Objectives: This study aimed to investigate hearing and auditory processing ability in primary school children with learning difficulties (LD). Design: A nonrandomized, cross-sectional single measure research design was used. A total of 486 children, aged 7.7 to 10.8 years and attending years 3 and 4 in six primary schools, were classified as having an LD (n = 67) or being typically developing (TD, n = 419). This classification was based on a Learning Score generated from their school report results and National Assessment Program – Literacy and Numeracy scores. All children attempted a conventional hearing assessment (CHA) involving pure-tone audiometry, tympanometry, acoustic reflexes (AR), and otoacoustic emissions (OAEs). Children returning pure-tone audiometry results within normal limits also attempted an auditory processing assessment (APA) including dichotic digits (DD) and low-pass filtered speech (LPFS) tests. Results: In children with LD, 21/67 (31.4%) failed the CHA, 20/58 (34.5%) failed the APA, and 32/58 (55.2%) failed the overall hearing assessment (OHA) if they failed either or both CHA and APA. In comparison, in TD children, 55/413 (13.3%) failed the CHA, 52/314 (16.6%) failed the APA, and 86/313 (27.5%) failed the OHA. Proportionally, children with LD were 2.4 times more likely than TD children to fail the CHA, 2.1 times more likely to fail the APA, and 2.0 times more likely to fail the OHA. In children who had completed the OHA, multiple linear regressions showed average AR thresholds, DD scores, and LPFS scores explained 13 to 18% of the variance in the Learning Score. Conclusion: The potential for hearing impairment should be investigated in children with LD. These investigations should begin with CHA, and for children returning normal-hearing thresholds, should continue with measures of AR, DD, and LPFS, to ensure these children receive the appropriate auditory support needed to enhance their learning. ACKNOWLEDGMENTS: All authors listed in this article contributed equally to this work. R.C., J.K., and W.J.W. designed the study. R.C. collected data with the patients. All authors discussed the results and implications and commented on the article at all stages. The authors have no conflicts of interest to disclose. Address for correspondence: Seong Min Robyn Choi, Hearing Research Unit for Children, Discipline of Audiology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072, Australia. E-mail: r.choi@uq.edu.au. Received January 4, 2018; accepted July 15, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Πέμπτη 6 Σεπτεμβρίου 2018
Top Scientist Says Japan's Decision To Financially Reward Fukushima Worker Is Not Based On Science
| Top Scientist Says Japan's Decision To Financially Reward Fukushima Worker Is Not Based On Science ForbesFull coverage |
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Loxo Oncology drug gains FDA Breakthrough status
| Loxo Oncology drug gains FDA Breakthrough status The AdvocateFull coverage |
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September Is Thyroid Cancer Awareness Month
| September Is Thyroid Cancer Awareness Month Newswise (press release)Full coverage |
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Why The Cancer Death Of A Fukushima Worker Was Likely Not Due To Fukushima
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Hearing and Auditory Processing Abilities in Primary School Children with Learning Difficulties
Objectives: This study aimed to investigate hearing and auditory processing ability in primary school children with learning difficulties (LD). Design: A nonrandomized, cross-sectional single measure research design was used. A total of 486 children, aged 7.7 to 10.8 years and attending years 3 and 4 in six primary schools, were classified as having an LD (n = 67) or being typically developing (TD, n = 419). This classification was based on a Learning Score generated from their school report results and National Assessment Program – Literacy and Numeracy scores. All children attempted a conventional hearing assessment (CHA) involving pure-tone audiometry, tympanometry, acoustic reflexes (AR), and otoacoustic emissions (OAEs). Children returning pure-tone audiometry results within normal limits also attempted an auditory processing assessment (APA) including dichotic digits (DD) and low-pass filtered speech (LPFS) tests. Results: In children with LD, 21/67 (31.4%) failed the CHA, 20/58 (34.5%) failed the APA, and 32/58 (55.2%) failed the overall hearing assessment (OHA) if they failed either or both CHA and APA. In comparison, in TD children, 55/413 (13.3%) failed the CHA, 52/314 (16.6%) failed the APA, and 86/313 (27.5%) failed the OHA. Proportionally, children with LD were 2.4 times more likely than TD children to fail the CHA, 2.1 times more likely to fail the APA, and 2.0 times more likely to fail the OHA. In children who had completed the OHA, multiple linear regressions showed average AR thresholds, DD scores, and LPFS scores explained 13 to 18% of the variance in the Learning Score. Conclusion: The potential for hearing impairment should be investigated in children with LD. These investigations should begin with CHA, and for children returning normal-hearing thresholds, should continue with measures of AR, DD, and LPFS, to ensure these children receive the appropriate auditory support needed to enhance their learning. ACKNOWLEDGMENTS: All authors listed in this article contributed equally to this work. R.C., J.K., and W.J.W. designed the study. R.C. collected data with the patients. All authors discussed the results and implications and commented on the article at all stages. The authors have no conflicts of interest to disclose. Address for correspondence: Seong Min Robyn Choi, Hearing Research Unit for Children, Discipline of Audiology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072, Australia. E-mail: r.choi@uq.edu.au. Received January 4, 2018; accepted July 15, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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FDA gives Loxo breakthrough tag for second cancer drug
| FDA gives Loxo breakthrough tag for second cancer drug PMLiVEFull coverage |
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Top Scientist Says Japan's Decision To Financially Reward Fukushima Worker Is Not Based On Science
| Top Scientist Says Japan's Decision To Financially Reward Fukushima Worker Is Not Based On Science ForbesFull coverage |
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Head and Neck Cancer Treatment Market Key Players, Industry Overview, Demand & Supply Chain Analysis, Forecast ...
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Loxo Oncology drug gains FDA Breakthrough status
| Loxo Oncology drug gains FDA Breakthrough status The AdvocateFull coverage |
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Biotech Dives After Experimental Lung Cancer Regimen Disappoints
| Biotech Dives After Experimental Lung Cancer Regimen Disappoints Investor's Business DailyAdaptimmune Therapeutics (ADAP) versus Iovance Biotherapeutics (IOVA) Head to Head Contrast Marea Informative (blog)Full coverage |
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Dr. Succaria on Targetable Immune Checkpoints in Head and Neck Cancer
| Dr. Succaria on Targetable Immune Checkpoints in Head and Neck Cancer OncLiveFull coverage |
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Treatment for Hurthle cell thyroid cancer may involve removing part or all of thyroid
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Anti-PD-1 drugs may cause hyperprogressive disease in lung cancer
| Anti-PD-1 drugs may cause hyperprogressive disease in lung cancer HealioFull coverage |
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September Is Thyroid Cancer Awareness Month
| September Is Thyroid Cancer Awareness Month Newswise (press release)Full coverage |
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Head and Neck Cancer Market | Current Trends And Emerging Estimations Through 2018-2026
| Head and Neck Cancer Market | Current Trends And Emerging Estimations Through 2018-2026 Business StrategiesFull coverage |
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Why The Cancer Death Of A Fukushima Worker Was Likely Not Due To Fukushima
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Clinical Trial Suggests New Direction for Heavy-Smoking Head and Neck Cancer Patients
| Clinical Trial Suggests New Direction for Heavy-Smoking Head and Neck Cancer Patients R & D MagazineFull coverage |
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FDA gives Loxo breakthrough tag for second cancer drug
| FDA gives Loxo breakthrough tag for second cancer drug PMLiVEFull coverage |
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Head and Neck Cancer Treatment Market Key Players, Industry Overview, Demand & Supply Chain Analysis, Forecast ...
