A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling

Abstract

The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.

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Two Cases of Lingual Arteriovenous Malformations with Comorbidities Treated by Glue Embolization: A Report with Review of Literature

Abstract

Arteriovenous malformations (AVMs) involving the tongue are uncommon lesions in the head and neck region. They present with bleeding that can be massive and life-threatening apart from debilitating symptoms of pain, ulcers, difficulty in phonation or swallowing. Various therapeutic approaches have been used in their management—surgery, endovascular embolization, radiation and ablation procedures like laser ablation. We report two patients—a 34 year-old man and 56 year-old female who presented with massive bleeding due to lingual AVM and had comorbidities as liver cirrhosis and chronic medical renal disease respectively, and treated with glue embolization, with a review of the literature.

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Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings

Abstract

The aim of the study is to document the long term oncological results of trans-oral laser microsurgery (TLM) for early and moderately advanced glottic cancer in primary and salvage settings. In this prospective cohort study 43 consecutive patients of glottic cancer (T1–30, T2–7, and selected T3 with mobile cords-6) were recruited. TLM was performed in these 35 primary and 8 previously treated cases. In our series, the local disease control rate with TLM was 90% (27/30) for T1 disease, 71.4% (5/7) for T2 cancer and 66.6% (4/6) for T3 lesions. The overall disease control rates after subsequent treatment for locoregional recurrences were 100% (30/30), 85.7% (6/7) and 83.3% (5/6) for T1, T2, and T3 glottic cancers respectively. The 5-years disease free survival rate for primary cases was 100% and 50% for salvage cases. The 5-years local disease control rate was 96.4% and 41.67% in primary and salvage TLM settings respectively. The 5-years laryngectomy free rates were 96.3% and 18.75% for primary and salvage cases respectively. TLM offers a minimally invasive and oncologically robust treatment option for early glottic cancer with an overall disease free survival of 100% at 5 years noted for primary untreated cases in this experience. TLM for post radiation salvage cases has however been disappointing and alternate larynx preserving option of open partial laryngectomy needs to be considered in this setting.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R7hDO9

A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling

Abstract

The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R7wDvk

Two Cases of Lingual Arteriovenous Malformations with Comorbidities Treated by Glue Embolization: A Report with Review of Literature

Abstract

Arteriovenous malformations (AVMs) involving the tongue are uncommon lesions in the head and neck region. They present with bleeding that can be massive and life-threatening apart from debilitating symptoms of pain, ulcers, difficulty in phonation or swallowing. Various therapeutic approaches have been used in their management—surgery, endovascular embolization, radiation and ablation procedures like laser ablation. We report two patients—a 34 year-old man and 56 year-old female who presented with massive bleeding due to lingual AVM and had comorbidities as liver cirrhosis and chronic medical renal disease respectively, and treated with glue embolization, with a review of the literature.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OYHjv5

Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings

Abstract

The aim of the study is to document the long term oncological results of trans-oral laser microsurgery (TLM) for early and moderately advanced glottic cancer in primary and salvage settings. In this prospective cohort study 43 consecutive patients of glottic cancer (T1–30, T2–7, and selected T3 with mobile cords-6) were recruited. TLM was performed in these 35 primary and 8 previously treated cases. In our series, the local disease control rate with TLM was 90% (27/30) for T1 disease, 71.4% (5/7) for T2 cancer and 66.6% (4/6) for T3 lesions. The overall disease control rates after subsequent treatment for locoregional recurrences were 100% (30/30), 85.7% (6/7) and 83.3% (5/6) for T1, T2, and T3 glottic cancers respectively. The 5-years disease free survival rate for primary cases was 100% and 50% for salvage cases. The 5-years local disease control rate was 96.4% and 41.67% in primary and salvage TLM settings respectively. The 5-years laryngectomy free rates were 96.3% and 18.75% for primary and salvage cases respectively. TLM offers a minimally invasive and oncologically robust treatment option for early glottic cancer with an overall disease free survival of 100% at 5 years noted for primary untreated cases in this experience. TLM for post radiation salvage cases has however been disappointing and alternate larynx preserving option of open partial laryngectomy needs to be considered in this setting.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R7hDO9

ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

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ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

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

ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

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

ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

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Automated on-line monitoring of the TiO2-based photocatalytic degradation of dimethyl phthalate and diethyl phthalate

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00307F, Paper

Daniel Salazar-Beltrán, Laura Hinojosa-Reyes, Fernando Maya-Alejandro, Gemma Turnes-Palomino, Carlos Palomino-Cabello, Aracely Hernández-Ramírez, Jorge Luis Guzmán-Mar
An automated on-line system for monitoring the TiO₂-based photocatalytic degradation of dimethyl phthalate and diethyl phthalate.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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Photocatalytic abatement of emerging pollutants in pure water and wastewater effluent by TiO2 and Ce-ZnO: degradation kinetics and assessment of transformation products

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00311D, Paper

Debora Fabbri, María José López-Muñoz, Alessandro Daniele, Claudio Medana, Paola Calza
A good removal efficiency was obtained for a mixture of seven emerging contaminants in wastewater effluent using two catalysts, Ce-ZnO and TiO₂-SG, as evidenced by the formation of several transient transformation products.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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Anoxic photocatalytic treatment of synthetic mining wastewater using TiO2 and scavengers for complexed cyanide recovery

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00281A, Paper

L. A. Betancourt-Buitrago, O. E. Ossa-Echeverry, J. C. Rodriguez-Vallejo, J. M. Barraza, N. Marriaga, F. Machuca-Martínez
A new pathway for selective photocatalytic reduction using a combination of scavengers for gold mining wastewater treatment.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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Automated on-line monitoring of the TiO2-based photocatalytic degradation of dimethyl phthalate and diethyl phthalate

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00307F, Paper

Daniel Salazar-Beltrán, Laura Hinojosa-Reyes, Fernando Maya-Alejandro, Gemma Turnes-Palomino, Carlos Palomino-Cabello, Aracely Hernández-Ramírez, Jorge Luis Guzmán-Mar
An automated on-line system for monitoring the TiO₂-based photocatalytic degradation of dimethyl phthalate and diethyl phthalate.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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

Photocatalytic abatement of emerging pollutants in pure water and wastewater effluent by TiO2 and Ce-ZnO: degradation kinetics and assessment of transformation products

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00311D, Paper

Debora Fabbri, María José López-Muñoz, Alessandro Daniele, Claudio Medana, Paola Calza
A good removal efficiency was obtained for a mixture of seven emerging contaminants in wastewater effluent using two catalysts, Ce-ZnO and TiO₂-SG, as evidenced by the formation of several transient transformation products.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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

Anoxic photocatalytic treatment of synthetic mining wastewater using TiO2 and scavengers for complexed cyanide recovery

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00281A, Paper

L. A. Betancourt-Buitrago, O. E. Ossa-Echeverry, J. C. Rodriguez-Vallejo, J. M. Barraza, N. Marriaga, F. Machuca-Martínez
A new pathway for selective photocatalytic reduction using a combination of scavengers for gold mining wastewater treatment.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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Button battery insertion in nose manifested as infraorbital cellulitis

Infraorbital cellulitis developing from a nasal foreign body is relatively rare and should be considered when diagnosing a child with a presentation similar to the one described in this article.

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The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis

Abstract Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 μm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R5xoVQ

Button battery insertion in nose manifested as infraorbital cellulitis

Infraorbital cellulitis developing from a nasal foreign body is relatively rare and should be considered when diagnosing a child with a presentation similar to the one described in this article.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NLf6v2

The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis

Abstract Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 μm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R5xoVQ

miR-350-3p Contributes to Age-Associated Impairment of IL-6 Production by Macrophages.

