Condition: Anesthesia, Local Interventions: Drug: Lidocaine 1%/Epi 1:200000; Other: Na Cl 0.9%/Epi 1:200000 Sponsor: Ain Shams University Completed (Source: ClinicalTrials.gov)
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Condition: Anesthesia, Local Interventions: Drug: Lidocaine 1%/Epi 1:200000; Other: Na Cl 0.9%/Epi 1:200000 Sponsor: Ain Shams University Completed (Source: ClinicalTrials.gov)
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Condition: HIV/AIDS Intervention: Biological: PGT121 + VRC07-523LS Sponsors: International AIDS Vaccine Initiative; Beth Israel Deaconess Medical Center; Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) Not yet recruiting (Source: ClinicalTrials.gov)
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Condition: Ebola Virus Interventions: Drug: ZMapp; Drug: Remdesivir; Drug: MAb114 Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Condition: Malaria Intervention: Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Condition: HIV/AIDS Intervention: Biological: PGT121 + VRC07-523LS Sponsors: International AIDS Vaccine Initiative; Beth Israel Deaconess Medical Center; Vaccine Research Center (VRC), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) Not yet recruiting (Source: ClinicalTrials.gov)
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Condition: Ebola Virus Interventions: Drug: ZMapp; Drug: Remdesivir; Drug: MAb114 Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Conditions: Breast Cancer; Estrogen Receptor-positive Breast Cancer; Healthy Intervention: Sponsors: Duke University; United States Department of Defense Not yet recruiting (Source: ClinicalTrials.gov)
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Condition: Malaria Intervention: Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Condition: Crohn Disease Interventions: Drug: Anti-TNF Drug; Drug: Ustekinumab Sponsor: Hospices Civils de Lyon Not yet recruiting (Source: ClinicalTrials.gov)
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Conditions: Gingivitis; Mucositis Intervention: Behavioral: Experimentally induced plaque Sponsor: University of Campinas, Brazil Completed (Source: ClinicalTrials.gov)
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Obesity is thought to be associated with poor asthma control, increased health resource utilization, and reduced responsiveness to inhaled corticosteroids. (Source: Annals of Allergy, Asthma and Immunology)
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Obesity is thought to be associated with poor asthma control, increased health resource utilization, and reduced responsiveness to inhaled corticosteroids. (Source: Annals of Allergy, Asthma and Immunology)
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This study sought to identify novel CD8+ T cell homing markers by studying acute graft versus host disease (aGvHD), typically involving increased T cell homing to the skin and gut. FACS-sorted skin-homing (CD8β+/CLA+), gut-homing (CD8β+/integrinβ7+), and reference (CD8β+/CLA-/integrinβ7-) T cells were compared in patients affected by cutaneous and/or gastrointestinal aGVHD. Microarray analysis, Q-PCR and flow cytometry revealed increased expression of peptidase inhibitor 16 (PI16) in skin-homing CD8+ T cells. Robust association of PI16 with skin-homing was confirmed in all types of aGvHD and in healthy controls, too. PI16 was not observed on CLA+ leukocytes other than T cells. Induction of PI16 expression on skin-homing T cells occurred independently of vitamin D3. Among skin-homing T...
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This article is protected by copyright. All rights reserved. PMID: 30365177 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
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This article is protected by copyright. All rights reserved. PMID: 30365177 [PubMed - as supplied by publisher] (Source: European Journal of Immunology)
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To summarize the current management of the neck lymph node basin for head and neck non-melanoma skin cancers.
Over the last 5 years, there have been updates to staging for cSCC and MCC. T classification of the AJCC staging system has been changed to match the UICC staging system. MCC staging has been updated based on data from the National Cancer Data Base. Sentinel lymph node biopsy, while established in MCC, is playing a growing role in the management of high-risk N0 cSCC.
The optimal management of N0 neck varies by metastatic potential. In low-risk malignancy, no workup is necessary. In cSCC, risk stratification is necessary. High-risk tumors with N0 necks should undergo preoperative imaging with CT and targeted FNA of suspicious lymph nodes. If radiologically negative, a SLNB should be considered. Selective neck dissection should be performed for N+ disease and positive SLNB. Elective neck dissection is not routinely recommended and should be reserved for positive parotid nodal disease. Merkel cell carcinoma has high rates of nodal metastases and requires preoperative imaging with targeted FNA of suspected metastases. SLNB should be performed for N0 disease to guide prognostication and further treatment. Management of negative SLN is controversial, and most can be observed while radiation may be considered for high-risk patients. Positive SLN requires completion neck dissection and radiation.
To summarize the current management of the neck lymph node basin for head and neck non-melanoma skin cancers.
Over the last 5 years, there have been updates to staging for cSCC and MCC. T classification of the AJCC staging system has been changed to match the UICC staging system. MCC staging has been updated based on data from the National Cancer Data Base. Sentinel lymph node biopsy, while established in MCC, is playing a growing role in the management of high-risk N0 cSCC.
The optimal management of N0 neck varies by metastatic potential. In low-risk malignancy, no workup is necessary. In cSCC, risk stratification is necessary. High-risk tumors with N0 necks should undergo preoperative imaging with CT and targeted FNA of suspicious lymph nodes. If radiologically negative, a SLNB should be considered. Selective neck dissection should be performed for N+ disease and positive SLNB. Elective neck dissection is not routinely recommended and should be reserved for positive parotid nodal disease. Merkel cell carcinoma has high rates of nodal metastases and requires preoperative imaging with targeted FNA of suspected metastases. SLNB should be performed for N0 disease to guide prognostication and further treatment. Management of negative SLN is controversial, and most can be observed while radiation may be considered for high-risk patients. Positive SLN requires completion neck dissection and radiation.
To summarize the current management of the neck lymph node basin for head and neck non-melanoma skin cancers.
Over the last 5 years, there have been updates to staging for cSCC and MCC. T classification of the AJCC staging system has been changed to match the UICC staging system. MCC staging has been updated based on data from the National Cancer Data Base. Sentinel lymph node biopsy, while established in MCC, is playing a growing role in the management of high-risk N0 cSCC.
The optimal management of N0 neck varies by metastatic potential. In low-risk malignancy, no workup is necessary. In cSCC, risk stratification is necessary. High-risk tumors with N0 necks should undergo preoperative imaging with CT and targeted FNA of suspicious lymph nodes. If radiologically negative, a SLNB should be considered. Selective neck dissection should be performed for N+ disease and positive SLNB. Elective neck dissection is not routinely recommended and should be reserved for positive parotid nodal disease. Merkel cell carcinoma has high rates of nodal metastases and requires preoperative imaging with targeted FNA of suspected metastases. SLNB should be performed for N0 disease to guide prognostication and further treatment. Management of negative SLN is controversial, and most can be observed while radiation may be considered for high-risk patients. Positive SLN requires completion neck dissection and radiation.