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Biotech Dives After Experimental Lung Cancer Regimen Disappoints
| Biotech Dives After Experimental Lung Cancer Regimen Disappoints Investor's Business DailyAdaptimmune Therapeutics (ADAP) versus Iovance Biotherapeutics (IOVA) Head to Head Contrast Marea Informative (blog)Full coverage |
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Dr. Succaria on Targetable Immune Checkpoints in Head and Neck Cancer
| Dr. Succaria on Targetable Immune Checkpoints in Head and Neck Cancer OncLiveFull coverage |
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Anti-PD-1 drugs may cause hyperprogressive disease in lung cancer
| Anti-PD-1 drugs may cause hyperprogressive disease in lung cancer HealioFull coverage |
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Head and Neck Cancer Market | Current Trends And Emerging Estimations Through 2018-2026
| Head and Neck Cancer Market | Current Trends And Emerging Estimations Through 2018-2026 Business StrategiesFull coverage |
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Clinical Trial Suggests New Direction for Heavy-Smoking Head and Neck Cancer Patients
| Clinical Trial Suggests New Direction for Heavy-Smoking Head and Neck Cancer Patients R & D MagazineFull coverage |
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Precise control of maxillary multidirectional movement in Le Fort I osteotomy using a surgical guiding device
We introduced a surgical protocol to achieve accurate maxillary multidirectional movement in Le Fort I osteotomies. This comprised a way of controlling precision and a guiding device together with prebent titanium plates. We evaluated the protocol using a semiautomated 3-dimensional assessment in 22 patients with maxillary multidirectional movement (movement in three or more of six directions). Operations were all done between October 2015 and April 2017 by the same surgeon, who followed the protocol strictly. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Orthodromic transfer of the temporalis tendon with extension of the fascia lata to reanimate the smile in facial palsy
Facial nerve palsy is a debilitating condition. The gold standard for facial reanimation is free tissue transfer with cross-facial grafts,1,2 but the outcome is unpredictable and the procedure depends upon the precision with which the technique is used. Orthodromic transfer of the temporalis muscle with or without an extension graft can re-establish the harmony of facial muscles during rest and animation.3,4 Unlike other techniques, it is predictable and offers early animation of the oral commissure and lower face. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Innovative use of a stereolithographic model together with the mirror image technique to reconstruct a defect in mandibular continuity
Reconstruction of mandibular defects after resection of a tumour is complicated by anatomical and functional complexities,1 and autografts together with reconstruction plates are among the most commonly used techniques. One shortcoming is the relatively long time spent on bending the plate during the operation, which not only increases the operating time, but also causes metal fatigue of the plate.1,2 Ideal symmetry between the affected and non-affected sides is impossible to achieve, but the use of a stereolithographic model (introduced in the 1980s3), combined with mirroring and superimposition of the non-affected side on to the affected side, is a suitable way to reduce or eliminate these complications. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Orthodromic transfer of the temporalis tendon with extension of the fascia lata to reanimate the smile in facial palsy
Facial nerve palsy is a debilitating condition. The gold standard for facial reanimation is free tissue transfer with cross-facial grafts,1,2 but the outcome is unpredictable and the procedure depends upon the precision with which the technique is used. Orthodromic transfer of the temporalis muscle with or without an extension graft can re-establish the harmony of facial muscles during rest and animation.3,4 Unlike other techniques, it is predictable and offers early animation of the oral commissure and lower face. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Innovative use of a stereolithographic model together with the mirror image technique to reconstruct a defect in mandibular continuity
Reconstruction of mandibular defects after resection of a tumour is complicated by anatomical and functional complexities,1 and autografts together with reconstruction plates are among the most commonly used techniques. One shortcoming is the relatively long time spent on bending the plate during the operation, which not only increases the operating time, but also causes metal fatigue of the plate.1,2 Ideal symmetry between the affected and non-affected sides is impossible to achieve, but the use of a stereolithographic model (introduced in the 1980s3), combined with mirroring and superimposition of the non-affected side on to the affected side, is a suitable way to reduce or eliminate these complications. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Molecular pathogenesis of proliferative verrucous leucoplakia: a systematic review
Proliferative verrucous leucoplakia (PVL) is a potentially premalignant lesion that undergoes malignant transformation in over 40% of cases. Its clinical homogeneity suggests that a single or a small number of molecular pathogenic pathways may exist. Using the Cochrane protocol for systematic reviews, we have looked at the reported evidence of the molecular aetiology and pathogenesis of PVL and compared it with that of conventional oral epithelial dysplasia (OED). Of the 43 papers studied, 19 met the inclusion criteria including 13 proteins assayed in 344 tissues, and genes investigated were TP53, p14ARF, and p16INK4A. (Source: The British Journal of Oral and Maxillofacial Surgery)
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Pediatric radiology outreach — World Federation of Pediatric Imaging commentary on opportunities and challenges
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Pediatric radiology outreach — World Federation of Pediatric Imaging commentary on opportunities and challenges
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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [REMEDYREPACK INC.]
Updated Date: Sep 6, 2018 EST (Source: DailyMed Drug Label Updates)
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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ALLERGY RESCUE (Acetylcholine Chloride, Histaminum Hydrochloricum, Serotonin (Hydrochloride)) Liquid [Deseret Biologicals, Inc.]
Updated Date: Aug 30, 2018 EST (Source: DailyMed Drug Label Updates)
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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [REMEDYREPACK INC.]
Updated Date: Sep 6, 2018 EST (Source: DailyMed Drug Label Updates)
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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ALLERGY RESCUE (Acetylcholine Chloride, Histaminum Hydrochloricum, Serotonin (Hydrochloride)) Liquid [Deseret Biologicals, Inc.]
Updated Date: Aug 30, 2018 EST (Source: DailyMed Drug Label Updates)
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Impact of Prior Pulmonary Tuberculosis in Treatment Outcomes of HCAP and CAP Patients in Intensive Care Units
ConclusionHistory of prior PTB is an independent clinical factor for increased 30-day mortality rate in ICU-admitted CAP patients, but not in ICU-admitted HCAP patients. (Source: Journal of Microbiology, Immunology and Infection)
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Gap Arthroplasty or Interpositional Arthroplasty for the Management of TMJ Ankylosis? A Prospective Randomized Comparative Multicenter Clinical Trial
Abstract
Aim
The main aim of this study is to compare the gap arthroplasty with interpositional gap arthroplasty for the management of TMJ ankylosis.
Methodology
A prospective randomized multicenter clinical trial had been performed, on 60 patients diagnosed with TMJ ankylosis from August 2005 to June 2015. Patients were equally divided into two groups: Group I patients were treated with gap arthroplasty, while patients in Group II were treated with interpositional arthroplasty.
Results
The mean age in Group I was 27.9 years and in Group II was 25.6 years. Trauma was the common etiological factor in both the groups. The mean postoperative mouth opening after 1 month, 6 months and 24 months was found to better in Group II. Open bite after 24 months was present in six patients in Group I and in one case in Group II. Permanent facial nerve palsy was present in one patient in both the groups. Frey's syndrome was present in one patient from Group I and none from Group II. Reoccurrence occurred in eight cases from Group I (26.6%) and none from Group II.
Conclusion
This study concluded that interpositional arthroplasty is better than gap arthroplasty in terms of mouth opening and reankylosis.
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Impact of Prior Pulmonary Tuberculosis in Treatment Outcomes of HCAP and CAP Patients in Intensive Care Units
ConclusionHistory of prior PTB is an independent clinical factor for increased 30-day mortality rate in ICU-admitted CAP patients, but not in ICU-admitted HCAP patients. (Source: Journal of Microbiology, Immunology and Infection)
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Microbiological features, clinical characteristics and outcomes of infective endocarditis in adults with and without hemodialysis: a 10-year retrospective study in Northern Taiwan
ConclusionAdvanced age, sex (female), comorbidities, diabetes mellitus, and hypertension were more common in HD patients than in non-HD patients with IE. HD patients had higher proportion of methicillin-resistant S. aureus and cardiac complication rates than non-HD patients with IE. Culture-negative IE was more common in non-HD patients. (Source: Journal of Microbiology, Immunology and Infection)
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Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Few studies have shown MR imaging features and ADC correlating with molecular markers and survival in patients with glioma. Our purpose was to correlate MR imaging features and ADC with molecular subtyping and survival in adult diffuse gliomas.
MATERIALS AND METHODS:Presurgical MRIs and ADC maps of 131 patients with diffuse gliomas and available molecular and survival data from The Cancer Genome Atlas were reviewed. MR imaging features, ADC (obtained by ROIs within the lowest ADC area), and mean relative ADC values were evaluated to predict isocitrate dehydrogenase (IDH) mutation, 1p/19q codeletion status, MGMT promoter methylation, and overall survival.
RESULTS:IDH wild-type gliomas tended to exhibit enhancement, necrosis, and edema; >50% enhancing area (P < .001); absence of a cystic area (P = .013); and lower mean relative ADC (median, 1.1 versus 1.6; P < .001) than IDH-mutant gliomas. By means of a cutoff value of 1.08 for mean relative ADC, IDH-mutant and IDH wild-type gliomas with lower mean relative ADC (<1.08) had poorer survival than those with higher mean relative ADC (median survival time, 24.2 months; 95% CI, 0.0–54.9 months versus 62.0 months; P = .003; and median survival time, 10.4 months; 95% CI, 4.4–16.4 months versus 17.7 months; 95% CI, 11.6–23.7 months; P = .041, respectively), regardless of World Health Organization grade. Median survival of those with IDH-mutant glioma with low mean relative ADC was not significantly different from that in those with IDH wild-type glioma. Other MR imaging features were not statistically significant predictors of survival.