Authors: Wang X, Chang H, Yang S Abstract Aging-associated dysfunction of the immune system contributes to the increase in pathophysiological processes that occur with age. Numerous studies have shown that microRNAs regulate immune responses, although their role in age-related macrophage dysfunction remains elusive. Here, we found that miR-350-3p is expressed at lower levels in peritoneal macrophages from aged mice compared with young mice, and that lipopolysaccharide (LPS) stimulation downregulates miR-350-3p expression to a greater extent in young macrophages compared with aged macrophages. Consequently, LPS-stimulated aged macrophages express more miR-350-3p than do similarly treated young macrophages. Luciferase reporter assays showed that interleukin (IL)-6 mRNA is a miR-350-3...

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HLA Class I in Egyptian patients with Beh çet's disease: new association with susceptibility, protection, presentation and severity of manifestations.

CONCLUSION: Behçet's disease is associated with HLA Class-I A*24, A*68 and B*15, B*42 and B*51 in Egyptian patients while A*03 and B*52 were found to be protective. Interestingly, HLA B*51 and A*68 could be considered as poor prognostic factor for eye involvement. PMID: 30260727 [PubMed - as supplied by publisher] (Source: Immunological Investigations)

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Efficacy of Silver-based Gel Compared With Fusidic Acid Cream in Topical Treatment Following Trichloroacetic Acid Facial Skin Peeling: A Pilot Study.

CONCLUSIONS: Comparing between the groups treated with silver-based gel and fusidic acid cream, the authors found no inferiority in the outcomes or the prevalence of any complaints, and a superior effect on the prevention of wound itch using a silver-based gel. PMID: 30260319 [PubMed - as supplied by publisher] (Source: Wounds)

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Food allergy symptoms: Nine signs you could be allergic to certain foods

FOOD allergy is when the body 's immune system reacts to particular foods, causing a range of uncomfortable symptoms. Common food allergies are seeds, fish and wheat, so what signs indicate you could be allergic? (Source: Daily Express - Health)

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

miR-350-3p Contributes to Age-Associated Impairment of IL-6 Production by Macrophages.

Authors: Wang X, Chang H, Yang S Abstract Aging-associated dysfunction of the immune system contributes to the increase in pathophysiological processes that occur with age. Numerous studies have shown that microRNAs regulate immune responses, although their role in age-related macrophage dysfunction remains elusive. Here, we found that miR-350-3p is expressed at lower levels in peritoneal macrophages from aged mice compared with young mice, and that lipopolysaccharide (LPS) stimulation downregulates miR-350-3p expression to a greater extent in young macrophages compared with aged macrophages. Consequently, LPS-stimulated aged macrophages express more miR-350-3p than do similarly treated young macrophages. Luciferase reporter assays showed that interleukin (IL)-6 mRNA is a miR-350-3...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IsGoR6

HLA Class I in Egyptian patients with Beh çet's disease: new association with susceptibility, protection, presentation and severity of manifestations.

CONCLUSION: Behçet's disease is associated with HLA Class-I A*24, A*68 and B*15, B*42 and B*51 in Egyptian patients while A*03 and B*52 were found to be protective. Interestingly, HLA B*51 and A*68 could be considered as poor prognostic factor for eye involvement. PMID: 30260727 [PubMed - as supplied by publisher] (Source: Immunological Investigations)

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

Efficacy of Silver-based Gel Compared With Fusidic Acid Cream in Topical Treatment Following Trichloroacetic Acid Facial Skin Peeling: A Pilot Study.

CONCLUSIONS: Comparing between the groups treated with silver-based gel and fusidic acid cream, the authors found no inferiority in the outcomes or the prevalence of any complaints, and a superior effect on the prevention of wound itch using a silver-based gel. PMID: 30260319 [PubMed - as supplied by publisher] (Source: Wounds)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IsG0C8

Food allergy symptoms: Nine signs you could be allergic to certain foods

FOOD allergy is when the body 's immune system reacts to particular foods, causing a range of uncomfortable symptoms. Common food allergies are seeds, fish and wheat, so what signs indicate you could be allergic? (Source: Daily Express - Health)

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The effect of cleft palate closure technique on speech and middle ear outcome: a systematic review

Otitis media with effusion and disturbed speech are highly prevalent problems in children after cleft palate repair. Although many techniques for palatal closure have been described, no consensus has yet been reached regarding the most effective technique for these issues. The aim of this systematic review is to provide evidence-based information related to the effectiveness of different palatal closure techniques on middle ear and speech outcomes.

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The effect of cleft palate closure technique on speech and middle ear outcome: a systematic review

Otitis media with effusion and disturbed speech are highly prevalent problems in children after cleft palate repair. Although many techniques for palatal closure have been described, no consensus has yet been reached regarding the most effective technique for these issues. The aim of this systematic review is to provide evidence-based information related to the effectiveness of different palatal closure techniques on middle ear and speech outcomes.

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Food allergy symptoms: Nine signs you could be allergic to certain foods

FOOD allergy is when the body 's immune system reacts to particular foods, causing a range of uncomfortable symptoms. Common food allergies are seeds, fish and wheat, so what signs indicate you could be allergic? (Source: Daily Express - Health)

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FDA OKs Pediatric Version of Alternative to EpiPen FDA OKs Pediatric Version of Alternative to EpiPen

The lower-dose version of the epinephrine prefilled syringe is indicated for the emergency treatment of allergic reactions in children weighing between 33 and 65 pounds.FDA Approvals (Source: Medscape Medical News Headlines)

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Food allergy symptoms: Nine signs you could be allergic to certain foods

FOOD allergy is when the body 's immune system reacts to particular foods, causing a range of uncomfortable symptoms. Common food allergies are seeds, fish and wheat, so what signs indicate you could be allergic? (Source: Daily Express - Health)

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FDA OKs Pediatric Version of Alternative to EpiPen FDA OKs Pediatric Version of Alternative to EpiPen

The lower-dose version of the epinephrine prefilled syringe is indicated for the emergency treatment of allergic reactions in children weighing between 33 and 65 pounds.FDA Approvals (Source: Medscape Medical News Headlines)

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ARIA Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best approach to integrated care pathways (ICPs) using mobile technology in AR and asthma multimorbidity. The proposed next phase of ARIA is Change Management (CM) with the aim of providing an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle whatever their gender or socio-economic status in order to reduce health and social inequities incurred by the disease.

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Unexpected Relevant Role of Gene Mosaicism in Primary Immunodeficiency Diseases

ADS revealed gene mosaicism in ≈25% of enrolled PID families. These data highlight the relevant role of mosaicism in PID, which may have serious consequences regarding patient's treatment and genetic counseling.

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FDA OKs Pediatric Version of Alternative to EpiPen FDA OKs Pediatric Version of Alternative to EpiPen

The lower-dose version of the epinephrine prefilled syringe is indicated for the emergency treatment of allergic reactions in children weighing between 33 and 65 pounds.FDA Approvals (Source: Medscape Medical News Headlines)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NMvV8R

ARIA Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best approach to integrated care pathways (ICPs) using mobile technology in AR and asthma multimorbidity. The proposed next phase of ARIA is Change Management (CM) with the aim of providing an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle whatever their gender or socio-economic status in order to reduce health and social inequities incurred by the disease.

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

Unexpected Relevant Role of Gene Mosaicism in Primary Immunodeficiency Diseases

ADS revealed gene mosaicism in ≈25% of enrolled PID families. These data highlight the relevant role of mosaicism in PID, which may have serious consequences regarding patient's treatment and genetic counseling.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Oi814C

FDA OKs Pediatric Version of Alternative to EpiPen FDA OKs Pediatric Version of Alternative to EpiPen

The lower-dose version of the epinephrine prefilled syringe is indicated for the emergency treatment of allergic reactions in children weighing between 33 and 65 pounds.FDA Approvals (Source: Medscape Medical News Headlines)

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Imaging of salivary gland pathology

The major salivary glands can be affected by a variety of acute or chronic, systemic, and neoplastic conditions. Several modalities can be used for salivary gland imaging, each with its own advantages and limitations. The article reviews the optimal imaging modality for different clinical scenarios, the typical imaging appearance of commonly encountered pathologies, and seeks to provide a framework for generating an appropriate differential diagnosis. Additionally, with regard to neoplastic conditions, the goals of the review are to highlight features suggestive of benign or low-grade lesions verses high grade malignancy, while recognizing the limitations of imaging in making specific histologic diagnoses.