To summarize the current management of the neck lymph node basin for head and neck non-melanoma skin cancers.
Over the last 5 years, there have been updates to staging for cSCC and MCC. T classification of the AJCC staging system has been changed to match the UICC staging system. MCC staging has been updated based on data from the National Cancer Data Base. Sentinel lymph node biopsy, while established in MCC, is playing a growing role in the management of high-risk N0 cSCC.
The optimal management of N0 neck varies by metastatic potential. In low-risk malignancy, no workup is necessary. In cSCC, risk stratification is necessary. High-risk tumors with N0 necks should undergo preoperative imaging with CT and targeted FNA of suspicious lymph nodes. If radiologically negative, a SLNB should be considered. Selective neck dissection should be performed for N+ disease and positive SLNB. Elective neck dissection is not routinely recommended and should be reserved for positive parotid nodal disease. Merkel cell carcinoma has high rates of nodal metastases and requires preoperative imaging with targeted FNA of suspected metastases. SLNB should be performed for N0 disease to guide prognostication and further treatment. Management of negative SLN is controversial, and most can be observed while radiation may be considered for high-risk patients. Positive SLN requires completion neck dissection and radiation.
CONCLUSIONS: An ongoing feedback loop is important in designing a modern Master of Science course in the context of the Bologna process. Valuable information is given by students and should be integrated continuously in the design and continuation process. PMID: 30362858 [PubMed - as supplied by publisher] (Source: International Journal of Radiation Biology)
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CONCLUSIONS: An ongoing feedback loop is important in designing a modern Master of Science course in the context of the Bologna process. Valuable information is given by students and should be integrated continuously in the design and continuation process. PMID: 30362858 [PubMed - as supplied by publisher] (Source: International Journal of Radiation Biology)
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In this study, we explored the relationship between PAR4 activation and the expression of p16, and elucidated the underlying mechanisms in PAR4 inducing the tumor suppressor role in ESCC. ESCC cell lines (EC109 and TE-1) were treated with PAR4-activating peptide (PAR4-AP). Immunohistochemistry for DNA methyltransferase 1 (DNMT1) and histone deacetylase 2 (HDAC2) was performed in 26 cases of ESCC tissues. We found that DNMT1 and HDAC2 immunoreactivities in ESCC were significantly higher than those in adjacent noncancerous tissues. PAR4 activation could suppress DNMT1 and HDAC2, as well as increase p16 expressions, whereas silencing PAR4 dramatically increased HDAC2 and DNMT1, as well as reduced p16 expressions. Importantly, the chromatin immunoprecipitation-PCR (ChIP-PCR) data indicated tha...
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Conclusion: Collectively, these data confirmed that DX5+NKT cells inhibit proliferation of colitis-inducing CD4+CD62Lhigh cells by induction of apoptosis. Furthermore, DX5+NKT cells likely mediate their cytotoxic and proapoptotic potentials via FasL, confirming recent reports about iNKT cells. Further studies will be necessary to evaluate the therapeutical potential of these immunoregulatory cells in patients with colitis. PMID: 30364054 [PubMed - in process] (Source: Journal of Immunology Research)
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Conclusion: Collectively, these data confirmed that DX5+NKT cells inhibit proliferation of colitis-inducing CD4+CD62Lhigh cells by induction of apoptosis. Furthermore, DX5+NKT cells likely mediate their cytotoxic and proapoptotic potentials via FasL, confirming recent reports about iNKT cells. Further studies will be necessary to evaluate the therapeutical potential of these immunoregulatory cells in patients with colitis. PMID: 30364054 [PubMed - in process] (Source: Journal of Immunology Research)
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Conclusion: Taken together, our data showed that sevoflurane ameliorated allergic airway inflammation by inhibiting Th2 responses and NLRP3 expression. The NLRP3 independent of inflammasomes participated in the pathogenesis of allergic asthma in this model. PMID: 30363922 [PubMed - in process] (Source: Journal of Immunology Research)
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Conclusion: Taken together, our data showed that sevoflurane ameliorated allergic airway inflammation by inhibiting Th2 responses and NLRP3 expression. The NLRP3 independent of inflammasomes participated in the pathogenesis of allergic asthma in this model. PMID: 30363922 [PubMed - in process] (Source: Journal of Immunology Research)
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In conclusion, HBcAg promoted proliferation and inhibited apoptosis through the PKC/NF‑κB/Bcl‑2 signaling pathway in DC2.4 cells. PMID: 30365118 [PubMed - as supplied by publisher] (Source: Molecular Medicine Reports)
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In this study, we explored the relationship between PAR4 activation and the expression of p16, and elucidated the underlying mechanisms in PAR4 inducing the tumor suppressor role in ESCC. ESCC cell lines (EC109 and TE-1) were treated with PAR4-activating peptide (PAR4-AP). Immunohistochemistry for DNA methyltransferase 1 (DNMT1) and histone deacetylase 2 (HDAC2) was performed in 26 cases of ESCC tissues. We found that DNMT1 and HDAC2 immunoreactivities in ESCC were significantly higher than those in adjacent noncancerous tissues. PAR4 activation could suppress DNMT1 and HDAC2, as well as increase p16 expressions, whereas silencing PAR4 dramatically increased HDAC2 and DNMT1, as well as reduced p16 expressions. Importantly, the chromatin immunoprecipitation-PCR (ChIP-PCR) data indicated tha...