CONCLUSIONS:IDH wild-type glioma showed lower ADC values, which also correlated with poor survival in both IDH-mutant and IDH wild-type gliomas, irrespective of histologic grade. A subgroup with IDH-mutant gliomas with lower ADC had dismal survival similar to that of those with IDH wild-type gliomas.
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Reply: [LETTERS]
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Comment on "Blood Flow Mimicking Aneurysmal Wall Enhancement: A Diagnostic Pitfall of Vessel Wall MRI Using the Postcontrast 3D Turbo Spin-Echo MR Imaging Sequence" [LETTERS]
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Near-Term Decrease in Brain Volume following Mild Traumatic Injury Is Detectible in the Context of Preinjury Volumetric Stability: Neurobiologic Insights from Analysis of Historical Imaging Examinations [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Neurodegeneration after mild traumatic brain injury may manifest as decreasing regional brain volume that evolves from months to years following mild traumatic brain injury and is associated with worse clinical outcomes. We hypothesized that quantitative brain volume derived from CT of the head, performed for clinical indications during routine care, would change with time and provide insights into the putative neuroinflammatory response to mild traumatic brain injury.
MATERIALS AND METHODS:We searched the electronic medical record of our institution for NCCTs of the head performed in patients with mild traumatic brain injury and included those who also underwent NCCTs of the head 1 month to 1 year before and after mild traumatic brain injury for an indication unrelated to trauma. Controls underwent 3 sequential NCCTs of the head with indications unrelated to trauma. The whole-brain and intracranial volume groups were computed using ITK-SNAP. Brain volumes normalized to intracranial volumes were compared across time points using the Wilcoxon signed-rank test.
RESULTS:We identified 48 patients from 2005 to 2015 who underwent NCCTs of the head in the emergency department for mild traumatic brain injury and had NCCTs of the head performed both before and after mild traumatic brain injury. Median normalized brain volumes significantly decreased on the follow-up study post-mild traumatic brain injury (0.86 versus 0.84, P < .001) and were similar compared with pre-mild traumatic brain injury studies (0.87 versus 0.86, P = .927). There was no significant difference between normalized brain volumes in the 48 controls.
CONCLUSIONS:A decrease in brain volume following mild traumatic brain injury is detectable on CT and is not seen in similar patients with non-mild traumatic brain injury during a similar timeframe. Given the stability of brain volume before mild traumatic brain injury, CT volume loss may represent the subtle effects of neurodegeneration.
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Apparent Diffusion Coefficient Levels and Neurodevelopmental Outcome in Fetuses with Brain MR Imaging White Matter Hyperintense Signal [PEDIATRICS]
BACKGROUND AND PURPOSE:
One of the perplexing findings of fetal brain MR imaging is white matter T2 hyperintense signal. The aims of our study were initially to determine the main etiologies associated with white matter T2 hyperintense signal, then to examine whether the different etiologies have different ADC values, and, last, to assess the association of white matter T2 hyperintense signal with developmental outcome.
MATERIALS AND METHODS:This was a prospective cohort study of 44 MR imaging scans of fetal brains obtained for suspected brain pathologies at a tertiary medical center during 2011–2015. Clinical data were collected from electronic medical charts. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes. Neurodevelopmental assessments were performed with the Vineland Adaptive Behavior Scales II.
RESULTS:Half of the cases of MRI hyperintense T2 signal of the fetal brain were associated with congenital cytomegalovirus infection. The other half were mainly idiopathic. Thus, the study group was divided to subgroups positive and negative for cytomegalovirus. Both groups had hyperintense signal in the temporal lobe. The group positive for cytomegalovirus had involvement of the parietal lobe. Only this group had increased ADC values in the temporal and parietal lobes. There was no association between the neurodevelopment outcome and the etiologies or ADC values.
CONCLUSIONS:T2 hyperintense signal in fetal brain MRI associated with positive cytomegalovirus infection has increased ADC values in the temporal and parietal lobes, suggestive of brain edema in these areas. However, the association between this finding and neurodevelopment outcome requires further evaluation.
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Cochlear Implantation: An Overview
J Neurol Surg B DOI: 10.1055/s-0038-1669411A cochlear implant (CI) is a surgically implanted device for the treatment of severe to profound sensorineural hearing loss in children and adults. It works by transducing acoustic energy into an electrical signal, which is used to stimulate surviving spiral ganglion cells of the auditory nerve. The past 2 decades have witnessed an exponential rise in the number of CI surgeries performed. Continual developments in programming strategies, device design, and minimally traumatic surgical technique have demonstrated the safety and efficacy of CI surgery. As a result, candidacy guidelines have expanded to include both pre and postlingually deaf children as young as 1 year of age, and those with greater degrees of residual hearing. A growing proportio...
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Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Few studies have shown MR imaging features and ADC correlating with molecular markers and survival in patients with glioma. Our purpose was to correlate MR imaging features and ADC with molecular subtyping and survival in adult diffuse gliomas.
MATERIALS AND METHODS:Presurgical MRIs and ADC maps of 131 patients with diffuse gliomas and available molecular and survival data from The Cancer Genome Atlas were reviewed. MR imaging features, ADC (obtained by ROIs within the lowest ADC area), and mean relative ADC values were evaluated to predict isocitrate dehydrogenase (IDH) mutation, 1p/19q codeletion status, MGMT promoter methylation, and overall survival.
RESULTS:IDH wild-type gliomas tended to exhibit enhancement, necrosis, and edema; >50% enhancing area (P < .001); absence of a cystic area (P = .013); and lower mean relative ADC (median, 1.1 versus 1.6; P < .001) than IDH-mutant gliomas. By means of a cutoff value of 1.08 for mean relative ADC, IDH-mutant and IDH wild-type gliomas with lower mean relative ADC (<1.08) had poorer survival than those with higher mean relative ADC (median survival time, 24.2 months; 95% CI, 0.0–54.9 months versus 62.0 months; P = .003; and median survival time, 10.4 months; 95% CI, 4.4–16.4 months versus 17.7 months; 95% CI, 11.6–23.7 months; P = .041, respectively), regardless of World Health Organization grade. Median survival of those with IDH-mutant glioma with low mean relative ADC was not significantly different from that in those with IDH wild-type glioma. Other MR imaging features were not statistically significant predictors of survival.
CONCLUSIONS:IDH wild-type glioma showed lower ADC values, which also correlated with poor survival in both IDH-mutant and IDH wild-type gliomas, irrespective of histologic grade. A subgroup with IDH-mutant gliomas with lower ADC had dismal survival similar to that of those with IDH wild-type gliomas.
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Reply: [LETTERS]
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Comment on "Blood Flow Mimicking Aneurysmal Wall Enhancement: A Diagnostic Pitfall of Vessel Wall MRI Using the Postcontrast 3D Turbo Spin-Echo MR Imaging Sequence" [LETTERS]
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Near-Term Decrease in Brain Volume following Mild Traumatic Injury Is Detectible in the Context of Preinjury Volumetric Stability: Neurobiologic Insights from Analysis of Historical Imaging Examinations [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Neurodegeneration after mild traumatic brain injury may manifest as decreasing regional brain volume that evolves from months to years following mild traumatic brain injury and is associated with worse clinical outcomes. We hypothesized that quantitative brain volume derived from CT of the head, performed for clinical indications during routine care, would change with time and provide insights into the putative neuroinflammatory response to mild traumatic brain injury.
MATERIALS AND METHODS:We searched the electronic medical record of our institution for NCCTs of the head performed in patients with mild traumatic brain injury and included those who also underwent NCCTs of the head 1 month to 1 year before and after mild traumatic brain injury for an indication unrelated to trauma. Controls underwent 3 sequential NCCTs of the head with indications unrelated to trauma. The whole-brain and intracranial volume groups were computed using ITK-SNAP. Brain volumes normalized to intracranial volumes were compared across time points using the Wilcoxon signed-rank test.
RESULTS:We identified 48 patients from 2005 to 2015 who underwent NCCTs of the head in the emergency department for mild traumatic brain injury and had NCCTs of the head performed both before and after mild traumatic brain injury. Median normalized brain volumes significantly decreased on the follow-up study post-mild traumatic brain injury (0.86 versus 0.84, P < .001) and were similar compared with pre-mild traumatic brain injury studies (0.87 versus 0.86, P = .927). There was no significant difference between normalized brain volumes in the 48 controls.