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Imaging of salivary gland pathology

The major salivary glands can be affected by a variety of acute or chronic, systemic, and neoplastic conditions. Several modalities can be used for salivary gland imaging, each with its own advantages and limitations. The article reviews the optimal imaging modality for different clinical scenarios, the typical imaging appearance of commonly encountered pathologies, and seeks to provide a framework for generating an appropriate differential diagnosis. Additionally, with regard to neoplastic conditions, the goals of the review are to highlight features suggestive of benign or low-grade lesions verses high grade malignancy, while recognizing the limitations of imaging in making specific histologic diagnoses.

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Efficient closure of earlobe cleft with biopsy punch

A biopsy punch with the support of the flat and even surface of a scalpel handle provides the appropriate balance to excise a smaller tract.

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Efficient closure of earlobe cleft with biopsy punch

A biopsy punch with the support of the flat and even surface of a scalpel handle provides the appropriate balance to excise a smaller tract.

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Pret accused of taking unnecessary risks by allergy sufferers

Two customers share their Pret allergy experiences, after an inquest into a 15-year-old girl's death. (Source: BBC News | Health | UK Edition)

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Pret accused of taking unnecessary risks by allergy sufferers

Two customers share their Pret allergy experiences, after an inquest into a 15-year-old girl's death. (Source: BBC News | Health | UK Edition)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NRh8tJ

The association between paracetamol use and the risk of asthma, rhinitis and eczema in the Polish population.

CONCLUSIONS: The use of paracetamol in the last 12 months was associated with a significant dose-dependent increase in the risk of rhinitis and skin allergy symptoms, as demonstrated by the odds ratio. Therefore, frequent paracetamol use may be a risk factor for symptoms of asthma, rhinitis, and skin allergy in the Polish population. PMID: 30260196 [PubMed - in process] (Source: Annals of Agricultural and Environmental Medicine : AAEM)

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IgE-dependent sensitization in patients with COPD.

CONCLUSIONS: Both the prevalence and profile of IgE-dependent sensitization to inhaled allergens did not differ between asthma and COPD. Both Th2 and Th1 played a role in the immunopathology of asthma and COPD. ABBREVIATIONS: COPD - Chronic Obstructive Pulmonary Disease; FEV1 - forced expiratory volume in one second; FVC - forced expiratory volume; GINA - Global Initiative for Asthma; GOLD - Global Initiative for Chronic Obstructive Lung Disease; MMRC - Modified Medical Research Council; Th1 - lymphocyte helper 1; Th2 - lymphocyte helper 2. PMID: 30260198 [PubMed - in process] (Source: Annals of Agricultural and Environmental Medicine : AAEM)

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Tree nut allergy and anxiety related factors modulate food consumption behaviour in peanut-allergic patients: Results of the MIRABEL survey.

CONCLUSIONS: and clinical relevance: It showed, for the first time, that consumption of food products by peanut-allergic patients, including those with PAL, is modulated by factors related to anxiety such as label reading and knowledge of threshold and concomitant tree nut allergy. Knowledge of peanut-allergic food behaviours will make it possible to improve risk assessment and help allergists and risk managers to make diet advices. PMID: 30253193 [PubMed - as supplied by publisher] (Source: Regulatory Toxicology and Pharmacology : RTP)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OYK8Mq

The association between paracetamol use and the risk of asthma, rhinitis and eczema in the Polish population.

CONCLUSIONS: The use of paracetamol in the last 12 months was associated with a significant dose-dependent increase in the risk of rhinitis and skin allergy symptoms, as demonstrated by the odds ratio. Therefore, frequent paracetamol use may be a risk factor for symptoms of asthma, rhinitis, and skin allergy in the Polish population. PMID: 30260196 [PubMed - in process] (Source: Annals of Agricultural and Environmental Medicine : AAEM)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OY3T6K

IgE-dependent sensitization in patients with COPD.

CONCLUSIONS: Both the prevalence and profile of IgE-dependent sensitization to inhaled allergens did not differ between asthma and COPD. Both Th2 and Th1 played a role in the immunopathology of asthma and COPD. ABBREVIATIONS: COPD - Chronic Obstructive Pulmonary Disease; FEV1 - forced expiratory volume in one second; FVC - forced expiratory volume; GINA - Global Initiative for Asthma; GOLD - Global Initiative for Chronic Obstructive Lung Disease; MMRC - Modified Medical Research Council; Th1 - lymphocyte helper 1; Th2 - lymphocyte helper 2. PMID: 30260198 [PubMed - in process] (Source: Annals of Agricultural and Environmental Medicine : AAEM)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OfvSC3

Tree nut allergy and anxiety related factors modulate food consumption behaviour in peanut-allergic patients: Results of the MIRABEL survey.

CONCLUSIONS: and clinical relevance: It showed, for the first time, that consumption of food products by peanut-allergic patients, including those with PAL, is modulated by factors related to anxiety such as label reading and knowledge of threshold and concomitant tree nut allergy. Knowledge of peanut-allergic food behaviours will make it possible to improve risk assessment and help allergists and risk managers to make diet advices. PMID: 30253193 [PubMed - as supplied by publisher] (Source: Regulatory Toxicology and Pharmacology : RTP)

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Cortical auditory evoked potential time-frequency growth functions for fully objective hearing threshold estimation

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Darren Mao, Hamish Innes-Brown, Matthew A. Petoe, Yan T. Wong, Colette M. McKay

Abstract

Cortical auditory evoked potential (CAEPs) thresholds have been shown to correlate well with behaviourally determined hearing thresholds. Growth functions of CAEPs show promise as an alternative to single level detection for objective hearing threshold estimation; however, the accuracy and clinical relevance of this method is not well examined.

In this study, we used temporal and spectral CAEP features to generate feature growth functions. Spectral features may be more robust than traditional peak-picking methods where CAEP morphology is variable, such as in children or hearing device users. Behavioural hearing thresholds were obtained and CAEPs were recorded in response to a 1 kHz puretone from twenty adults with no hearing loss. Four features, peak-to-peak amplitude, root-mean-square, peak spectral power and peak phase-locking value (PLV) were extracted from the CAEPs. Functions relating each feature with stimulus level were used to calculate objective hearing threshold estimates. We assessed the performance of each feature by calculating the difference between the objective estimate and the behaviourally-determined threshold.

We compared the accuracy of the estimates using each feature and found that the peak PLV feature performed best, with a mean threshold error of 2.7 dB and standard deviation of 5.9 dB across subjects from behavioural threshold. We also examined the relation between recording time, data quality and threshold estimate errors, and found that on average for a single threshold, 12.7 minutes of recording was needed for a 95% confidence that the threshold estimate was within 20 dB of the behavioural threshold, using the peak-to-peak amplitude feature, while 14 minutes is needed for the peak PLV feature. These results show that the PLV of CAEPs can be used to find a clinically relevant hearing threshold estimate. Its potential stability in differing morphology may be an advantage in testing infants or cochlear implant users.

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Cortical auditory evoked potential time-frequency growth functions for fully objective hearing threshold estimation

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Darren Mao, Hamish Innes-Brown, Matthew A. Petoe, Yan T. Wong, Colette M. McKay

Abstract

Cortical auditory evoked potential (CAEPs) thresholds have been shown to correlate well with behaviourally determined hearing thresholds. Growth functions of CAEPs show promise as an alternative to single level detection for objective hearing threshold estimation; however, the accuracy and clinical relevance of this method is not well examined.

In this study, we used temporal and spectral CAEP features to generate feature growth functions. Spectral features may be more robust than traditional peak-picking methods where CAEP morphology is variable, such as in children or hearing device users. Behavioural hearing thresholds were obtained and CAEPs were recorded in response to a 1 kHz puretone from twenty adults with no hearing loss. Four features, peak-to-peak amplitude, root-mean-square, peak spectral power and peak phase-locking value (PLV) were extracted from the CAEPs. Functions relating each feature with stimulus level were used to calculate objective hearing threshold estimates. We assessed the performance of each feature by calculating the difference between the objective estimate and the behaviourally-determined threshold.