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CONCLUSION: The Russian USH cohort shows both novel and known USH mutations. Clinically the prevalence of USH2 is low (39.28%) and the frequency of MYO7A mutations responsible for USH1B is very high (63.63%, N = 7/11) compared to other cohorts. These seven patients carrying MYO7A mutations are preliminarily eligible for the UshStat® gene therapy. PMID: 30358468 [PubMed - as supplied by publisher] (Source: Ophthalmic Genetics)
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In conclusion, HBcAg promoted proliferation and inhibited apoptosis through the PKC/NF‑κB/Bcl‑2 signaling pathway in DC2.4 cells. PMID: 30365118 [PubMed - as supplied by publisher] (Source: Molecular Medicine Reports)
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. (Source: Journal of American College Health)
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CONCLUSION: The Russian USH cohort shows both novel and known USH mutations. Clinically the prevalence of USH2 is low (39.28%) and the frequency of MYO7A mutations responsible for USH1B is very high (63.63%, N = 7/11) compared to other cohorts. These seven patients carrying MYO7A mutations are preliminarily eligible for the UshStat® gene therapy. PMID: 30358468 [PubMed - as supplied by publisher] (Source: Ophthalmic Genetics)
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. (Source: Journal of American College Health)
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In conclusion, we suggest that complexation with EGCG could be a promising strategy to reduce the allergenicity of whey proteins.Graphical abstract (Source: Journal of Functional Foods)
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In conclusion, we suggest that complexation with EGCG could be a promising strategy to reduce the allergenicity of whey proteins.Graphical abstract (Source: Journal of Functional Foods)
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Video 1. Axial (horizontal) CT of the right temporal bone showing the changes in the anterior ear canal. (Source: The Hearing Journal - Video)
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Video 1. Axial (horizontal) CT of the right temporal bone showing the changes in the anterior ear canal. (Source: The Hearing Journal - Video)
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Video 2. Axial (horizontal) bone-window CT of bilateral temporal bones showing the difference between the two skull base appearances (Source: The Hearing Journal - Video)
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Video 2. Axial (horizontal) bone-window CT of bilateral temporal bones showing the difference between the two skull base appearances (Source: The Hearing Journal - Video)
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Video 3. Axial (horizontal) soft tissue window CT of skull base demonstrating the edema in the skull base and nasopharynx. (Source: The Hearing Journal - Video)
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Video 3. Axial (horizontal) soft tissue window CT of skull base demonstrating the edema in the skull base and nasopharynx. (Source: The Hearing Journal - Video)
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Video 1. Axial (horizontal) CT of the right temporal bone showing the changes in the anterior ear canal. (Source: The Hearing Journal - Video)
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Video 4. Coronal (vertical, parallel to face) CT of the right temporal bone showing the temporal bone changes in the coronal plane. (Source: The Hearing Journal - Video)
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Video 1. Axial (horizontal) CT of the right temporal bone showing the changes in the anterior ear canal. (Source: The Hearing Journal - Video)
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Video 4. Coronal (vertical, parallel to face) CT of the right temporal bone showing the temporal bone changes in the coronal plane. (Source: The Hearing Journal - Video)
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Video 2. Axial (horizontal) bone-window CT of bilateral temporal bones showing the difference between the two skull base appearances (Source: The Hearing Journal - Video)
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Video 5. Sagittal (vertical, parallel to auricle) CT of the right temporal bone showing the extent of changes to anterior ear canal and TMJ. (Source: The Hearing Journal - Video)
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Video 2. Axial (horizontal) bone-window CT of bilateral temporal bones showing the difference between the two skull base appearances (Source: The Hearing Journal - Video)
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Video 5. Sagittal (vertical, parallel to auricle) CT of the right temporal bone showing the extent of changes to anterior ear canal and TMJ. (Source: The Hearing Journal - Video)
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Video 3. Axial (horizontal) soft tissue window CT of skull base demonstrating the edema in the skull base and nasopharynx. (Source: The Hearing Journal - Video)
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Video 6. Coronal (vertical, parallel to face) soft tissue window CT of the neck showing the extension of edema to the pharynx from the skull base. (Source: The Hearing Journal - Video)
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Video 3. Axial (horizontal) soft tissue window CT of skull base demonstrating the edema in the skull base and nasopharynx. (Source: The Hearing Journal - Video)
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Video 6. Coronal (vertical, parallel to face) soft tissue window CT of the neck showing the extension of edema to the pharynx from the skull base. (Source: The Hearing Journal - Video)
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Video 4. Coronal (vertical, parallel to face) CT of the right temporal bone showing the temporal bone changes in the coronal plane. (Source: The Hearing Journal - Video)
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Video 4. Coronal (vertical, parallel to face) CT of the right temporal bone showing the temporal bone changes in the coronal plane. (Source: The Hearing Journal - Video)
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Video 5. Sagittal (vertical, parallel to auricle) CT of the right temporal bone showing the extent of changes to anterior ear canal and TMJ. (Source: The Hearing Journal - Video)
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Video 5. Sagittal (vertical, parallel to auricle) CT of the right temporal bone showing the extent of changes to anterior ear canal and TMJ. (Source: The Hearing Journal - Video)
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Video 6. Coronal (vertical, parallel to face) soft tissue window CT of the neck showing the extension of edema to the pharynx from the skull base. (Source: The Hearing Journal - Video)
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Video 6. Coronal (vertical, parallel to face) soft tissue window CT of the neck showing the extension of edema to the pharynx from the skull base. (Source: The Hearing Journal - Video)
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Neuropathy of the Baxter nerve (BN) seems to be the first cause of the heel pain syndrome (HPS) of neurological origin.
41 alcohol–glycerol embalmed feet were dissected. We documented the pattern of the branches of the tibial nerve (TN) and describe all relevant osteofibrous structures. Measurements for the TN branches were related to the Dellon–McKinnon malleolar-calcaneal line also called DM line (DML) for the proximal TT and the Heimkes Triangle for the distal TT. Additionally, we performed an ultrasound-guided injection procedure of the BN and provide an algorithm for clinical usage.
The division of the TN was 16.4 mm proximal to the DML. The BN branches off 20 mm above the DML center or 30 mm distally to it. In most of the cases, the medial calcaneal branch (MCB) originated from the TN proximal to the bifurcation. Possible entrapment spots for the medial and lateral plantar nerve (MPN, LPN), the BN and the MCB are found within a circle of 5 mm radius with a probability of 80%, 83%, and 84%, respectively. In ten out of ten feet, the US-guided injection was precisely allocated around the BN.
Our detailed mapping of the TN branches and their osteofibrous tubes at the TT might be of importance for foot and ankle surgeons during minimally invasive procedures in HPS such as ultrasound-guided ankle and foot decompression surgery (UGAFDS).
Neuropathy of the Baxter nerve (BN) seems to be the first cause of the heel pain syndrome (HPS) of neurological origin.
41 alcohol–glycerol embalmed feet were dissected. We documented the pattern of the branches of the tibial nerve (TN) and describe all relevant osteofibrous structures. Measurements for the TN branches were related to the Dellon–McKinnon malleolar-calcaneal line also called DM line (DML) for the proximal TT and the Heimkes Triangle for the distal TT. Additionally, we performed an ultrasound-guided injection procedure of the BN and provide an algorithm for clinical usage.
The division of the TN was 16.4 mm proximal to the DML. The BN branches off 20 mm above the DML center or 30 mm distally to it. In most of the cases, the medial calcaneal branch (MCB) originated from the TN proximal to the bifurcation. Possible entrapment spots for the medial and lateral plantar nerve (MPN, LPN), the BN and the MCB are found within a circle of 5 mm radius with a probability of 80%, 83%, and 84%, respectively. In ten out of ten feet, the US-guided injection was precisely allocated around the BN.
Our detailed mapping of the TN branches and their osteofibrous tubes at the TT might be of importance for foot and ankle surgeons during minimally invasive procedures in HPS such as ultrasound-guided ankle and foot decompression surgery (UGAFDS).