CONCLUSIONS:A decrease in brain volume following mild traumatic brain injury is detectable on CT and is not seen in similar patients with non-mild traumatic brain injury during a similar timeframe. Given the stability of brain volume before mild traumatic brain injury, CT volume loss may represent the subtle effects of neurodegeneration.
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Apparent Diffusion Coefficient Levels and Neurodevelopmental Outcome in Fetuses with Brain MR Imaging White Matter Hyperintense Signal [PEDIATRICS]
BACKGROUND AND PURPOSE:
One of the perplexing findings of fetal brain MR imaging is white matter T2 hyperintense signal. The aims of our study were initially to determine the main etiologies associated with white matter T2 hyperintense signal, then to examine whether the different etiologies have different ADC values, and, last, to assess the association of white matter T2 hyperintense signal with developmental outcome.
MATERIALS AND METHODS:This was a prospective cohort study of 44 MR imaging scans of fetal brains obtained for suspected brain pathologies at a tertiary medical center during 2011–2015. Clinical data were collected from electronic medical charts. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes. Neurodevelopmental assessments were performed with the Vineland Adaptive Behavior Scales II.
RESULTS:Half of the cases of MRI hyperintense T2 signal of the fetal brain were associated with congenital cytomegalovirus infection. The other half were mainly idiopathic. Thus, the study group was divided to subgroups positive and negative for cytomegalovirus. Both groups had hyperintense signal in the temporal lobe. The group positive for cytomegalovirus had involvement of the parietal lobe. Only this group had increased ADC values in the temporal and parietal lobes. There was no association between the neurodevelopment outcome and the etiologies or ADC values.
CONCLUSIONS:T2 hyperintense signal in fetal brain MRI associated with positive cytomegalovirus infection has increased ADC values in the temporal and parietal lobes, suggestive of brain edema in these areas. However, the association between this finding and neurodevelopment outcome requires further evaluation.
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Cochlear Implantation: An Overview
J Neurol Surg B DOI: 10.1055/s-0038-1669411A cochlear implant (CI) is a surgically implanted device for the treatment of severe to profound sensorineural hearing loss in children and adults. It works by transducing acoustic energy into an electrical signal, which is used to stimulate surviving spiral ganglion cells of the auditory nerve. The past 2 decades have witnessed an exponential rise in the number of CI surgeries performed. Continual developments in programming strategies, device design, and minimally traumatic surgical technique have demonstrated the safety and efficacy of CI surgery. As a result, candidacy guidelines have expanded to include both pre and postlingually deaf children as young as 1 year of age, and those with greater degrees of residual hearing. A growing proportio...
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A Computational Model of Thalamocortical Dysrhythmia in People With Tinnitus
Tinnitus is a problem that affects a diverse range of people. One common trait amongst people with tinnitus is the presence of hearing loss, which is apparent in over 90% of the cohort. It is postulated that the remainder of people with tinnitus have hidden hearing loss in the form of cochlear synaptopathy. The loss of hearing sensation is thought to cause a reduction in the bottom-up excitatory signals of the auditory pathway leading to a change in the frequency of thalamocortical oscillations known as thalamocortical dysrhythmia (TCD). The downward shift in oscillatory behavior, characteristic of TCD, has been recorded experimentally but the underlying mechanisms responsible for TCD in tinnitus subjects cannot be directly observed. This paper investigates these underlying mechanis...
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Test-retest reliability and measurement error of the Danish WHO-5 Well-being Index in outpatients with epilepsy
The generic questionnaire WHO-5 Well-being Index (WHO-5), which measures the construct of mental well-being has been widely used in several populations across countries. The questionnaire has demonstrated suff...
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Test-retest reliability and measurement error of the Danish WHO-5 Well-being Index in outpatients with epilepsy
The generic questionnaire WHO-5 Well-being Index (WHO-5), which measures the construct of mental well-being has been widely used in several populations across countries. The questionnaire has demonstrated suff...
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Safety in Anesthesia: Latin American Perspective
Abstract
Purpose of Review
This review intends to broadly illustrate the current anesthesia safety issues in Latin America, discussing the residency training schemes, anesthesia workforce shortages, equipment shortages, and safety initiatives in Latin America that include minimum standards and adverse event reporting systems.
Recent Findings
Latin America's distinction is that of a continent of major contrasts which poses major difficulties as quality of anesthesia care ranges between that of high-income countries to that of very low income nations. A major effort to attenuate these is the creation and adoption of mandatory national standards that aim to guarantee that even in the worst conditions, minimal safety strategies are met to safeguard patients. Colombia's and Brazil's anesthesia societies have been at the forefront in Latin America in developing strategies to promote anesthesia safety.
Summary
The creation, promotion, and adoption of Minimal Standards has been key to improve anesthesia safety in the continent.
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Safety in Anesthesia: Latin American Perspective
Abstract
Purpose of Review
This review intends to broadly illustrate the current anesthesia safety issues in Latin America, discussing the residency training schemes, anesthesia workforce shortages, equipment shortages, and safety initiatives in Latin America that include minimum standards and adverse event reporting systems.
Recent Findings
Latin America's distinction is that of a continent of major contrasts which poses major difficulties as quality of anesthesia care ranges between that of high-income countries to that of very low income nations. A major effort to attenuate these is the creation and adoption of mandatory national standards that aim to guarantee that even in the worst conditions, minimal safety strategies are met to safeguard patients. Colombia's and Brazil's anesthesia societies have been at the forefront in Latin America in developing strategies to promote anesthesia safety.
Summary
The creation, promotion, and adoption of Minimal Standards has been key to improve anesthesia safety in the continent.
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Modulation of growth performance and nonspecific immunity of red swamp crayfish Procambarus clarkia upon dietary fulvic acid supplementation
Publication date: Available online 6 September 2018Source: Fish & Shellfish ImmunologyAuthor(s): Jingmin ZhangAbstractAn eight-week experiment was conducted to determine the effects of dietary fulvic acids (FAs) on the growth performance, digestive enzymes and nonspecific immunity of red swamp crayfish Procambarus clarkia. Three diets supplemented with three different levels of FAs (0.1, 0.5 and 1 g kg−1) were formulated and tested for the growth performance, digestive enzymes and nonspecific immunity of the crayfish, and a diet without FAs served as control. After eight weeks of feeding, survival rate, phenoloxidase activity, superoxide dismutase activity, glutathione peroxidase level, total haemocyte count and number of hyaline cells, semigranular cells and granular cells and resis...
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Modulation of growth performance and nonspecific immunity of red swamp crayfish Procambarus clarkia upon dietary fulvic acid supplementation
Publication date: Available online 6 September 2018Source: Fish & Shellfish ImmunologyAuthor(s): Jingmin ZhangAbstractAn eight-week experiment was conducted to determine the effects of dietary fulvic acids (FAs) on the growth performance, digestive enzymes and nonspecific immunity of red swamp crayfish Procambarus clarkia. Three diets supplemented with three different levels of FAs (0.1, 0.5 and 1 g kg−1) were formulated and tested for the growth performance, digestive enzymes and nonspecific immunity of the crayfish, and a diet without FAs served as control. After eight weeks of feeding, survival rate, phenoloxidase activity, superoxide dismutase activity, glutathione peroxidase level, total haemocyte count and number of hyaline cells, semigranular cells and granular cells and resis...
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[The Kangaroo Mother Care Program of Yopal, Colombia: an opportunity to keep track of preterm infants].
CONCLUSION : It is important to implement KMCP in intermediate and isolated cities to ensure a high-risk follow-up for all LBW and / or premature babies, to detect somatic, sensory or neuro-psychomotor development anomalies and to perform timely interventions. PMID: 30183879 [PubMed - in process] (Source: Revista de Salud Publica)
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[The Kangaroo Mother Care Program of Yopal, Colombia: an opportunity to keep track of preterm infants].