We compared the accuracy of the estimates using each feature and found that the peak PLV feature performed best, with a mean threshold error of 2.7 dB and standard deviation of 5.9 dB across subjects from behavioural threshold. We also examined the relation between recording time, data quality and threshold estimate errors, and found that on average for a single threshold, 12.7 minutes of recording was needed for a 95% confidence that the threshold estimate was within 20 dB of the behavioural threshold, using the peak-to-peak amplitude feature, while 14 minutes is needed for the peak PLV feature. These results show that the PLV of CAEPs can be used to find a clinically relevant hearing threshold estimate. Its potential stability in differing morphology may be an advantage in testing infants or cochlear implant users.

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

Randomized in situ study on the efficacy of CO 2 laser irradiation in increasing enamel erosion resistance

Abstract

Objectives

The aim of this double-blind, randomized in situ study was to evaluate the erosion-preventive effect of a specific set of CO₂ laser parameters, associated or not with fluoride.

Methods

Two hundred forty bovine enamel blocks were prepared for individual palatal appliances (n = 6 samples/appliance). The study had four phases of 5 days each, with ten volunteers and the following treatments: CO₂ laser irradiation (L), fluoride treatment (F), combined fluoride and laser treatment (FL), and no treatment, control (C). Laser irradiation was performed at 0.3 J/cm² (5 μs/226 Hz/10.6 μm) and the fluoride gel contained AmF/NaF (12′500 ppm F⁻/pH = 4.8–6). For erosive demineralization, the appliances were immersed extra-orally in citric acid (0.05 M/20 min/pH = 2.3) twice daily. Analysis of enamel surface loss was done using a 3D-laser profilometer on 3 days. Additionally, fluoride uptake was quantified and scanning electron microscopies were done. Data were analyzed with repeated measures ANOVA and post hoc pairwise comparisons (α = 0.05).

Results

At all analyzing days, both laser groups caused the lowest means of enamel loss, which were also statistically significant lower than C (p < 0.05). At day 5, FL means ± SD (33.6 ± 12.6 μm) were even significantly lower than all other groups (C 67.8 ± 15.4 μm; F 57.5 ± 20.3 μm; L 46.8 ± 14.5 μm). Significantly increased enamel fluoride uptake was observed for both fluoride-containing groups (p < 0.05) at day 1.

Conclusion

Compared to the control, the CO₂ laser irradiation with a specific set of laser parameters (0.3 J/cm²/5 μs/226 Hz) either alone or in combination with a fluoride gel (AmF/NaF) could significantly decrease enamel erosive loss up to 5 days in situ.

Clinical relevance

Combined CO₂ laser-fluoride treatment has a significant anti-erosive effect.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1xdJW

Randomized in situ study on the efficacy of CO 2 laser irradiation in increasing enamel erosion resistance

Abstract

Objectives

The aim of this double-blind, randomized in situ study was to evaluate the erosion-preventive effect of a specific set of CO₂ laser parameters, associated or not with fluoride.

Methods

Two hundred forty bovine enamel blocks were prepared for individual palatal appliances (n = 6 samples/appliance). The study had four phases of 5 days each, with ten volunteers and the following treatments: CO₂ laser irradiation (L), fluoride treatment (F), combined fluoride and laser treatment (FL), and no treatment, control (C). Laser irradiation was performed at 0.3 J/cm² (5 μs/226 Hz/10.6 μm) and the fluoride gel contained AmF/NaF (12′500 ppm F⁻/pH = 4.8–6). For erosive demineralization, the appliances were immersed extra-orally in citric acid (0.05 M/20 min/pH = 2.3) twice daily. Analysis of enamel surface loss was done using a 3D-laser profilometer on 3 days. Additionally, fluoride uptake was quantified and scanning electron microscopies were done. Data were analyzed with repeated measures ANOVA and post hoc pairwise comparisons (α = 0.05).

Results

At all analyzing days, both laser groups caused the lowest means of enamel loss, which were also statistically significant lower than C (p < 0.05). At day 5, FL means ± SD (33.6 ± 12.6 μm) were even significantly lower than all other groups (C 67.8 ± 15.4 μm; F 57.5 ± 20.3 μm; L 46.8 ± 14.5 μm). Significantly increased enamel fluoride uptake was observed for both fluoride-containing groups (p < 0.05) at day 1.

Conclusion

Compared to the control, the CO₂ laser irradiation with a specific set of laser parameters (0.3 J/cm²/5 μs/226 Hz) either alone or in combination with a fluoride gel (AmF/NaF) could significantly decrease enamel erosive loss up to 5 days in situ.

Clinical relevance

Combined CO₂ laser-fluoride treatment has a significant anti-erosive effect.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2P1xdJW

Pret accused of taking unnecessary risks by allergy sufferers

Two customers share their Pret allergy experiences, after an inquest into a 15-year-old girl's death. (Source: BBC News | Health | UK Edition)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NRh8tJ

Current aspects in treatment of breast cancer based of nanodrug delivery systems and future prospects.

Authors: Allahverdiyev AM, Parlar E, Dinparvar S, Bagirova M, Abamor EŞ Abstract Breast cancer is one of the most common diseases worldwide. The risk of getting this disease in female is 30% and the mortality rate is 14%. The breast cancer treatment is based on surgery, chemotherapy and radiotherapy. However, an effective treatment method has not been developed. The main cause of failure in the treatment is cancer stem cells metastasis and chemo-resistance. The use of nanocarrier systems against breast cancer stem cells has great importance. Not only advantages of polymeric drug delivery systems are increasing the stability and reduce the side effects of drugs, but also they have disadvantages such as biocompatibility and long-term potential safety. However, in recent years, studi...

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Immunological impact of graphene oxide sheets in the abdominal cavity is governed by surface reactivity.

In conclusion, large dimension was not a determining factor of the immunological impact of GO sheets after i.p. administration. For an equal dose, GO sheets with lateral dimensions similar to the length of long MWCNTs were less pathogenic than the MWCNTs. On the other hand, surface reactivity and the ability of some smaller GO sheets to interact more readily with immune cells seem to be key parameters that can be tuned to improve the safety profile of GO. In particular, the choice of dispersion modality, which affected these two parameters, was found to be of crucial importance in the assessment of GO impact in this model. Overall, these findings are essential for a better understanding of the parameters governing GO toxicity and inflammation, and the rational design of safe GO-based formu...

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

Pret accused of taking unnecessary risks by allergy sufferers

Two customers share their Pret allergy experiences, after an inquest into a 15-year-old girl's death. (Source: BBC News | Health | UK Edition)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NRh8tJ

Current aspects in treatment of breast cancer based of nanodrug delivery systems and future prospects.

Authors: Allahverdiyev AM, Parlar E, Dinparvar S, Bagirova M, Abamor EŞ Abstract Breast cancer is one of the most common diseases worldwide. The risk of getting this disease in female is 30% and the mortality rate is 14%. The breast cancer treatment is based on surgery, chemotherapy and radiotherapy. However, an effective treatment method has not been developed. The main cause of failure in the treatment is cancer stem cells metastasis and chemo-resistance. The use of nanocarrier systems against breast cancer stem cells has great importance. Not only advantages of polymeric drug delivery systems are increasing the stability and reduce the side effects of drugs, but also they have disadvantages such as biocompatibility and long-term potential safety. However, in recent years, studi...

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

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

Immunological impact of graphene oxide sheets in the abdominal cavity is governed by surface reactivity.