ConclusionThe chloroform extract of D. foveolatum find use as broad-spectrum larvicidal agent in the near future. It is hoped that more work would be undertaken to evaluate the utility of these plant extracts for field applications considering the promising leads given by the present study. (Source: Comparative Immunology, Microbiology and Infectious Diseases)
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Publication date: October 2018Source: Comparative Immunology, Microbiology and Infectious Diseases, Volume 60Author(s): Gamal A. Elmowalid, Adel Attia M. Ahmad, Muhammad N. Hassan, Norhan K. Abd El-Aziz, Ashraf M. Abdelwahab, Shymaa I. ElwanAbstractThe emergence of multidrug-resistant (MDR) pathogens was reported worldwide. Herein, SHV extended-spectrum β-lactamase (SHV-ESBL) variants detection was investigated in MDR E. coli and K. pneumoniae isolates recovered from human subjects (n = 144), one day-old chicks (n = 36) and broiler clinical samples (n = 90). All examined samples were positive for E. coli (n = 246/270; 91.11%) and Klebsiella pneumoniae (n = 24/270; 8.89%). Antimicrobial susceptibility testing was performed on E. coli and K. pneumoniae. SHV-ESBL producin...
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Publication date: October 2018Source: Comparative Immunology, Microbiology and Infectious Diseases, Volume 60Author(s): Gamal A. Elmowalid, Adel Attia M. Ahmad, Muhammad N. Hassan, Norhan K. Abd El-Aziz, Ashraf M. Abdelwahab, Shymaa I. ElwanAbstractThe emergence of multidrug-resistant (MDR) pathogens was reported worldwide. Herein, SHV extended-spectrum β-lactamase (SHV-ESBL) variants detection was investigated in MDR E. coli and K. pneumoniae isolates recovered from human subjects (n = 144), one day-old chicks (n = 36) and broiler clinical samples (n = 90). All examined samples were positive for E. coli (n = 246/270; 91.11%) and Klebsiella pneumoniae (n = 24/270; 8.89%). Antimicrobial susceptibility testing was performed on E. coli and K. pneumoniae. SHV-ESBL producin...
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ConclusionThe chloroform extract of D. foveolatum find use as broad-spectrum larvicidal agent in the near future. It is hoped that more work would be undertaken to evaluate the utility of these plant extracts for field applications considering the promising leads given by the present study. (Source: Comparative Immunology, Microbiology and Infectious Diseases)
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CONCLUSION: Comparative analyzes of risk-benefit, economic costs, patient satisfaction, protections vs. other measures are lacking. It is necessary to continue the development of these products and to compare more precisely their intrinsic characteristics, to best support patients choices. PMID: 30361139 [PubMed - as supplied by publisher] (Source: Progres en Urologie)
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CONCLUSION: Comparative analyzes of risk-benefit, economic costs, patient satisfaction, protections vs. other measures are lacking. It is necessary to continue the development of these products and to compare more precisely their intrinsic characteristics, to best support patients choices. PMID: 30361139 [PubMed - as supplied by publisher] (Source: Progres en Urologie)
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Semin Hear 2018; 39: 405-413 DOI: 10.1055/s-0038-1670706Binaural hearing offers numerous advantages over monaural hearing. While bilateral implants are a successful treatment option for some patients, many individuals choose to achieve binaural hearing by using a cochlear implant with a contralateral hearing aid. Compared with monaural hearing, benefits of bimodal hearing include improved speech perception in quiet and in noise, improved localization, and more natural sound quality. Despite the advantages, there exist disadvantages to bimodal hearing, primarily related to binaural integration. Management of these devices can be challenging in that the hearing aid and cochlear implant may be managed by different clinicians. When fitting devices, strategies are recommended to optimize the in...
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This article provides a review of the current literature on the topic of frequency lowering hearing aid technology specific to the treatment of severe and profound levels of hearing impairment in child and adult listeners. Factors to consider when assessing listener candidacy for frequency lowering technology are discussed. These include factors related to audiometric assessment, the listener, the type of hearing aid technology, and the verification and validation procedures that can assist in determining candidacy for frequency lowering technology. An individualized candidacy assessment including the use of real-ear verification measures and carefully chosen validation tools are recommended for listeners requiring greater audibility of high-frequency sounds, when compared with amplificati...
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Semin Hear 2018; 39: 390-404 DOI: 10.1055/s-0038-1670705Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one's surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and real...
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Semin Hear 2018; 39: 349-363 DOI: 10.1055/s-0038-1670698Substantial loss of cochlear function is required to elevate pure-tone thresholds to the severe hearing loss range; yet, individuals with severe or profound hearing loss continue to rely on hearing for communication. Despite the impairment, sufficient information is encoded at the periphery to make acoustic hearing a viable option. However, the probability of significant cochlear and/or neural damage associated with the loss has consequences for sound perception and speech recognition. These consequences include degraded frequency selectivity, which can be assessed with tests including psychoacoustic tuning curves and broadband rippled stimuli. Because speech recognition depends on the ability to resolve frequency detail, a listener w...
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Semin Hear 2018; 39: 414-427 DOI: 10.1055/s-0038-1670707Hearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life. [...] Thieme Medical Publish...
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Semin Hear 2018; 39: 428-436 DOI: 10.1055/s-0038-1670708The impact of profound hearing loss on infants and adults is variable and greatly influenced by improved audition derived from hearing aids and cochlear implants. However, barriers to healthcare, hearing healthcare in particular, can offset the benefits provided by these sensory devices. Common barriers include cost, location, availability of trained professionals, acceptance of the hearing loss, language and cultural differences, secondary disabilities, and mental health issues. These barriers and their distinct presentations vary somewhat by age, language, and where people live (urban vs. rural), and can interfere with receiving testing and devices in a timely manner. They also can limit auditory, speech and language therapies, and ...
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Conclusions: If the SOT is to be used as a measure of improvement, the learning effect should be exhausted (which typically occurs following the third administration) prior to the introduction of therapy. Future research should further investigate the results from those with other vestibular pathologies. PMID: 30357271 [PubMed - as supplied by publisher] (Source: American Journal of Audiology)
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Semin Hear 2018; 39: 405-413 DOI: 10.1055/s-0038-1670706Binaural hearing offers numerous advantages over monaural hearing. While bilateral implants are a successful treatment option for some patients, many individuals choose to achieve binaural hearing by using a cochlear implant with a contralateral hearing aid. Compared with monaural hearing, benefits of bimodal hearing include improved speech perception in quiet and in noise, improved localization, and more natural sound quality. Despite the advantages, there exist disadvantages to bimodal hearing, primarily related to binaural integration. Management of these devices can be challenging in that the hearing aid and cochlear implant may be managed by different clinicians. When fitting devices, strategies are recommended to optimize the in...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2yFHq8q
This article provides a review of the current literature on the topic of frequency lowering hearing aid technology specific to the treatment of severe and profound levels of hearing impairment in child and adult listeners. Factors to consider when assessing listener candidacy for frequency lowering technology are discussed. These include factors related to audiometric assessment, the listener, the type of hearing aid technology, and the verification and validation procedures that can assist in determining candidacy for frequency lowering technology. An individualized candidacy assessment including the use of real-ear verification measures and carefully chosen validation tools are recommended for listeners requiring greater audibility of high-frequency sounds, when compared with amplificati...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Obh7vT
Semin Hear 2018; 39: 390-404 DOI: 10.1055/s-0038-1670705Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one's surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and real...
MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.
Semin Hear 2018; 39: 349-363 DOI: 10.1055/s-0038-1670698Substantial loss of cochlear function is required to elevate pure-tone thresholds to the severe hearing loss range; yet, individuals with severe or profound hearing loss continue to rely on hearing for communication. Despite the impairment, sufficient information is encoded at the periphery to make acoustic hearing a viable option. However, the probability of significant cochlear and/or neural damage associated with the loss has consequences for sound perception and speech recognition. These consequences include degraded frequency selectivity, which can be assessed with tests including psychoacoustic tuning curves and broadband rippled stimuli. Because speech recognition depends on the ability to resolve frequency detail, a listener w...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OcqueZ
Semin Hear 2018; 39: 414-427 DOI: 10.1055/s-0038-1670707Hearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life. [...] Thieme Medical Publish...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2yFH4i6
Semin Hear 2018; 39: 428-436 DOI: 10.1055/s-0038-1670708The impact of profound hearing loss on infants and adults is variable and greatly influenced by improved audition derived from hearing aids and cochlear implants. However, barriers to healthcare, hearing healthcare in particular, can offset the benefits provided by these sensory devices. Common barriers include cost, location, availability of trained professionals, acceptance of the hearing loss, language and cultural differences, secondary disabilities, and mental health issues. These barriers and their distinct presentations vary somewhat by age, language, and where people live (urban vs. rural), and can interfere with receiving testing and devices in a timely manner. They also can limit auditory, speech and language therapies, and ...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OaUcAW
Conclusions: If the SOT is to be used as a measure of improvement, the learning effect should be exhausted (which typically occurs following the third administration) prior to the introduction of therapy. Future research should further investigate the results from those with other vestibular pathologies. PMID: 30357271 [PubMed - as supplied by publisher] (Source: American Journal of Audiology)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2yFGXmG
Publication date: Available online 26 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Danny M. Cohn, Sacha S. Zeerleder, Joost C.M. Meijers, Erik S.G. Stroes, Marcel Levi (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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Publication date: Available online 26 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Renee Kleris, Monica Tang, Cristine Radojicic, Patricia L. Lugar (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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Clinical&Experimental Allergy,Volume 0, Issue ja, -Not available-. (Source: Clinical and Experimental Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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European Journal of Immunology,Volume 0, Issue ja, -Not available-. (Source: European Journal of Immunology)
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European Journal of Immunology,Volume 0, Issue ja, -Not available-. (Source: European Journal of Immunology)
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Publication date: Available online 26 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Danny M. Cohn, Sacha S. Zeerleder, Joost C.M. Meijers, Erik S.G. Stroes, Marcel Levi (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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Publication date: Available online 26 October 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Renee Kleris, Monica Tang, Cristine Radojicic, Patricia L. Lugar (Source: The Journal of Allergy and Clinical Immunology: In Practice)
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Clinical&Experimental Allergy,Volume 0, Issue ja, -Not available-. (Source: Clinical and Experimental Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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Allergy,Volume 0, Issue ja, -Not available-. (Source: Allergy)
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European Journal of Immunology,Volume 0, Issue ja, -Not available-. (Source: European Journal of Immunology)
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European Journal of Immunology,Volume 0, Issue ja, -Not available-. (Source: European Journal of Immunology)
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As an aspiring physician on the pre-med track (a microbiology and immunology major), I believe that creating a strong academic foundation, especially in math and science, is essential for future career and academic success. Growing up in Miami's more improvised area, Liberty City, quality learning materials were scarce. Even when there were resources for active learning, most students were completely unaware of their existence or lacked the training to make effective use of the learning materials. The end result would usually be that students lacked the essential study skills they need to make use of all the educational resources when they hit college, myself included. Situations like these emphasize that the science of learning (i.e., learning how to learn) is a valuable skill to have e...
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As an aspiring physician on the pre-med track (a microbiology and immunology major), I believe that creating a strong academic foundation, especially in math and science, is essential for future career and academic success. Growing up in Miami's more improvised area, Liberty City, quality learning materials were scarce. Even when there were resources for active learning, most students were completely unaware of their existence or lacked the training to make effective use of the learning materials. The end result would usually be that students lacked the essential study skills they need to make use of all the educational resources when they hit college, myself included. Situations like these emphasize that the science of learning (i.e., learning how to learn) is a valuable skill to have e...
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Publication date: Available online 26 October 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): F. Dezoteux, R. Dubois, G. Lefèvre, J.P. Lecoutre, D. Staumont-Sallé, O. Carpentier
Kimura disease (KD) is a chronic lymphoproliferative disorder of unknown etiology that affects the skin and lymph nodes, mostly observed in males of Asian descent. The natural history of asymptomatic epiglottal KD remains unknown. This rare site of KD is often only diagnosed when tumor growth starts to obstruct the upper airways.
A 34-year-old North African male presented with fatigue and multiple, slowly progressive, fluctuating skin nodules in the right mandibular and retroauricular regions. Computed tomography of the head and neck revealed a large soft tissue tumor close to the right mandibular body and unexpected thickening of the epiglottis. Transnasal laryngoscopy confirmed the CT findings and showed thickening of the epiglottis. The diagnosis of KD was based on histological examination of biopsy specimens taken from the right mandibular tumor, a cervical lymph node, and the epiglottis.
Most cases of KD with epiglottal involvement present with dysphonia and dysphagia. No consensus guidelines are available concerning the complementary investigations that should be performed. This case report raises the question of whether patients with suspected KD should be systematically screened for lesions in unusual and potentially dangerous anatomic sites.
Publication date: Available online 26 October 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): F. Dezoteux, R. Dubois, G. Lefèvre, J.P. Lecoutre, D. Staumont-Sallé, O. Carpentier
Kimura disease (KD) is a chronic lymphoproliferative disorder of unknown etiology that affects the skin and lymph nodes, mostly observed in males of Asian descent. The natural history of asymptomatic epiglottal KD remains unknown. This rare site of KD is often only diagnosed when tumor growth starts to obstruct the upper airways.
A 34-year-old North African male presented with fatigue and multiple, slowly progressive, fluctuating skin nodules in the right mandibular and retroauricular regions. Computed tomography of the head and neck revealed a large soft tissue tumor close to the right mandibular body and unexpected thickening of the epiglottis. Transnasal laryngoscopy confirmed the CT findings and showed thickening of the epiglottis. The diagnosis of KD was based on histological examination of biopsy specimens taken from the right mandibular tumor, a cervical lymph node, and the epiglottis.