CONCLUSION : It is important to implement KMCP in intermediate and isolated cities to ensure a high-risk follow-up for all LBW and / or premature babies, to detect somatic, sensory or neuro-psychomotor development anomalies and to perform timely interventions. PMID: 30183879 [PubMed - in process] (Source: Revista de Salud Publica)
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Untersuchung der Qualität der Hörgeräteversorgung bei Senioren unter Berücksichtigung kognitiver Einflussfaktoren
Laryngo-Rhino-Otol
DOI: 10.1055/a-0671-2295
In der Gruppe der über 65-Jährigen ist die Hörminderung eines der häufigsten gesundheitlichen Probleme. Um die Kommunikationsfähigkeit in dieser Population aufrecht zu erhalten, ist eine adäquate Hörgeräteversorgung essentiell. Das Ziel der vorliegenden Studie war die Überprüfung der Qualität der Hörgeräteversorgung bei Senioren in Bezug auf die Wiederherstellung der Sprachdiskrimination. Weiterhin sollte der Einfluss des Alters und einiger kognitiver Parameter auf das Sprachverstehen betrachtet werden. Es wurden 40 Probanden im Alter von 66 bis 88 Jahren mit ein- oder beidseitiger Hörgeräteversorgung untersucht. Es wurde der gemittelte Hörverlust der Frequenzen 0,5–1-2–4 kHz und der gemittelte Hochton-Hörverlust bei den Frequenzen 2–4-6 kHz sowie das maximale Einsilberverstehen (mEV) und das hörgeräteversorgte Sprachverstehen bei 65 dB betrachtet. Um mögliche kognitive Einflussfaktoren zu ermitteln, wurden ein Demenzscreening-Verfahren (DemTect-Test) und ein Test zur Prüfung des Arbeitsgedächtnisses angewendet. Zwar zeigte sich ein Gewinn durch die Hörgeräteversorgung in 82 % der untersuchten Fälle, die nach Hilfsmittelrichtlinie geforderte Verbesserung von mindestens 20 % gegenüber der unversorgten Situation wurde jedoch in 56 % der Fälle nicht erreicht. Weiterhin wurde das individuelle mEV mit Abweichung von höchstens zehn Prozentpunkten von 81 % aller Fälle nicht erreicht. Signifikante Korrelationen zwischen Zahlenfolgen-Merkspanne bzw. DemTect-Ergebnis und mEV konnten nicht festgestellt werden. Im untersuchten Probandenkollektiv ergaben sich auch keine Hinweise für eine Abhängigkeit des Ergebnisses der Hörgeräteversorgung vom Lebensalter oder von (milder) kognitiver Beeinträchtigung sowie reduzierter Arbeitsgedächtnisleistung.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Gap Arthroplasty or Interpositional Arthroplasty for the Management of TMJ Ankylosis? A Prospective Randomized Comparative Multicenter Clinical Trial
Abstract
Aim
The main aim of this study is to compare the gap arthroplasty with interpositional gap arthroplasty for the management of TMJ ankylosis.
Methodology
A prospective randomized multicenter clinical trial had been performed, on 60 patients diagnosed with TMJ ankylosis from August 2005 to June 2015. Patients were equally divided into two groups: Group I patients were treated with gap arthroplasty, while patients in Group II were treated with interpositional arthroplasty.
Results
The mean age in Group I was 27.9 years and in Group II was 25.6 years. Trauma was the common etiological factor in both the groups. The mean postoperative mouth opening after 1 month, 6 months and 24 months was found to better in Group II. Open bite after 24 months was present in six patients in Group I and in one case in Group II. Permanent facial nerve palsy was present in one patient in both the groups. Frey's syndrome was present in one patient from Group I and none from Group II. Reoccurrence occurred in eight cases from Group I (26.6%) and none from Group II.
Conclusion
This study concluded that interpositional arthroplasty is better than gap arthroplasty in terms of mouth opening and reankylosis.
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Is quantitative sIgE serology suitable to distinguish between silent sensitization and allergic rhinitis to D. pteronyssinus?
CONCLUSIONS: Despite the high correlation between sIgE levels and symptoms, no serologic parameter had a sufficiently high accuracy to distinguish between silent sensitization and clinically relevant allergy. Therefore, nasal provocation tests remain the gold-standard to investigate the clinical relevance in Dermatophagoides pteronyssinus sensitization. PMID: 30183658 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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False-positive results of serological tests for allergy in alcoholics.
CONCLUSIONS: Serological tests for allergy should be interpreted with caution in alcoholics, who frequently show increased levels of total IgE, CCD-sIgE and subsequent positivity of sIgE to glycosylated allergen components, irrespective of the method used. PMID: 30183656 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Hymenoptera Venom Allergy: Management of children and adults in clinical practice.
This report on the management of children and adults allergic to Hymenoptera venom was drawn up by a panel of Italian experts. The main objective of this consensus is to review the scientific evidences related to diagnosis, therapy and management of patients allergic to Hymenoptera venom and is aimed to improve the knowledge about this disease and promote good clinical practices. Practical suggestions for a correct diagnosis, prescription of emergency therapy and immunotherapy, as well as strategies for taking care of patients´ management are included. PMID: 30183660 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Accurate of the diagnosis of allergy reactions at the Emergency Department.
CONCLUSIONS: Of the 528 patients that finally underwent full allergological study, less than half could be confirmed as allergic. Moreover, there appears to be an underdiagnosis of anaphylaxis in ED. Better communication between ED and AD is necessary to improve this situation and improve the diagnosis and management of these patients. PMID: 30183657 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Elevated exhaled nitric oxide in adolescents relates to incident allergic symptoms: a prospective cohort study.
CONCLUSIONS: Elevated FeNO in adolescents related to an increased risk of developing allergic symptoms to cat and dog, but not pollen allergens, within four years. PMID: 30183659 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Limited long-term impact of insect venom immunotherapy on the micro-RNA landscape in whole blood.
CONCLUSIONS: Our results indicate an overall low effect of VIT on the miRNA expression pattern in whole blood. PMID: 30183661 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Autoimmune Aspects of Kawasaki Disease.
Authors: Sakurai Y Abstract Kawasaki disease (KD) is classified as a medium-sized vasculitis of systemic vasculitis syndrome characterized by hypercytokinemia. Although the etiology of KD remains unidentified, epidemiological features point to the role of infection and genetic predisposition. Recent studies revealed endothelial damage and resultant thrombin generation, as well as B-cell activation during the acute phase of KD. Several anti-endothelial cell autoantibodies (AECAs) have been identified in KD patients. Taken together with the recently developed concept of immunothrombosis, a potential pathogenic mechanism for KD emerges. First, some polyclonal antibodies generated against invading microorganisms would exhibit cross-reactivity toward endothelial cell components and beco...
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Is quantitative sIgE serology suitable to distinguish between silent sensitization and allergic rhinitis to D. pteronyssinus?
CONCLUSIONS: Despite the high correlation between sIgE levels and symptoms, no serologic parameter had a sufficiently high accuracy to distinguish between silent sensitization and clinically relevant allergy. Therefore, nasal provocation tests remain the gold-standard to investigate the clinical relevance in Dermatophagoides pteronyssinus sensitization. PMID: 30183658 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NTKuDL
False-positive results of serological tests for allergy in alcoholics.
CONCLUSIONS: Serological tests for allergy should be interpreted with caution in alcoholics, who frequently show increased levels of total IgE, CCD-sIgE and subsequent positivity of sIgE to glycosylated allergen components, irrespective of the method used. PMID: 30183656 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wRPqCr
Hymenoptera Venom Allergy: Management of children and adults in clinical practice.
This report on the management of children and adults allergic to Hymenoptera venom was drawn up by a panel of Italian experts. The main objective of this consensus is to review the scientific evidences related to diagnosis, therapy and management of patients allergic to Hymenoptera venom and is aimed to improve the knowledge about this disease and promote good clinical practices. Practical suggestions for a correct diagnosis, prescription of emergency therapy and immunotherapy, as well as strategies for taking care of patients´ management are included. PMID: 30183660 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Accurate of the diagnosis of allergy reactions at the Emergency Department.
CONCLUSIONS: Of the 528 patients that finally underwent full allergological study, less than half could be confirmed as allergic. Moreover, there appears to be an underdiagnosis of anaphylaxis in ED. Better communication between ED and AD is necessary to improve this situation and improve the diagnosis and management of these patients. PMID: 30183657 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Elevated exhaled nitric oxide in adolescents relates to incident allergic symptoms: a prospective cohort study.
CONCLUSIONS: Elevated FeNO in adolescents related to an increased risk of developing allergic symptoms to cat and dog, but not pollen allergens, within four years. PMID: 30183659 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Limited long-term impact of insect venom immunotherapy on the micro-RNA landscape in whole blood.
CONCLUSIONS: Our results indicate an overall low effect of VIT on the miRNA expression pattern in whole blood. PMID: 30183661 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)
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Autoimmune Aspects of Kawasaki Disease.
Authors: Sakurai Y Abstract Kawasaki disease (KD) is classified as a medium-sized vasculitis of systemic vasculitis syndrome characterized by hypercytokinemia. Although the etiology of KD remains unidentified, epidemiological features point to the role of infection and genetic predisposition. Recent studies revealed endothelial damage and resultant thrombin generation, as well as B-cell activation during the acute phase of KD. Several anti-endothelial cell autoantibodies (AECAs) have been identified in KD patients. Taken together with the recently developed concept of immunothrombosis, a potential pathogenic mechanism for KD emerges. First, some polyclonal antibodies generated against invading microorganisms would exhibit cross-reactivity toward endothelial cell components and beco...