In conclusion, large dimension was not a determining factor of the immunological impact of GO sheets after i.p. administration. For an equal dose, GO sheets with lateral dimensions similar to the length of long MWCNTs were less pathogenic than the MWCNTs. On the other hand, surface reactivity and the ability of some smaller GO sheets to interact more readily with immune cells seem to be key parameters that can be tuned to improve the safety profile of GO. In particular, the choice of dispersion modality, which affected these two parameters, was found to be of crucial importance in the assessment of GO impact in this model. Overall, these findings are essential for a better understanding of the parameters governing GO toxicity and inflammation, and the rational design of safe GO-based formu...

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

Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk

Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-d...

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Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk

Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-d...

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The risk of MRSA and C difficile in people with documented'penicillin allergy '

This Medicines Evidence Commentary discusses UK large population-based cohort study that found people with a documented'penicillin allergy'had increased risk of MRSA and C.diff, highlighting importance of ensuring only'true'penicillin allergies are documented, in line with NICE guideline on drug allergy. (Source: Current Awareness Service for Health (CASH))

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The risk of MRSA and C difficile in people with documented'penicillin allergy '

This Medicines Evidence Commentary discusses UK large population-based cohort study that found people with a documented'penicillin allergy'had increased risk of MRSA and C.diff, highlighting importance of ensuring only'true'penicillin allergies are documented, in line with NICE guideline on drug allergy. (Source: Current Awareness Service for Health (CASH))

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Vaccine, anti-PD1 drug show promise against incurable HPV-related cancers

A tumor-specific vaccine combined with an immune checkpoint inhibitor shrank tumors in one third of patients with incurable cancer related to […]

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

OCF’s Tobacco Cessation Spokesperson and Bradley Cooper’s Stunt Double Rides in Pendleton

You won't find Cody Kiser at this year's NFR, but you will find him working as a stuntman in the 2014 […]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N94zoe

Vaccine, anti-PD1 drug show promise against incurable HPV-related cancers

A tumor-specific vaccine combined with an immune checkpoint inhibitor shrank tumors in one third of patients with incurable cancer related to […]

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

OCF’s Tobacco Cessation Spokesperson and Bradley Cooper’s Stunt Double Rides in Pendleton

You won't find Cody Kiser at this year's NFR, but you will find him working as a stuntman in the 2014 […]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N94zoe

Vaccine, anti-PD1 drug show promise against incurable HPV-related cancers

A tumor-specific vaccine combined with an immune checkpoint inhibitor shrank tumors in one third of patients with incurable cancer related to […]

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

Vaccine, anti-PD1 drug show promise against incurable HPV-related cancers

A tumor-specific vaccine combined with an immune checkpoint inhibitor shrank tumors in one third of patients with incurable cancer related to […]

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

Treatment of urticarial vasculitis: A systematic review

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Pavel Kolkhir, Maria Grakhova, Hanna Bonnekoh, Karoline Krause, Marcus Maurer

Abstract

Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review. Most UV patients are adult females with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic, but can be associated with drugs, malignancy, autoimmunity and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of skin symptoms in >80% of UV patients. However, their long-term administration can lead to potentially serious adverse effects. The addition of immunomodulatory or immunosuppressive agents often allows corticosteroids tapering and improves the efficacy of therapy. Biologicals, including omalizumab, as well as corticosteroids, cyclophosphamide, dapsone, mycophenolate mofetil, plasmapheresis, colchicine, hydroxychloroquine, intravenous immunoglobulins, NSAIDs, and cyclosporine can be effective for skin as well as systemic symptoms in UV patients. H₁-antihistamines, montelukast, danazol, H₂-antihistamines, pentoxifylline, doxepin and tranexamic acid are not effective in most UV patients. As of yet, no drugs have been approved for UV, and management recommendations are based mostly on case reports and retrospective studies. Prospective studies investigating the effects of treatment on the signs and symptoms of UV are needed.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OYpEn6

Treatment of urticarial vasculitis: A systematic review

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Pavel Kolkhir, Maria Grakhova, Hanna Bonnekoh, Karoline Krause, Marcus Maurer

Abstract

Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review. Most UV patients are adult females with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic, but can be associated with drugs, malignancy, autoimmunity and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of skin symptoms in >80% of UV patients. However, their long-term administration can lead to potentially serious adverse effects. The addition of immunomodulatory or immunosuppressive agents often allows corticosteroids tapering and improves the efficacy of therapy. Biologicals, including omalizumab, as well as corticosteroids, cyclophosphamide, dapsone, mycophenolate mofetil, plasmapheresis, colchicine, hydroxychloroquine, intravenous immunoglobulins, NSAIDs, and cyclosporine can be effective for skin as well as systemic symptoms in UV patients. H₁-antihistamines, montelukast, danazol, H₂-antihistamines, pentoxifylline, doxepin and tranexamic acid are not effective in most UV patients. As of yet, no drugs have been approved for UV, and management recommendations are based mostly on case reports and retrospective studies. Prospective studies investigating the effects of treatment on the signs and symptoms of UV are needed.

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A skewed pool of resident T cells triggers psoriasis-associated tissue responses in never-lesional psoriasis skin

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irène Gallais Sérézal, Elena Hoffer, Borislav Ignatov, Elisa Martini, Beatrice Zitti, Marcus Ehrström, Liv Eidsmo

Abstract

Background

Resident T cells are implicated in the maintenance and recurrence of psoriasis lesions. Whether skin that has not yet experienced psoriasis in subjects with established disease harbours pathogenic T cells is less investigated.

Objective

To analyse the composition of resident T cells and T cell driven tissue responses in skin never affected by disease from psoriasis patients.

Methods

Never-lesional skin was collected from patients with mild psoriasis. T cell profiles were assessed with confocal imaging and flow cytometry. Tissue responses to T cell stimulation were measured by multiplex and Nanostring.

Results

T cell activation ex vivo triggered psoriasiform and type-I interferon tissue responses in epidermis from never-lesional psoriasis. Accordingly, keratinocytes from never-lesional psoriasis responded to IFN-γ stimulation with MX1 expression and IFN-α release. Additionally, CCR6 expressing resident T cells poised to produce IFN-γ and IL-17 were enriched in never-lesional epidermis whereas dermal tissue responses and T cell compositions were similar to healthy skin. Finally, never-lesional keratinocytes exposed to IL-17 and skin explants exposed to common fungal antigens responded with upregulation of the CCR6-ligand CCL20.

Conclusion

Epidermal resident T cells capable of triggering psoriasiform tissue responses accumulate in never-lesional epidermis. Our global analysis of never-lesional psoriasis reveals that microbial interplay with genetically predisposed keratinocytes may shape the local pool of resident T cells.

Graphical abstract

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A skewed pool of resident T cells triggers psoriasis-associated tissue responses in never-lesional psoriasis skin

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irène Gallais Sérézal, Elena Hoffer, Borislav Ignatov, Elisa Martini, Beatrice Zitti, Marcus Ehrström, Liv Eidsmo

Abstract

Background

Resident T cells are implicated in the maintenance and recurrence of psoriasis lesions. Whether skin that has not yet experienced psoriasis in subjects with established disease harbours pathogenic T cells is less investigated.

Objective

To analyse the composition of resident T cells and T cell driven tissue responses in skin never affected by disease from psoriasis patients.

Methods

Never-lesional skin was collected from patients with mild psoriasis. T cell profiles were assessed with confocal imaging and flow cytometry. Tissue responses to T cell stimulation were measured by multiplex and Nanostring.

Results

T cell activation ex vivo triggered psoriasiform and type-I interferon tissue responses in epidermis from never-lesional psoriasis. Accordingly, keratinocytes from never-lesional psoriasis responded to IFN-γ stimulation with MX1 expression and IFN-α release. Additionally, CCR6 expressing resident T cells poised to produce IFN-γ and IL-17 were enriched in never-lesional epidermis whereas dermal tissue responses and T cell compositions were similar to healthy skin. Finally, never-lesional keratinocytes exposed to IL-17 and skin explants exposed to common fungal antigens responded with upregulation of the CCR6-ligand CCL20.

Conclusion

Epidermal resident T cells capable of triggering psoriasiform tissue responses accumulate in never-lesional epidermis. Our global analysis of never-lesional psoriasis reveals that microbial interplay with genetically predisposed keratinocytes may shape the local pool of resident T cells.