Most cases of KD with epiglottal involvement present with dysphonia and dysphagia. No consensus guidelines are available concerning the complementary investigations that should be performed. This case report raises the question of whether patients with suspected KD should be systematically screened for lesions in unusual and potentially dangerous anatomic sites.
Publication date: Available online 27 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Mistry Taher, Natarajan Srivalli, Mistry Yusuf
To evaluate the clinical outcomes of laser skin resurfacing using ultrapulse CO2 laser and manual dermabrasion using medium grit drywall sand screen for scar revision in adults with Fitzpatrick Skin type III – V.
ology: A total of 20 post-surgical and post-traumatic scars in individuals with Fitzpatrick Skin type III – V were included in this study. Pre-operative evaluation of the scar was done using the Manchester scar rating scale by three blinded observers. Each scar to be treated was divided into two equal halves and each half was allotted to either group A (ultrapulse CO2 laser resurfacing) or group B (manual dermabrasion) randomly.
Postoperative clinical evaluation was done by the same observers using the Manchester scar rating scale at the end of, 1st, 3rd, and 6th month, respectively.
This study showed that both the methods are effective in improving the appearance of the post-surgical and post-traumatic scars. However, there is no significant difference among them (p=0.978). Hyperpigmentation occurred in four scars in both the halves treated with manual dermabrasion and laser resurfacing, however it had resolved by the end of the 6th month in all the four scars.
This study concluded that CO2 laser resurfacing and manual dermabrasion, both are equally efficacious and safe methods for scar resurfacing in adults with Fitzpatrick skin type III - V.
Publication date: Available online 27 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Mistry Taher, Natarajan Srivalli, Mistry Yusuf
To evaluate the clinical outcomes of laser skin resurfacing using ultrapulse CO2 laser and manual dermabrasion using medium grit drywall sand screen for scar revision in adults with Fitzpatrick Skin type III – V.
ology: A total of 20 post-surgical and post-traumatic scars in individuals with Fitzpatrick Skin type III – V were included in this study. Pre-operative evaluation of the scar was done using the Manchester scar rating scale by three blinded observers. Each scar to be treated was divided into two equal halves and each half was allotted to either group A (ultrapulse CO2 laser resurfacing) or group B (manual dermabrasion) randomly.
Postoperative clinical evaluation was done by the same observers using the Manchester scar rating scale at the end of, 1st, 3rd, and 6th month, respectively.
This study showed that both the methods are effective in improving the appearance of the post-surgical and post-traumatic scars. However, there is no significant difference among them (p=0.978). Hyperpigmentation occurred in four scars in both the halves treated with manual dermabrasion and laser resurfacing, however it had resolved by the end of the 6th month in all the four scars.
This study concluded that CO2 laser resurfacing and manual dermabrasion, both are equally efficacious and safe methods for scar resurfacing in adults with Fitzpatrick skin type III - V.
Journal of Cellular Physiology, EarlyView. (Source: Journal of Cellular Physiology)
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Authors: Simoneti CS, Ferraz E, Menezes MB, Icuma TR, Vianna EO Abstract The association between pet ownership and the development of allergic and respiratory diseases has been the aim of several studies, however, the effects of exposure in adults remain uncertain. The aims of the present study were to investigate the prevalence of asthma and lung function status among dog and cat owners. This cross-sectional study was performed at two universities with students and workers who were allocated into 3 groups according to pet ownership in the previous year: cat owners, dog owners, and no pets (control group). Subjects underwent spirometry, bronchial challenge test with mannitol, skin prick tests, and questionnaires about animal exposures and respiratory symptoms. Control group compris...
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Authors: Simoneti CS, Ferraz E, Menezes MB, Icuma TR, Vianna EO Abstract The association between pet ownership and the development of allergic and respiratory diseases has been the aim of several studies, however, the effects of exposure in adults remain uncertain. The aims of the present study were to investigate the prevalence of asthma and lung function status among dog and cat owners. This cross-sectional study was performed at two universities with students and workers who were allocated into 3 groups according to pet ownership in the previous year: cat owners, dog owners, and no pets (control group). Subjects underwent spirometry, bronchial challenge test with mannitol, skin prick tests, and questionnaires about animal exposures and respiratory symptoms. Control group compris...
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Journal of Cellular Physiology, EarlyView. (Source: Journal of Cellular Physiology)
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Journal of Cellular Physiology, EarlyView. (Source: Journal of Cellular Physiology)
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Journal of Cellular Physiology, EarlyView. (Source: Journal of Cellular Physiology)
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Publication date: Available online 27 October 2018
Source: Academic Radiology
Author(s): Fengyong Liu, Hongjun Yuan, Xin Li, Xin Ma, Maoqiang Wang
To assess the feasibility, safety, and effect of hypothermic perfusion on postoperative renal function employing a renal artery balloon catheter inserted via robot-assisted partial nephrectomy (h-RAPN) to treat renal tumors.
Forty-three patients with renal tumors were studied between March 2013 and August 2017. Renal artery balloon catheters were placed under angiographic guidance, and the balloon was fully inflated to occlude the renal artery during surgery. After establishing venous outflow, a robot-assisted partial nephrectomy was performed following perfusion with sodium lactate Ringer's solution at 4°C through the balloon catheter. Renal dynamic imaging was used to assess renal function, with calculation units consisting of glomerular filtration rate per unit volume of the kidney (GFR-UV).
Six patients were converted to radical nephrectomy intraoperatively, and the remaining 37 patients successfully underwent the h-RAPN procedure. Two patients had incomplete occlusion of the renal artery and received supplementary arterial clamp occlusion intraoperatively. One patient's balloon catheter slipped out of position preoperatively, and the patient was returned to the interventional radiology suite for balloon reinsertion, after which the patient underwent surgery successfully. No patients had severe complications. The average cold ischemia time was 39.5 ± 9.7 min (range, 22–123 min), the average temperature of the affected kidney during surgery was 19.3 ± 3.5°C (17.2–26.7°C), the average postoperative GFR-UV of the affected kidney was 0.42 ± 0.09 ml/min/ml (0.21–1.24 ml/min), and the average postoperative GFR-UV of the healthy kidney was 0.30 ± 0.04 ml/min/ml (P > 0.05). Multiple regression analysis indicated that cold ischemia time was an independent risk factor affecting the postoperative GFR of the affected kidney.
The advantages of h-RAPN include a clear surgical field enabling precise resection. When hypothermic perfusion via a renal artery balloon catheter is performed in conjunction with h-RAPN, the surgical time can be lengthened without increasing impairment of the affected kidney function, making this a safe and effective method of treating kidney tumors.