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“The validity of the EQ-5D-5L in measuring quality of life benefits of breast reconstruction”
The EuroQol EQ-5D-5L instrument is the most widely-used quality of life measure in health economic evaluations. It is unclear whether such a generic instrument is valid enough to estimate the benefits of breast reconstruction (BR), given the specific changes observed in quality of life after BR. Hence, we aimed to evaluate the validity of EQ-5D-5L in patients who had undergone postmastectomy BR.
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Precise control of maxillary multidirectional movement in Le Fort I osteotomy using a surgical guiding device
We introduced a surgical protocol to achieve accurate maxillary multidirectional movement in Le Fort I osteotomies. This comprised a way of controlling precision and a guiding device together with prebent titanium plates. We evaluated the protocol using a semiautomated 3-dimensional assessment in 22 patients with maxillary multidirectional movement (movement in three or more of six directions). Operations were all done between October 2015 and April 2017 by the same surgeon, who followed the protocol strictly.
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Noise-Induced Hypersensitization of the Acoustic Startle Response in Larval Zebrafish
ABSTRACTOverexposure to loud noise is known to lead to deficits in auditory sensitivity and perception. We studied the effects of noise exposure on sensorimotor behaviors of larval (5 –7 days post-fertilization) zebrafish (Danio rerio), particularly the auditory-evoked startle response and hearing sensitivity to acoustic startle stimuli. We observed a temporary 10 –15 dB decrease in startle response threshold after 18 h of flat-spectrum noise exposure at 20 dB re·1 ms−2. Larval zebrafish also exhibited decreased habituation to startle-inducing stimuli following noise exposure. The noise-induced sensitization was not due to changes in absolute hearing thresholds, but was specific to the auditory-evoked escape responses. The observed noise-induced sensitization was disrupted by AM...
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Surface Motion of Tympanic Membrane in a Chinchilla Model of Acute Otitis Media
In this study, the TM surface motion was determined using scanning laser Doppler vibrometry (SLDV) in a chinchilla model of AOM. The AOM was established by transbullar injection of nontypeableHaemophilus influenzae. The TM surface vibration was measured in control (uninfected) animals and two AOM groups of animals: 4 days (4D) and 8 days (8D) post inoculation. To quantify the effect of middle ear pressure in those infected ears, the SLDV measurement was first conducted in unopened AOM ears and then in middle ear pressure released ears. Results showed that middle ear infection generally reduced the TM displace ment across the entire surface, but the reduction in the umbo displacement over the time course, from 4 to 8 days post inoculation, was less than the reduction in the displacement...
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A clinicopathologic study on central odontogenic fibroma: with special reference to amyloid variant
. To clarify the clinicopathological features of central odontogenic fibroma (OF), especially the amyloid variant, and to discuss its relationship with Langerhans cell variant of calcifying epithelial odontogenic tumor (CEOT).
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Noise-Induced Hypersensitization of the Acoustic Startle Response in Larval Zebrafish
ABSTRACTOverexposure to loud noise is known to lead to deficits in auditory sensitivity and perception. We studied the effects of noise exposure on sensorimotor behaviors of larval (5 –7 days post-fertilization) zebrafish (Danio rerio), particularly the auditory-evoked startle response and hearing sensitivity to acoustic startle stimuli. We observed a temporary 10 –15 dB decrease in startle response threshold after 18 h of flat-spectrum noise exposure at 20 dB re·1 ms−2. Larval zebrafish also exhibited decreased habituation to startle-inducing stimuli following noise exposure. The noise-induced sensitization was not due to changes in absolute hearing thresholds, but was specific to the auditory-evoked escape responses. The observed noise-induced sensitization was disrupted by AM...
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Surface Motion of Tympanic Membrane in a Chinchilla Model of Acute Otitis Media
In this study, the TM surface motion was determined using scanning laser Doppler vibrometry (SLDV) in a chinchilla model of AOM. The AOM was established by transbullar injection of nontypeableHaemophilus influenzae. The TM surface vibration was measured in control (uninfected) animals and two AOM groups of animals: 4 days (4D) and 8 days (8D) post inoculation. To quantify the effect of middle ear pressure in those infected ears, the SLDV measurement was first conducted in unopened AOM ears and then in middle ear pressure released ears. Results showed that middle ear infection generally reduced the TM displace ment across the entire surface, but the reduction in the umbo displacement over the time course, from 4 to 8 days post inoculation, was less than the reduction in the displacement...
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A clinicopathologic study on central odontogenic fibroma: with special reference to amyloid variant
. To clarify the clinicopathological features of central odontogenic fibroma (OF), especially the amyloid variant, and to discuss its relationship with Langerhans cell variant of calcifying epithelial odontogenic tumor (CEOT).
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Regulatory T cell deficiency and autoimmune skin disease: beyond scurfy mouse and IPEX
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Regulatory T cell deficiency and autoimmune skin disease: beyond scurfy mouse and IPEX
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The limitations of cross-sectional data: perinatal risk factors for asthma
The relationship between perinatal factors and lung function or development of asthma has been studied for decades and we have increasing evidence for the importance of early life factors for respiratory health in adulthood [1]. Pregnancies in adolescent and older women have implications for maternal and child health. The topic is relevant at present, as first-birth rates for women aged >35 years have increased exponentially [2]. A number of studies showed an association between maternal age and respiratory symptoms and asthma in childhood, suggesting that lung development might differ between children born to very young or very old mothers [3]. However, the evidence for longer lasting effects is scarce. (Source: European Respiratory Journal)
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Hormonal Contraceptive Methods on Immunologic Changes in the Female Genital Tract (FGT) and Systemically
Condition: Hormonal Contraception Interventions: Drug: Depot medroxyprogesterone acetate (DMPA); Drug: Etonogestrel implant (Eng-Implant); Drug: Levonorgestrel IUD (Lng-IUD) Sponsors: Emory University; National Institutes of Health (NIH); Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Recruiting (Source: ClinicalTrials.gov)
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Mite Asthma Pediatric Immunotherapy Trial
Conditions: Allergic Asthma Due to Dermatophagoides Farinae; Allergic Asthma Due to Dermatophagoides Pteronyssinus; Allergic Rhinitis Due to House Dust Mite (HDM) Interventions: Biological: HDM SLIT-tablet; Other: Placebo Sponsor: ALK-Abelló A/S Recruiting (Source: ClinicalTrials.gov)
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To Evaluate the Efficacy and Safety of HL151 Versus Placebo in Perennial Allergic Rhinitis Patients
Condition: Perennial Allergic Rhinitis Interventions: Drug: HL151; Drug: placebo Sponsor: Hanlim Pharm. Co., Ltd. Completed (Source: ClinicalTrials.gov)
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Microbicide/PrEP Acceptability Among Mothers and Male Partners in Africa
Discussion (FGD); Behavioral: In-depth Interview (IDI) Sponsors: Microbicide Trials Network; National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Multi-Drug Resistant Organism Network
Conditions: Infection Resistant to Multiple Drugs; Bacterial Infections Intervention: Other: Standard of Care Sponsors: Duke University; National Institute of Allergy and Infectious Diseases (NIAID) Enrolling by invitation (Source: ClinicalTrials.gov)
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Hormonal Contraceptive Methods on Immunologic Changes in the Female Genital Tract (FGT) and Systemically
Condition: Hormonal Contraception Interventions: Drug: Depot medroxyprogesterone acetate (DMPA); Drug: Etonogestrel implant (Eng-Implant); Drug: Levonorgestrel IUD (Lng-IUD) Sponsors: Emory University; National Institutes of Health (NIH); Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Recruiting (Source: ClinicalTrials.gov)
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Mite Asthma Pediatric Immunotherapy Trial
Conditions: Allergic Asthma Due to Dermatophagoides Farinae; Allergic Asthma Due to Dermatophagoides Pteronyssinus; Allergic Rhinitis Due to House Dust Mite (HDM) Interventions: Biological: HDM SLIT-tablet; Other: Placebo Sponsor: ALK-Abelló A/S Recruiting (Source: ClinicalTrials.gov)
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To Evaluate the Efficacy and Safety of HL151 Versus Placebo in Perennial Allergic Rhinitis Patients
Condition: Perennial Allergic Rhinitis Interventions: Drug: HL151; Drug: placebo Sponsor: Hanlim Pharm. Co., Ltd. Completed (Source: ClinicalTrials.gov)
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Immune Response and Risk of Side Effects After Influenza Vaccination in Athletes
Conditions: Influenza Virus Vaccine Adverse Reaction; Influenza Vaccine Allergy Intervention: Biological: Influenza Vaccination Sponsors: Saarland University; German Federal Institute of Sport Science Completed (Source: ClinicalTrials.gov)
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Liver Transplantation With Tregs at UCSF
Condition: Liver Transplant Interventions: Biological: arTreg; Procedure: leukapheresis; Drug: cyclophosphamide; Drug: mesna; Drug: everolimus Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); Immune Tolerance Network (ITN) Not yet recruiting (Source: ClinicalTrials.gov)
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Microbicide/PrEP Acceptability Among Mothers and Male Partners in Africa
Discussion (FGD); Behavioral: In-depth Interview (IDI) Sponsors: Microbicide Trials Network; National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Food Protein-induced Enterocolitis Syndrome (FPIES) in 14 Children
Conditions: Allergy; Pediatric Disorder Intervention: Sponsor: Central Hospital, Nancy, France Completed (Source: ClinicalTrials.gov)