Graphical abstract

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The risk of MRSA and C difficile in people with documented'penicillin allergy '

This Medicines Evidence Commentary discusses UK large population-based cohort study that found people with a documented'penicillin allergy'had increased risk of MRSA and C.diff, highlighting importance of ensuring only'true'penicillin allergies are documented, in line with NICE guideline on drug allergy. (Source: Current Awareness Service for Health (CASH))

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DD6pOB

The risk of MRSA and C difficile in people with documented'penicillin allergy '

This Medicines Evidence Commentary discusses UK large population-based cohort study that found people with a documented'penicillin allergy'had increased risk of MRSA and C.diff, highlighting importance of ensuring only'true'penicillin allergies are documented, in line with NICE guideline on drug allergy. (Source: Current Awareness Service for Health (CASH))

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DD6pOB

OCF’s Tobacco Cessation Spokesperson and Bradley Cooper’s Stunt Double Rides in Pendleton

You won't find Cody Kiser at this year's NFR, but you will find him working as a stuntman in the 2014 […]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N94zoe

OCF’s Tobacco Cessation Spokesperson and Bradley Cooper’s Stunt Double Rides in Pendleton

You won't find Cody Kiser at this year's NFR, but you will find him working as a stuntman in the 2014 […]

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N94zoe

Post-traumatic stress and gambling related cognitions: Analyses in inpatient and online samples

Publication date: Available online 28 September 2018

Source: Addictive Behaviors

Author(s): Joshua B. Grubbs, Heather Chapman, Kathrine A. Shepherd

Abstract

Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity.

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Post-traumatic stress and gambling related cognitions: Analyses in inpatient and online samples

Publication date: Available online 28 September 2018

Source: Addictive Behaviors

Author(s): Joshua B. Grubbs, Heather Chapman, Kathrine A. Shepherd

Abstract

Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity.

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An introduction to the electronic waterpipe

Publication date: Available online 27 September 2018

Source: Addictive Behaviors

Author(s): Andrea M. Stroup, Steven A. Branstetter

Abstract

Despite the associated negative health outcomes, waterpipe smoking remains a popular method of tobacco consumption, specifically in young adults. While there have been expanding efforts to decrease waterpipe use, there is a new, non-combustible waterpipe device on the market, the electronic waterpipe (e-waterpipe), that could serve as an alternative to traditional, combustible waterpipe smoking. There is currently no known literature evaluating the e-waterpipe including prevalence of use or its health risks. This mini review defines the e-waterpipe, explains how an e-head is used to construct an e-waterpipe, and describes the various e-head models available for use. The review also discusses implications of e-head use and provides recommendations for future research and regulation.

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An introduction to the electronic waterpipe

Publication date: Available online 27 September 2018

Source: Addictive Behaviors

Author(s): Andrea M. Stroup, Steven A. Branstetter

Abstract

Despite the associated negative health outcomes, waterpipe smoking remains a popular method of tobacco consumption, specifically in young adults. While there have been expanding efforts to decrease waterpipe use, there is a new, non-combustible waterpipe device on the market, the electronic waterpipe (e-waterpipe), that could serve as an alternative to traditional, combustible waterpipe smoking. There is currently no known literature evaluating the e-waterpipe including prevalence of use or its health risks. This mini review defines the e-waterpipe, explains how an e-head is used to construct an e-waterpipe, and describes the various e-head models available for use. The review also discusses implications of e-head use and provides recommendations for future research and regulation.

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Laryngeal reconstruction in children with recurrent respiratory papillomatosis

Publication date: Available online 28 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): M.L. Scatolini, A. Cocciaglia, C.G. Pérez, H.A. Rodríguez

Abstract

OBJETIVES

To describe our experience in reconstructive laryngeal surgery in patients with recurrent respiratory papillomatosis (RRP). INTRODUCTION: RRP is a rare laryngeal disease requiring multiple surgical endoscopic interventions during its course. These interventions may cause secondary lesions that may compromise airway patency. Open larynx reconstructive surgery, as tracheostomy, is a procedure considered to potentially favor extralaryngeal papilloma dissemination. In patients with RRP, the use of endoscopic posterior cricoid grafting has not been previously described.

METHODS

The clinical charts of 230 patients with RRP seen between 1996 and 2017 were reviewed. All patients who underwent airway expansion procedures either by open or endoscopic approach were included in the study. RESULTS: Four patients with RRP underwent laryngeal surgery for laryngeal stenosis were included. A doble-stage open approach was used in two patients and a single-stage endoscopic approach in the remaining two. The two tracheostomized patients were decannulated while tracheostomy was avoided in the two patients who underwent a single-stage endoscopic procedure. Two patients had active papillomatous lesions limited to the larynx at the time of surgery; no dissemination was observed during follow-up (cases 1 and 3). One patient had extralaryngeal disseminated papilomatosis; surgery did not lead to an increased lesion load compared to presurgical lesions (case 4). The patient who did not have active lesions did not have recurrence (case 2).

CONCLUSIONS

Reconstructive laryngeal surgery is a safe and effective option in the management of stenotic sequelae resulting from the surgical treatment of RRP, allowing for decannulation or avoiding tracheostomy.

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Laryngeal reconstruction in children with recurrent respiratory papillomatosis

Publication date: Available online 28 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): M.L. Scatolini, A. Cocciaglia, C.G. Pérez, H.A. Rodríguez

Abstract

OBJETIVES

To describe our experience in reconstructive laryngeal surgery in patients with recurrent respiratory papillomatosis (RRP). INTRODUCTION: RRP is a rare laryngeal disease requiring multiple surgical endoscopic interventions during its course. These interventions may cause secondary lesions that may compromise airway patency. Open larynx reconstructive surgery, as tracheostomy, is a procedure considered to potentially favor extralaryngeal papilloma dissemination. In patients with RRP, the use of endoscopic posterior cricoid grafting has not been previously described.

METHODS

The clinical charts of 230 patients with RRP seen between 1996 and 2017 were reviewed. All patients who underwent airway expansion procedures either by open or endoscopic approach were included in the study. RESULTS: Four patients with RRP underwent laryngeal surgery for laryngeal stenosis were included. A doble-stage open approach was used in two patients and a single-stage endoscopic approach in the remaining two. The two tracheostomized patients were decannulated while tracheostomy was avoided in the two patients who underwent a single-stage endoscopic procedure. Two patients had active papillomatous lesions limited to the larynx at the time of surgery; no dissemination was observed during follow-up (cases 1 and 3). One patient had extralaryngeal disseminated papilomatosis; surgery did not lead to an increased lesion load compared to presurgical lesions (case 4). The patient who did not have active lesions did not have recurrence (case 2).

CONCLUSIONS

Reconstructive laryngeal surgery is a safe and effective option in the management of stenotic sequelae resulting from the surgical treatment of RRP, allowing for decannulation or avoiding tracheostomy.

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An analysis of the literature addressing tonsillectomy knowledge gaps

Publication date: Available online 27 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Craig M. Cooper, Jake X. Checketts, Lacy Brame, Harrison Gray, Jaye Bea Downs, Matt Vassar

Abstract

Importance

The ability of clinical practice guidelines to improve patient outcomes depends on the quality of evidence that they are built upon. Research into tonsillectomy in children is lacking, and the gaps in evidence were identified by guideline authors.

Objective

The objective of this study is to evaluate the extent that new research is addressing the gaps identified in the AAO-HNS Tonsillectomy in Children Guideline.

Design

For each recommendation in the AAO-HNS guideline Tonsillectomy In Children, we created PICO (Participants, Intervention, Comparator, Outcome) questions and search strings. PubMed was searched to locate studies undertaken after the final literature search performed by the AAO-HNS work group. These studies were then extracted and analyzed.

Setting

This study is relevant to all invested in focusing otolaryngological research on questions which currently lack strong evidence.