Publication date: Available online 27 October 2018
Source: Academic Radiology
Author(s): Fengyong Liu, Hongjun Yuan, Xin Li, Xin Ma, Maoqiang Wang
To assess the feasibility, safety, and effect of hypothermic perfusion on postoperative renal function employing a renal artery balloon catheter inserted via robot-assisted partial nephrectomy (h-RAPN) to treat renal tumors.
Forty-three patients with renal tumors were studied between March 2013 and August 2017. Renal artery balloon catheters were placed under angiographic guidance, and the balloon was fully inflated to occlude the renal artery during surgery. After establishing venous outflow, a robot-assisted partial nephrectomy was performed following perfusion with sodium lactate Ringer's solution at 4°C through the balloon catheter. Renal dynamic imaging was used to assess renal function, with calculation units consisting of glomerular filtration rate per unit volume of the kidney (GFR-UV).
Six patients were converted to radical nephrectomy intraoperatively, and the remaining 37 patients successfully underwent the h-RAPN procedure. Two patients had incomplete occlusion of the renal artery and received supplementary arterial clamp occlusion intraoperatively. One patient's balloon catheter slipped out of position preoperatively, and the patient was returned to the interventional radiology suite for balloon reinsertion, after which the patient underwent surgery successfully. No patients had severe complications. The average cold ischemia time was 39.5 ± 9.7 min (range, 22–123 min), the average temperature of the affected kidney during surgery was 19.3 ± 3.5°C (17.2–26.7°C), the average postoperative GFR-UV of the affected kidney was 0.42 ± 0.09 ml/min/ml (0.21–1.24 ml/min), and the average postoperative GFR-UV of the healthy kidney was 0.30 ± 0.04 ml/min/ml (P > 0.05). Multiple regression analysis indicated that cold ischemia time was an independent risk factor affecting the postoperative GFR of the affected kidney.
The advantages of h-RAPN include a clear surgical field enabling precise resection. When hypothermic perfusion via a renal artery balloon catheter is performed in conjunction with h-RAPN, the surgical time can be lengthened without increasing impairment of the affected kidney function, making this a safe and effective method of treating kidney tumors.
Publication date: Available online 27 October 2018
Source: Academic Radiology
Author(s): Seth Stalcup, Rebecca Leddy, Jeanne Hill, Madelene Lewis
Rationale and Objectives: In the newest revision of the Accreditation Council for Graduate Medical Education Common Program Requirements, substantial changes were made to section VI now entitled "The Learning and Working Environment."
The Accreditation Council for Graduate Medical Education expanded section VI to include patient safety, quality improvement, supervision, accountability, well-being, and fatigue mitigation realizing work hours represent only one part of the work environment.
Materials and Methods: These new requirements prompted us to evaluate our current curriculum, including our current tools for meeting program requirements such as the didactic lecture series and tracking resident progress in our Clinical Competency Committee, and identified areas of our curriculum that were lacking or could be improved upon.
Results: This assessment leads to incorporation of innovative and novel strategies to not only satisfy the requirements but also to engage our trainees throughout the process.
Conclusion: Our model can be used as an example for other residency programs looking for ways to fulfill these new requirements.
Publication date: Available online 27 October 2018
Source: Academic Radiology
Author(s): Seth Stalcup, Rebecca Leddy, Jeanne Hill, Madelene Lewis
Rationale and Objectives: In the newest revision of the Accreditation Council for Graduate Medical Education Common Program Requirements, substantial changes were made to section VI now entitled "The Learning and Working Environment."
The Accreditation Council for Graduate Medical Education expanded section VI to include patient safety, quality improvement, supervision, accountability, well-being, and fatigue mitigation realizing work hours represent only one part of the work environment.
Materials and Methods: These new requirements prompted us to evaluate our current curriculum, including our current tools for meeting program requirements such as the didactic lecture series and tracking resident progress in our Clinical Competency Committee, and identified areas of our curriculum that were lacking or could be improved upon.
Results: This assessment leads to incorporation of innovative and novel strategies to not only satisfy the requirements but also to engage our trainees throughout the process.
Conclusion: Our model can be used as an example for other residency programs looking for ways to fulfill these new requirements.
CONCLUSIONS: Interestingly, acute fulminant infection or sinusitis complications in solid organ transplant patients were much lower than expected. CRS in this patient group was less frequent than expected as well. Whether chronic immunosuppression minimizes the likelihood for CRS deserves further investigation. A more surgically oriented approach in CRS patients may be favored early in the management course of medically refractory patients in light of patients excellent outcomes. PMID: 30362361 [PubMed - as supplied by publisher] (Source: American Journal of Rhinology and Allergy)
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CONCLUSIONS: Interestingly, acute fulminant infection or sinusitis complications in solid organ transplant patients were much lower than expected. CRS in this patient group was less frequent than expected as well. Whether chronic immunosuppression minimizes the likelihood for CRS deserves further investigation. A more surgically oriented approach in CRS patients may be favored early in the management course of medically refractory patients in light of patients excellent outcomes. PMID: 30362361 [PubMed - as supplied by publisher] (Source: American Journal of Rhinology and Allergy)
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Publication date: Available online 27 October 2018
Source: European Journal of Radiology
Author(s): Alessandra Bartoloni, Maria Pilar Aparisi Gómez, Marco Cirillo, Georgina Allen, Giuseppe Battista, Giuseppe Guglielmi, Paolo Tomà, Alberto Bazzocchi
Limping is a challenging symptom in the pediatric patient as the diagnosis can range from traumatic, malformative, infectious/inflammatory and neoplastic diseases.
In this paper, we propose a schematic imaging algorithm to the limping child in three different age groups (Toddler: 1-3years, child: 4-10 years; adolescent: 11-16 years) based on presence of signs of infection, any specific localization of pain, and history of trauma. In this setting, the most common imaging pitfalls are also summarised. Finally, a literature review of the main differential causes of limping in the pediatric patient is reported.
Publication date: Available online 26 October 2018
Source: European Journal of Radiology
Author(s): Jie Wang, Xiang Li, Hai Ming Li, Feng Hua Ma, Guo Fu Zhang, Shu Hui Zhao, Jin Wei Qiang
To investigate the magnetic resonance (MR) imaging morphological relationship between adnexal tumors and the ipsilateral ovaries to characterize the origin and malignancy of tumors.
Clinical and MR imaging data of 496 adnexal tumors confirmed by histology (ovary tumors, n = 400, non-ovarian tumors, n = 96; benign tumors, n = 183, borderline tumors, n = 120, and malignant tumors, n = 193) were retrospectively analyzed. The presence and shape of the ipsilateral ovaries within the context of adnexal tumors of different origins, malignancies and configurations were evaluated. The relationships between the presence of the ipsilateral ovary and patient age, menstrual status and tumor size were also analyzed.