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Effect and Underlying Immunological Mechanisms of Sublingual Immunotherapy in Allergic Rhinitis
Condition: Seasonal Allergic Rhinitis Interventions: Drug: sublingual immunotherapy drops; Drug: Placebo drops Sponsors: Beijing Tongren Hospital; Wolwo Pharma Active, not recruiting (Source: ClinicalTrials.gov)
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Multi-Drug Resistant Organism Network
Conditions: Infection Resistant to Multiple Drugs; Bacterial Infections Intervention: Other: Standard of Care Sponsors: Duke University; National Institute of Allergy and Infectious Diseases (NIAID) Enrolling by invitation (Source: ClinicalTrials.gov)
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Noise-Induced Hypersensitization of the Acoustic Startle Response in Larval Zebrafish
ABSTRACT
Overexposure to loud noise is known to lead to deficits in auditory sensitivity and perception. We studied the effects of noise exposure on sensorimotor behaviors of larval (5–7 days post-fertilization) zebrafish (Danio rerio), particularly the auditory-evoked startle response and hearing sensitivity to acoustic startle stimuli. We observed a temporary 10–15 dB decrease in startle response threshold after 18 h of flat-spectrum noise exposure at 20 dB re·1 ms−2. Larval zebrafish also exhibited decreased habituation to startle-inducing stimuli following noise exposure. The noise-induced sensitization was not due to changes in absolute hearing thresholds, but was specific to the auditory-evoked escape responses. The observed noise-induced sensitization was disrupted by AMPA receptor blockade using DNQX, but not NMDA receptor blockade. Together, these experiments suggest a complex effect of noise exposure on the neural circuits mediating auditory-evoked behaviors in larval zebrafish.
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The Stress Response in the Non-sensory Cells of the Cochlea Under Pathological Conditions—Possible Role in Mediating Noise Vulnerability
Abstract
Various stressors, such as loud sounds and the effects of aging, impair the function and viability of the cochlear sensory cells, the hair cells. Stressors trigger pathophysiological changes in the cochlear non-sensory cells as well. We have here studied the stress response mounted in the lateral wall of the cochlea during acute noise stress and during age-related chronic stress. We have used the activation of JNK/c-Jun, ERK, and NF-κB pathways as a readout of the stress response, and the expression of the FoxO3 transcription factor as a possible additional player in cellular stress. In the aging cochlea, NF-κB transcriptional activity was strongly induced in the stria vascularis of the lateral wall. This induction was linked with the atrophy of the stria vascularis, suggesting a role for NF-κB signaling in mediating age-related strial degeneration. Acutely following noise exposure, the JNK/c-Jun, ERK, and NF-κB pathways were activated in the spiral ligament of the lateral wall of CBA/Ca mice. This activation was concomitant with the morphological transformation of macrophages, suggesting that the upregulation of stress signaling leads to macrophage activation. In contrast, C57BL/6J mice lacked these responses. Only the combination of noise exposure and a systemic stressor, lipopolysaccharide, exceeded the threshold for the activation of stress signaling in the lateral wall of C57BL/6J mice. In addition, we found that, at the young adult age, outer hair cells of CBA/Ca mice are much more vulnerable to loud sounds compared to these cells of C57BL/6J mice. These results suggest that the differential stress response in the lateral wall of the two mouse strains underlies, in part, the differential noise vulnerability of their outer hair cells. Together, we propose that the molecular stress response in the lateral wall modulates the outcome of the stressed cochlea.
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Is conservative surgery a better choice for the solid/multicystic ameloblastoma than radical surgery regarding recurrence? A systematic review
ConclusionsConservative surgery does not reduce the recurrence rate as efficiently as radical surgery for primary SMA. However, there is not enough evidence to support this statement. (Source: Oral and Maxillofacial Surgery)
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Anatomic evaluation of the incisive canal with cone beam computed tomography and its relevance to surgical procedures in the mental region: a retrospective study in a Brazilian population
ConclusionsThe measurements show the need for care from professionals when performing intraosseous surgical procedures in the mental region. The distances between the IC and the references studied must be observed. Thus, CBCT becomes essential for surgical planning in the mental region.Clinical relevanceThe mental region of the mandible is considered a safe area to perform surgical procedures such as the placement of osseointegrated implants, orthognathic surgery, and the removal of bone grafts. However, this region includes important neurovascular structures that must be considered or else hemorrhage and neurologic disorders can be experienced. (Source: Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MSiTGD
Noise-Induced Hypersensitization of the Acoustic Startle Response in Larval Zebrafish
ABSTRACT
Overexposure to loud noise is known to lead to deficits in auditory sensitivity and perception. We studied the effects of noise exposure on sensorimotor behaviors of larval (5–7 days post-fertilization) zebrafish (Danio rerio), particularly the auditory-evoked startle response and hearing sensitivity to acoustic startle stimuli. We observed a temporary 10–15 dB decrease in startle response threshold after 18 h of flat-spectrum noise exposure at 20 dB re·1 ms−2. Larval zebrafish also exhibited decreased habituation to startle-inducing stimuli following noise exposure. The noise-induced sensitization was not due to changes in absolute hearing thresholds, but was specific to the auditory-evoked escape responses. The observed noise-induced sensitization was disrupted by AMPA receptor blockade using DNQX, but not NMDA receptor blockade. Together, these experiments suggest a complex effect of noise exposure on the neural circuits mediating auditory-evoked behaviors in larval zebrafish.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NSJ1O1
The Stress Response in the Non-sensory Cells of the Cochlea Under Pathological Conditions—Possible Role in Mediating Noise Vulnerability
Abstract
Various stressors, such as loud sounds and the effects of aging, impair the function and viability of the cochlear sensory cells, the hair cells. Stressors trigger pathophysiological changes in the cochlear non-sensory cells as well. We have here studied the stress response mounted in the lateral wall of the cochlea during acute noise stress and during age-related chronic stress. We have used the activation of JNK/c-Jun, ERK, and NF-κB pathways as a readout of the stress response, and the expression of the FoxO3 transcription factor as a possible additional player in cellular stress. In the aging cochlea, NF-κB transcriptional activity was strongly induced in the stria vascularis of the lateral wall. This induction was linked with the atrophy of the stria vascularis, suggesting a role for NF-κB signaling in mediating age-related strial degeneration. Acutely following noise exposure, the JNK/c-Jun, ERK, and NF-κB pathways were activated in the spiral ligament of the lateral wall of CBA/Ca mice. This activation was concomitant with the morphological transformation of macrophages, suggesting that the upregulation of stress signaling leads to macrophage activation. In contrast, C57BL/6J mice lacked these responses. Only the combination of noise exposure and a systemic stressor, lipopolysaccharide, exceeded the threshold for the activation of stress signaling in the lateral wall of C57BL/6J mice. In addition, we found that, at the young adult age, outer hair cells of CBA/Ca mice are much more vulnerable to loud sounds compared to these cells of C57BL/6J mice. These results suggest that the differential stress response in the lateral wall of the two mouse strains underlies, in part, the differential noise vulnerability of their outer hair cells. Together, we propose that the molecular stress response in the lateral wall modulates the outcome of the stressed cochlea.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2wQcoKm
Is conservative surgery a better choice for the solid/multicystic ameloblastoma than radical surgery regarding recurrence? A systematic review
ConclusionsConservative surgery does not reduce the recurrence rate as efficiently as radical surgery for primary SMA. However, there is not enough evidence to support this statement. (Source: Oral and Maxillofacial Surgery)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NTrQMe
Anatomic evaluation of the incisive canal with cone beam computed tomography and its relevance to surgical procedures in the mental region: a retrospective study in a Brazilian population
ConclusionsThe measurements show the need for care from professionals when performing intraosseous surgical procedures in the mental region. The distances between the IC and the references studied must be observed. Thus, CBCT becomes essential for surgical planning in the mental region.Clinical relevanceThe mental region of the mandible is considered a safe area to perform surgical procedures such as the placement of osseointegrated implants, orthognathic surgery, and the removal of bone grafts. However, this region includes important neurovascular structures that must be considered or else hemorrhage and neurologic disorders can be experienced. (Source: Oral and Maxillofacial Surgery)
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Early immune response regulated by a bone marrow mesenchymal stem cell model of multiple trauma in rats
Immunotherapy,Volume 10, Issue 12, Page 1053-1064, September 2018. (Source: Immunotherapy)
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The Effect of Nonsurgical Periodontal Treatment on Gingival Crevicular Fluid Stress Hormone Levels: A Prospective Study
Oral Diseases,Volume 0, Issue ja, -Not available-. (Source: Oral Diseases)
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Early immune response regulated by a bone marrow mesenchymal stem cell model of multiple trauma in rats
Immunotherapy,Volume 10, Issue 12, Page 1053-1064, September 2018. (Source: Immunotherapy)
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The Effect of Nonsurgical Periodontal Treatment on Gingival Crevicular Fluid Stress Hormone Levels: A Prospective Study
Oral Diseases,Volume 0, Issue ja, -Not available-. (Source: Oral Diseases)
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Delivery Assist Catheters
Abstract
Purpose
To report in vivo experience of a delivery assist catheter as ascending aid for a large-bore catheter for intracranial thromboaspiration.