Participants

Trials in tonsillectomy that started after the development of the AAO-HNS clinical practice guidelines.

Main Outcome Measures

The main outcome measures of this study is the extent to which tonsillectomy research is addressing the evidence gaps listed in the clinical practice guideline.

Results

Of the 2519 studies included in our sample, 276 (11%) were relevant to the 18 recommendations made within the Tonsillectomy in Pediatric Patients clinical practice guideline. All but one of the recommendations was met by at least one study.

Conclusions

and Relevance: Our findings indicate that knowledge gaps within the guideline at publication may have since been addressed and a guideline update may thus be warranted.

Level of Evidence

NA.

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An analysis of the literature addressing tonsillectomy knowledge gaps

Publication date: Available online 27 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Craig M. Cooper, Jake X. Checketts, Lacy Brame, Harrison Gray, Jaye Bea Downs, Matt Vassar

Abstract

Importance

The ability of clinical practice guidelines to improve patient outcomes depends on the quality of evidence that they are built upon. Research into tonsillectomy in children is lacking, and the gaps in evidence were identified by guideline authors.

Objective

The objective of this study is to evaluate the extent that new research is addressing the gaps identified in the AAO-HNS Tonsillectomy in Children Guideline.

Design

For each recommendation in the AAO-HNS guideline Tonsillectomy In Children, we created PICO (Participants, Intervention, Comparator, Outcome) questions and search strings. PubMed was searched to locate studies undertaken after the final literature search performed by the AAO-HNS work group. These studies were then extracted and analyzed.

Setting

This study is relevant to all invested in focusing otolaryngological research on questions which currently lack strong evidence.

Participants

Trials in tonsillectomy that started after the development of the AAO-HNS clinical practice guidelines.

Main Outcome Measures

The main outcome measures of this study is the extent to which tonsillectomy research is addressing the evidence gaps listed in the clinical practice guideline.

Results

Of the 2519 studies included in our sample, 276 (11%) were relevant to the 18 recommendations made within the Tonsillectomy in Pediatric Patients clinical practice guideline. All but one of the recommendations was met by at least one study.

Conclusions

and Relevance: Our findings indicate that knowledge gaps within the guideline at publication may have since been addressed and a guideline update may thus be warranted.

Level of Evidence

NA.

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Estimating and accounting for the effect of MRI scanner changes on longitudinal whole-brain volume change measurements

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): Hyunwoo Lee, Kunio Nakamura, Sridar Narayanan, Robert A. Brown, Douglas L. Arnold, for the Alzheimer's Disease Neuroimaging Initiative

Abstract

Objective

Longitudinal MRI studies are often subjected to mid-study scanner changes, which may alter image characteristics such as contrast, signal-to-noise ratio, contrast-to-noise ratio, intensity non-uniformity and geometric distortion. Measuring brain volume loss under these conditions can render the results potentially unreliable across the timepoint of the change. Estimating and accounting for this effect may improve the reliability of estimates of brain atrophy rates.

Methods

We analyzed 237 subjects who were scanned at 1.5 T for the Alzheimer's Disease Neuroimaging Initiative (ADNI) study and were subject to intra-vendor or inter-vendor scanner changes during follow-up (up to 8 years). Sixty-three subjects scanned on GE Signa HDx and HDxt platforms were also subject to a T1-weighted sequence change from Magnetization Prepared Rapid Gradient Echo (MP-RAGE) to Fast Spoiled Gradient Echo with IR Preparation (IR-FSPGR), as part of the transition from ADNI-1 to ADNI-2/GO. Two-timepoint percentage brain volume changes (PBVCs) between the baseline "screening" and the follow-up scans were calculated using SIENA. A linear mixed-effects model with subject-specific random slopes and intercepts was applied to estimate the fixed effects of scanner hardware changes on the PBVC measures. The same model also included a term to estimate the fixed effects of the T1-weighted sequence change.

Results

Different hardware upgrade or change combinations led to different offsets in the PBVC (SE; p): Philips Intera to Siemens Avanto, −1.81% (0.30; p < 0.0001); GE Genesis Signa to Philips Intera, 0.99% (0.47, p = 0.042); GE Signa Excite to Signa HDx, 0.33% (0.095, p = 0.0005); GE Signa Excite to Signa HDxt, −0.023% (0.23, p = 0.92); GE Signa Excite to Signa HDx to Signa HDxt, 0.25% (0.095, p = 0.010) and 0.27% (0.16, p = 0.098), respectively; GE Signa HDx to Signa HDxt, −0.24% (0.25, p = 0.34); Siemens Symphony to Symphony TIM, −0.39% (0.16; p = 0.019). The sequence change from MP-RAGE to IR-SPGR was associated with an average −1.63% (0.12; p < 0.0001) change.

Conclusion

Inter-vendor scanner changes generally led to greater effects on PBVC measurements than did intra-vendor scanner upgrades. The effect of T1-weighted sequence change was comparable to that of the inter-vendor scanner changes. Inclusion of the corrective fixed-effects terms for the scanner hardware and T1-weighted sequence changes yielded better model goodness-of-fits, and thus, potentially more reliable estimates of whole-brain atrophy rates.

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Estimating and accounting for the effect of MRI scanner changes on longitudinal whole-brain volume change measurements

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): Hyunwoo Lee, Kunio Nakamura, Sridar Narayanan, Robert A. Brown, Douglas L. Arnold, for the Alzheimer's Disease Neuroimaging Initiative

Abstract

Objective

Longitudinal MRI studies are often subjected to mid-study scanner changes, which may alter image characteristics such as contrast, signal-to-noise ratio, contrast-to-noise ratio, intensity non-uniformity and geometric distortion. Measuring brain volume loss under these conditions can render the results potentially unreliable across the timepoint of the change. Estimating and accounting for this effect may improve the reliability of estimates of brain atrophy rates.

Methods

We analyzed 237 subjects who were scanned at 1.5 T for the Alzheimer's Disease Neuroimaging Initiative (ADNI) study and were subject to intra-vendor or inter-vendor scanner changes during follow-up (up to 8 years). Sixty-three subjects scanned on GE Signa HDx and HDxt platforms were also subject to a T1-weighted sequence change from Magnetization Prepared Rapid Gradient Echo (MP-RAGE) to Fast Spoiled Gradient Echo with IR Preparation (IR-FSPGR), as part of the transition from ADNI-1 to ADNI-2/GO. Two-timepoint percentage brain volume changes (PBVCs) between the baseline "screening" and the follow-up scans were calculated using SIENA. A linear mixed-effects model with subject-specific random slopes and intercepts was applied to estimate the fixed effects of scanner hardware changes on the PBVC measures. The same model also included a term to estimate the fixed effects of the T1-weighted sequence change.

Results

Different hardware upgrade or change combinations led to different offsets in the PBVC (SE; p): Philips Intera to Siemens Avanto, −1.81% (0.30; p < 0.0001); GE Genesis Signa to Philips Intera, 0.99% (0.47, p = 0.042); GE Signa Excite to Signa HDx, 0.33% (0.095, p = 0.0005); GE Signa Excite to Signa HDxt, −0.023% (0.23, p = 0.92); GE Signa Excite to Signa HDx to Signa HDxt, 0.25% (0.095, p = 0.010) and 0.27% (0.16, p = 0.098), respectively; GE Signa HDx to Signa HDxt, −0.24% (0.25, p = 0.34); Siemens Symphony to Symphony TIM, −0.39% (0.16; p = 0.019). The sequence change from MP-RAGE to IR-SPGR was associated with an average −1.63% (0.12; p < 0.0001) change.

Conclusion

Inter-vendor scanner changes generally led to greater effects on PBVC measurements than did intra-vendor scanner upgrades. The effect of T1-weighted sequence change was comparable to that of the inter-vendor scanner changes. Inclusion of the corrective fixed-effects terms for the scanner hardware and T1-weighted sequence changes yielded better model goodness-of-fits, and thus, potentially more reliable estimates of whole-brain atrophy rates.

