile (MBSImP) and hospital admissions for pneumonia and choking, in groups of patients with PD on different feeding modes. 157 patients who completed MBS studies were divided into three groups based on their feeding modes (oral, enteral, and rejected enteral feeding with oral feeding at own risk). Videos were analysed using the MBSImP. We evaluated the association of the oral, pharyngeal, and combined scores, with risk of admission for pneumonia and choking. Ka...

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

Overheard: Using Respiratory Muscle Strength Training in Dysphagia

The objective data comes from what you measure as an outcome. The device is the trainer. Again, use pressure threshold and then set out to measure the outcomes, a scale, a swallow exam, a cough flow rate, a voice quality, etc. Participant: How do you establish goals? There are norms for peak cough, is this what you use? Kiourkas: Respiratory uses cough peak flow to qualify for noninvasive ventilation for ALS and neuromuscular patients. The norms are different for each person. Suggested ranges are used as a guide to assist in determining if the patient is getting worse at subsequent visits. We also use a SNIP (sniffing pressure) when they are extremely weak as a trending tool. Participant: Would you recommend using RMST in the pediatric population? Kiourkas: I would. Children are very resou...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Xf26z3

Overheard: Using Respiratory Muscle Strength Training in Dysphagia

The objective data comes from what you measure as an outcome. The device is the trainer. Again, use pressure threshold and then set out to measure the outcomes, a scale, a swallow exam, a cough flow rate, a voice quality, etc. Participant: How do you establish goals? There are norms for peak cough, is this what you use? Kiourkas: Respiratory uses cough peak flow to qualify for noninvasive ventilation for ALS and neuromuscular patients. The norms are different for each person. Suggested ranges are used as a guide to assist in determining if the patient is getting worse at subsequent visits. We also use a SNIP (sniffing pressure) when they are extremely weak as a trending tool. Participant: Would you recommend using RMST in the pediatric population? Kiourkas: I would. Children are very resou...

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Characterization of a subgroup of non-type 2 asthma with cow’s milk hypersensitivity in young subjects

Asthma with atopy is often characterized by type 2 inflammation but less progress has been made in defining non-type 2 asthma. We have previously identified a subgroup of young non-atopic asthmatics with perce...

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

Characterization of a subgroup of non-type 2 asthma with cow’s milk hypersensitivity in young subjects

Asthma with atopy is often characterized by type 2 inflammation but less progress has been made in defining non-type 2 asthma. We have previously identified a subgroup of young non-atopic asthmatics with perce...

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

Introducing real-life listening features into the clinical test environment: Part I: Measuring the hearing performance and evaluating the listening effort of individuals with normal hearing

. (Source: Cochlear Implants International)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2V8XOag

The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson’s Disease

Abstract

Dysphagia increases risk of pneumonia in patients with Parkinson's disease (PD). However, no studies have investigated the association between objective measures of swallowing dysfunction and clinical outcomes. Therefore, we aimed to study the link between scores obtained on the modified barium swallow impairment scale profile (MBSImP) and hospital admissions for pneumonia and choking, in groups of patients with PD on different feeding modes. 157 patients who completed MBS studies were divided into three groups based on their feeding modes (oral, enteral, and rejected enteral feeding with oral feeding at own risk). Videos were analysed using the MBSImP. We evaluated the association of the oral, pharyngeal, and combined scores, with risk of admission for pneumonia and choking. Kaplan–Meier plots and log-rank tests were used to compare survival distributions among feeding groups. Cox regression models were generated to estimate hazard ratios (HRs) and 95% confidence intervals. Patients in the group that rejected enteral feeding scored the highest on the MBSImP, followed by enteral then oral feeding. Within the group that rejected enteral feeding, higher pharyngeal (HR = 3.73, p = 0.036) and combined scores (HR = 1.63, p = 0.034) significantly increased the risk of pneumonia and choking. In the enteral feeding group, higher oral subscores (HR = 2.16, p = 0.011) increased risk for the event, while higher pharyngeal (HR = 0.40, p = 0.004) subscores reduced risk for pneumonia and choking. This is the first study to analyse the association of MBSImP scores with clinical outcomes in PD patients. Patients who rejected enteral feeding had the highest risk for pneumonia and choking that could be predicted by their MBSImP scores. In the enteral feeding group, this risk was partially reversed. Compliance with feeding modes reduces the risk of pneumonia and choking.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U2MbSl

Introducing real-life listening features into the clinical test environment: Part I: Measuring the hearing performance and evaluating the listening effort of individuals with normal hearing

. (Source: Cochlear Implants International)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2V8XOag

The Modified Barium Swallow Impairment Profile as a Predictor of Clinical Outcomes of Admission for Pneumonia or Choking in Dysphagic Patients with Parkinson’s Disease

Abstract

Dysphagia increases risk of pneumonia in patients with Parkinson's disease (PD). However, no studies have investigated the association between objective measures of swallowing dysfunction and clinical outcomes. Therefore, we aimed to study the link between scores obtained on the modified barium swallow impairment scale profile (MBSImP) and hospital admissions for pneumonia and choking, in groups of patients with PD on different feeding modes. 157 patients who completed MBS studies were divided into three groups based on their feeding modes (oral, enteral, and rejected enteral feeding with oral feeding at own risk). Videos were analysed using the MBSImP. We evaluated the association of the oral, pharyngeal, and combined scores, with risk of admission for pneumonia and choking. Kaplan–Meier plots and log-rank tests were used to compare survival distributions among feeding groups. Cox regression models were generated to estimate hazard ratios (HRs) and 95% confidence intervals. Patients in the group that rejected enteral feeding scored the highest on the MBSImP, followed by enteral then oral feeding. Within the group that rejected enteral feeding, higher pharyngeal (HR = 3.73, p = 0.036) and combined scores (HR = 1.63, p = 0.034) significantly increased the risk of pneumonia and choking. In the enteral feeding group, higher oral subscores (HR = 2.16, p = 0.011) increased risk for the event, while higher pharyngeal (HR = 0.40, p = 0.004) subscores reduced risk for pneumonia and choking. This is the first study to analyse the association of MBSImP scores with clinical outcomes in PD patients. Patients who rejected enteral feeding had the highest risk for pneumonia and choking that could be predicted by their MBSImP scores. In the enteral feeding group, this risk was partially reversed. Compliance with feeding modes reduces the risk of pneumonia and choking.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2U2MbSl