Methods
Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters – primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter – from patients receiving endovascular stroke treatment using an AXS Offset™ delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017.
Results
Using the delivery assist catheter, a 6F catheter could be advanced to an intracranial occlusion for direct thromboaspiration in 30 (88.2%) out of a total of 34 patients (male: n = 14 out of 34 [41.2%], age in years: mean [SD]: 75 [11], median baseline NIHSS [National Institutes of Health stroke scale]: 16 [interquartile range, IQR 12-21]). In 4 out of 34 (11.7%) cases the occlusion could not be reached with the aspiration catheter because of a preceding non-occlusive arteriosclerotic plaque (n = 1, 2.9%) or because of severe elongation and tortuosity of the arterial access route (n = 3, 8.8%). After thromboaspiration mTICI (modified thrombolysis in cerebral infarction) 2b‑3 was reached in 14 out of 30 (46.7%) patients. In 21 out of 34 (61.8%) patients stent-retriever-maneuvers (median: 1 [IQR: 0‑2]) were needed. In 28 out of 34 (82.3%) patients final mTICI 2b-3 could be achieved.
Conclusion
Delivery assist catheters can be used as ascending aid for large-bore catheters for thromboaspiration in acute ischemic stroke, in particular to overcome vessel tortuosity and anatomic obstacles.
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Delivery Assist Catheters
Abstract
Purpose
To report in vivo experience of a delivery assist catheter as ascending aid for a large-bore catheter for intracranial thromboaspiration.
Methods
Retrospective data collection and analysis of stroke databases of two comprehensive stroke centers focusing on technical and angiographic parameters – primary endpoint defined as reaching the occlusion with a large-bore reperfusion catheter – from patients receiving endovascular stroke treatment using an AXS Offset™ delivery assist catheter (Stryker, Fremont, CA, USA) between May 2017 and November 2017.
Results
Using the delivery assist catheter, a 6F catheter could be advanced to an intracranial occlusion for direct thromboaspiration in 30 (88.2%) out of a total of 34 patients (male: n = 14 out of 34 [41.2%], age in years: mean [SD]: 75 [11], median baseline NIHSS [National Institutes of Health stroke scale]: 16 [interquartile range, IQR 12-21]). In 4 out of 34 (11.7%) cases the occlusion could not be reached with the aspiration catheter because of a preceding non-occlusive arteriosclerotic plaque (n = 1, 2.9%) or because of severe elongation and tortuosity of the arterial access route (n = 3, 8.8%). After thromboaspiration mTICI (modified thrombolysis in cerebral infarction) 2b‑3 was reached in 14 out of 30 (46.7%) patients. In 21 out of 34 (61.8%) patients stent-retriever-maneuvers (median: 1 [IQR: 0‑2]) were needed. In 28 out of 34 (82.3%) patients final mTICI 2b-3 could be achieved.
Conclusion
Delivery assist catheters can be used as ascending aid for large-bore catheters for thromboaspiration in acute ischemic stroke, in particular to overcome vessel tortuosity and anatomic obstacles.
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Improved Neural Coding of ITD with Bilateral Cochlear Implants by Introducing Short Inter-pulse Intervals
AbstractBilateral cochlear implant (CI) users have poor perceptual sensitivity to interaural time differences (ITDs), which limits their ability to localize sounds and understand speech in noisy environments. This is especially true for high-rate (> 300 pps) periodic pulse trains, which are used as carriers in CI processors. Here, we investigate a novel stimulation strategy in which extra pulses are added to high-rate periodic pulse trains to introduce short inter-pulse intervals (SIPIs). We hypothesized that SIPIs can improve neural ITD se nsitivity similarly to the effect observed by randomly jittering IPIs (Hancock et al., J. Neurophysiol. 108:714–28,2012). To test this hypothesis, we measured ITD sensitivity of single units in the inferior colliculus (IC) of unanesthetized rab...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2oMpGmL
The Stress Response in the Non-sensory Cells of the Cochlea Under Pathological Conditions —Possible Role in Mediating Noise Vulnerability
AbstractVarious stressors, such as loud sounds and the effects of aging, impair the function and viability of the cochlear sensory cells, the hair cells. Stressors trigger pathophysiological changes in the cochlear non-sensory cells as well. We have here studied the stress response mounted in the lateral wall of the cochlea during acute noise stress and during age-related chronic stress. We have used the activation of JNK/c-Jun, ERK, and NF- κB pathways as a readout of the stress response, and the expression of the FoxO3 transcription factor as a possible additional player in cellular stress. In the aging cochlea, NF-κB transcriptional activity was strongly induced in the stria vascularis of the lateral wall. This induction was linked with the atrophy of the stria vascularis, suggesting ...
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Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique
Abstract
Background
Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.
Methods
The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.
Results
Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.
Conclusions
The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MPwA9b
Improved Neural Coding of ITD with Bilateral Cochlear Implants by Introducing Short Inter-pulse Intervals
AbstractBilateral cochlear implant (CI) users have poor perceptual sensitivity to interaural time differences (ITDs), which limits their ability to localize sounds and understand speech in noisy environments. This is especially true for high-rate (> 300 pps) periodic pulse trains, which are used as carriers in CI processors. Here, we investigate a novel stimulation strategy in which extra pulses are added to high-rate periodic pulse trains to introduce short inter-pulse intervals (SIPIs). We hypothesized that SIPIs can improve neural ITD se nsitivity similarly to the effect observed by randomly jittering IPIs (Hancock et al., J. Neurophysiol. 108:714–28,2012). To test this hypothesis, we measured ITD sensitivity of single units in the inferior colliculus (IC) of unanesthetized rab...
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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2oMpGmL
The Stress Response in the Non-sensory Cells of the Cochlea Under Pathological Conditions —Possible Role in Mediating Noise Vulnerability
AbstractVarious stressors, such as loud sounds and the effects of aging, impair the function and viability of the cochlear sensory cells, the hair cells. Stressors trigger pathophysiological changes in the cochlear non-sensory cells as well. We have here studied the stress response mounted in the lateral wall of the cochlea during acute noise stress and during age-related chronic stress. We have used the activation of JNK/c-Jun, ERK, and NF- κB pathways as a readout of the stress response, and the expression of the FoxO3 transcription factor as a possible additional player in cellular stress. In the aging cochlea, NF-κB transcriptional activity was strongly induced in the stria vascularis of the lateral wall. This induction was linked with the atrophy of the stria vascularis, suggesting ...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NQzWoH
Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique
Abstract
Background
Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.
Methods
The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.
Results
Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.
Conclusions
The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MPwA9b
Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique
Abstract
Background
Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.
Methods
The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.
Results
Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.
Conclusions
The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2MPwA9b
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