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Increased responses of the reward circuitry to positive task feedback following acute stress in healthy controls but not in siblings of schizophrenia patients

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): J.M.C. van Leeuwen, M. Vink, M. Joëls, R.S. Kahn, E.J. Hermans, C.H. Vinkers

Abstract

Acute stress is known to affect the way we process rewards. For example, during, or directly after stress, activity within key brain areas of the reward circuitry is reduced when a reward is presented. Generally, the effects of stress on the brain are time-dependent, changing neural and cognitive processing in the aftermath of stress to aid recovery. Such a dynamic response to stress is important for resilience on the longer term. However, relatively little is known about reward processing during the recovery phase of stress and whether this is changed in individuals at increased risk for stress-related psychopathology.

Healthy male individuals (N = 40) and unaffected siblings of schizophrenia patients (N = 40) were randomized to either an acute stress task (Trier Social Stress Test) or a no-stress task. Neural responses during reward anticipation and reward feedback (monetary gain or no gain) were examined 50 min later using an fMRI monetary incentive delay task. The ventral striatum and orbitofrontal cortex (OFC) were used as predefined hypothesis-driven regions of interest.

Neural responses following stress differed between controls and siblings during reward feedback (group × stress interaction OFC p = 0.003, ventral striatum p = 0.031), showing increased ventral striatum and OFC responses following stress in healthy controls only. Exploratory analyses revealed that this effect was most pronounced during hit trials (compared to when a reward was omitted), and independent of monetary value. Stress did not affect subsequent reward processing in siblings of schizophrenia patients. We found no significant differences between controls and siblings in ventral striatum and OFC responses during reward anticipation following stress.

This study shows that ventral striatum and OFC responses to positive task feedback are increased in the aftermath of stress in healthy male controls, regardless of monetary value. This indicates a dynamic shift from previously reported reduced responses in the striatum and OFC to reward feedback directly after stress to increased responses to both reward and non-reward feedback during the recovery phase of stress. These increased neural responses following stress were absent in siblings of schizophrenia patients. Together, these findings indicate that stress recovery is affected in this at-risk group, particularly in responses to positive feedback following stress.

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Increased responses of the reward circuitry to positive task feedback following acute stress in healthy controls but not in siblings of schizophrenia patients

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): J.M.C. van Leeuwen, M. Vink, M. Joëls, R.S. Kahn, E.J. Hermans, C.H. Vinkers

Abstract

Acute stress is known to affect the way we process rewards. For example, during, or directly after stress, activity within key brain areas of the reward circuitry is reduced when a reward is presented. Generally, the effects of stress on the brain are time-dependent, changing neural and cognitive processing in the aftermath of stress to aid recovery. Such a dynamic response to stress is important for resilience on the longer term. However, relatively little is known about reward processing during the recovery phase of stress and whether this is changed in individuals at increased risk for stress-related psychopathology.

Healthy male individuals (N = 40) and unaffected siblings of schizophrenia patients (N = 40) were randomized to either an acute stress task (Trier Social Stress Test) or a no-stress task. Neural responses during reward anticipation and reward feedback (monetary gain or no gain) were examined 50 min later using an fMRI monetary incentive delay task. The ventral striatum and orbitofrontal cortex (OFC) were used as predefined hypothesis-driven regions of interest.

Neural responses following stress differed between controls and siblings during reward feedback (group × stress interaction OFC p = 0.003, ventral striatum p = 0.031), showing increased ventral striatum and OFC responses following stress in healthy controls only. Exploratory analyses revealed that this effect was most pronounced during hit trials (compared to when a reward was omitted), and independent of monetary value. Stress did not affect subsequent reward processing in siblings of schizophrenia patients. We found no significant differences between controls and siblings in ventral striatum and OFC responses during reward anticipation following stress.

This study shows that ventral striatum and OFC responses to positive task feedback are increased in the aftermath of stress in healthy male controls, regardless of monetary value. This indicates a dynamic shift from previously reported reduced responses in the striatum and OFC to reward feedback directly after stress to increased responses to both reward and non-reward feedback during the recovery phase of stress. These increased neural responses following stress were absent in siblings of schizophrenia patients. Together, these findings indicate that stress recovery is affected in this at-risk group, particularly in responses to positive feedback following stress.

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Interactions between neural decision-making circuits predict long-term dietary treatment success in obesity

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): Martin Weygandt, Joachim Spranger, Verena Leupelt, Lukas Maurer, Thomas Bobbert, Knut Mai, John-Dylan Haynes

Abstract

Although dietary decision-making is regulated by multiple interacting neural controllers, their impact on dietary treatment success in obesity has only been investigated individually. Here, we used fMRI to test how well interactions between the Pavlovian system (automatically triggering urges of consumption after food cue exposure) and the goal-directed system (considering long-term consequences of food decisions) predict future dietary success achieved in 39 months. Activity of the Pavlovian system was measured with a cue-reactivity task by comparing perception of food versus control pictures, activity of the goal-directed system with a food-specific delay discounting paradigm. Both tasks were applied in 30 individuals with obesity up to five times: Before a 12-week diet, immediately thereafter, and at three annual follow-up visits. Brain activity was analyzed in two steps. In the first, we searched for areas involved in Pavlovian processes and goal-directed control across the 39-month study period with voxel-wise linear mixed-effects (LME) analyses. In the second, we computed network parameters reflecting the covariation of longitudinal voxel activity (i.e. principal components) in the regions identified in the first step and used them to predict body mass changes across the 39 months with LME models. Network analyses testing the link of dietary success with activity of the individual systems as reference found a moderate negative link to Pavlovian activity primarily in left hippocampus and a moderate positive association to goal-directed activity primarily in right inferior parietal gyrus. A cross-paradigm network analysis that integrated activity measured in both tasks revealed a strong positive link for interactions between visual Pavlovian areas and goal-directed decision-making regions mainly located in right insular cortex. We conclude that adaptation of food cue processing resources to goal-directed control activity is an important prerequisite of sustained dietary weight loss, presumably since the latter activity can modulate Pavlovian urges triggered by frequent cue exposure in everyday life.

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Interactions between neural decision-making circuits predict long-term dietary treatment success in obesity

Publication date: 1 January 2019

Source: NeuroImage, Volume 184

Author(s): Martin Weygandt, Joachim Spranger, Verena Leupelt, Lukas Maurer, Thomas Bobbert, Knut Mai, John-Dylan Haynes

Abstract

Although dietary decision-making is regulated by multiple interacting neural controllers, their impact on dietary treatment success in obesity has only been investigated individually. Here, we used fMRI to test how well interactions between the Pavlovian system (automatically triggering urges of consumption after food cue exposure) and the goal-directed system (considering long-term consequences of food decisions) predict future dietary success achieved in 39 months. Activity of the Pavlovian system was measured with a cue-reactivity task by comparing perception of food versus control pictures, activity of the goal-directed system with a food-specific delay discounting paradigm. Both tasks were applied in 30 individuals with obesity up to five times: Before a 12-week diet, immediately thereafter, and at three annual follow-up visits. Brain activity was analyzed in two steps. In the first, we searched for areas involved in Pavlovian processes and goal-directed control across the 39-month study period with voxel-wise linear mixed-effects (LME) analyses. In the second, we computed network parameters reflecting the covariation of longitudinal voxel activity (i.e. principal components) in the regions identified in the first step and used them to predict body mass changes across the 39 months with LME models. Network analyses testing the link of dietary success with activity of the individual systems as reference found a moderate negative link to Pavlovian activity primarily in left hippocampus and a moderate positive association to goal-directed activity primarily in right inferior parietal gyrus. A cross-paradigm network analysis that integrated activity measured in both tasks revealed a strong positive link for interactions between visual Pavlovian areas and goal-directed decision-making regions mainly located in right insular cortex. We conclude that adaptation of food cue processing resources to goal-directed control activity is an important prerequisite of sustained dietary weight loss, presumably since the latter activity can modulate Pavlovian urges triggered by frequent cue exposure in everyday life.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NK9xwZ