The ipsilateral ovary was detected on MRI in 23% (90/400) of ovarian tumors and in 45% (43/96) of non-ovarian tumors (p < 0.001). A normal ovoid morphology of the ipsilateral ovary was found in only 7% (26/400) of ovarian tumors and in 26% (25/96) of non-ovarian tumors (p < 0.001). The ipsilateral ovary was detectable in 38% (69/183) of benign tumors, 35% (42/120) of borderline tumors, and 11% (22/193) of malignant tumors (p < 0.001); in 24% (24/101) of cystic tumors, 27% (49/179) of mixed cystic-solid tumors and 28% (60/216) of solid tumors (p = 0.737); and in 40% (120/303) of adnexal tumors in premenopausal patients and 7% (13/193) of adnexal tumors in postmenopausal patients (p < 0.001).
Detection of the ipsilateral ovary contributes to the localization and characterization of adnexal tumors. The ipsilateral ovary can be detected more frequently in non-ovarian tumors and in benign or borderline ovarian tumors.
Publication date: December 2018
Source: Oral Oncology, Volume 87
Author(s): Alberto Schreiber, Marco Ferrari, Davide Mattavelli, Vittorio Rampinelli, Stefano Taboni, Alperen Vural, Maurizio Bignami, Paolo Castelnuovo, Piero Nicolai
Intestinal-type adenocarcinoma (ITAC) of the ethmoid mostly affects patients exposed to wood dust and has been traditionally treated with bilateral resection. The aim of the present study was to validate unilateral endoscopic resection with transnasal craniectomy (uERTC) in selected ITACs.
Patients affected by ITAC receiving uERTC from 2004 to 2017 at two tertiary referral centers were retrospectively analyzed. A control group of patients treated with bilateral endoscopic resection with transnasal craniectomy (bERTC) was selected. Olfaction, taste, and quality of life were evaluated. Survival and functional outcomes in the two groups were compared.
Fifty-four patients who underwent uERTC (case group: 27/54) or bERTC (control group: 27/54) were enrolled. The two groups were statistically comparable. Five-year overall (OS), disease-specific (DSS), recurrence-free (RFS) survivals, and local recurrence rates were not significantly different between groups. Hospitalization time was significantly shorter in the uERTC group (p = 0.0004) and no significant difference in terms of complications was demonstrated. The rate of subjective olfaction preservation was significantly higher in the uERTC group (45.5%) than in the bERTC group (0.0%) (p = 0.0007). Median 22-Items Sinonasal Outcome Test (SNOT-22) values were not significantly different between groups. No significant association of olfaction and taste preservation/worsening with reconstructive technique, radiation therapy, and chemotherapy was observed.
uERTC is an adequate surgical procedure for selected unilateral ITAC with similar survival rates and lower morbidity compared to bERTC. A rigorous follow-up of patients with ITAC is crucial and strongly recommended independently of the extent of resection.
Publication date: December 2018
Source: Oral Oncology, Volume 87
Author(s): Mijin Kim, Hye In Kim, Min Ji Jeon, Hee Kyung Kim, Eun Heui Kim, Hyon-Seung Yi, Eun Sook Kim, Hosu Kim, Bo Hyun Kim, Tae Yong Kim, Sun Wook Kim, Ho-Cheol Kang, Won Bae Kim, Jae Hoon Chung, Young Kee Shong, Tae Hyuk Kim, Won Gu Kim
This study aimed to evaluate the proposed changes in the eighth edition of the tumor-node-metastasis staging system (TNM-8) compared with the seventh edition (TNM-7) in terms of pathologic subtypes, using a large multicenter thyroid cancer cohort.
We retrospectively reviewed 7717 patients with papillary (PTC) and 273 with follicular thyroid carcinoma (FTC) who underwent thyroid surgery between 1996 and 2005. We assessed the proportion of variation explained (PVE) to compare the predictive accuracy of disease-specific survival (DSS).
During a median 11.3 years of follow-up, 169 (2%) disease-specific deaths were recorded. In patients with PTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 99.6%, 95.7%, 81.5%, and 54.8%, respectively; the corresponding rates in TNM-7 were 99.6%, 98.4%, 98.4%, and 90.1%, respectively. In patients with FTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 97.2%, 69.8%, 50.0%, and 45.5%, respectively; the corresponding rates in TNM-7 were 98.3%, 90.0%, 92.3%, and 42.1%, respectively. Comparing TNM-7 and TNM-8, the PVE values increased from 3.4% to 4.7% in the PTC group, whereas they decreased from 17.5% to 14.5% in the FTC group.
Our study suggests that the changes in TNM-8 have improved the clinical usefulness of the TNM staging system in terms of predicting DSS in patients with PTC but not FTC. Further studies to establish a more predictable TNM staging system that focuses on patients with FTC are necessary.
Publication date: Available online 27 October 2018
Source: European Journal of Radiology
Author(s): Alessandra Bartoloni, Maria Pilar Aparisi Gómez, Marco Cirillo, Georgina Allen, Giuseppe Battista, Giuseppe Guglielmi, Paolo Tomà, Alberto Bazzocchi
Limping is a challenging symptom in the pediatric patient as the diagnosis can range from traumatic, malformative, infectious/inflammatory and neoplastic diseases.
In this paper, we propose a schematic imaging algorithm to the limping child in three different age groups (Toddler: 1-3years, child: 4-10 years; adolescent: 11-16 years) based on presence of signs of infection, any specific localization of pain, and history of trauma. In this setting, the most common imaging pitfalls are also summarised. Finally, a literature review of the main differential causes of limping in the pediatric patient is reported.
Publication date: Available online 26 October 2018
Source: European Journal of Radiology
Author(s): Jie Wang, Xiang Li, Hai Ming Li, Feng Hua Ma, Guo Fu Zhang, Shu Hui Zhao, Jin Wei Qiang
To investigate the magnetic resonance (MR) imaging morphological relationship between adnexal tumors and the ipsilateral ovaries to characterize the origin and malignancy of tumors.
Clinical and MR imaging data of 496 adnexal tumors confirmed by histology (ovary tumors, n = 400, non-ovarian tumors, n = 96; benign tumors, n = 183, borderline tumors, n = 120, and malignant tumors, n = 193) were retrospectively analyzed. The presence and shape of the ipsilateral ovaries within the context of adnexal tumors of different origins, malignancies and configurations were evaluated. The relationships between the presence of the ipsilateral ovary and patient age, menstrual status and tumor size were also analyzed.
The ipsilateral ovary was detected on MRI in 23% (90/400) of ovarian tumors and in 45% (43/96) of non-ovarian tumors (p < 0.001). A normal ovoid morphology of the ipsilateral ovary was found in only 7% (26/400) of ovarian tumors and in 26% (25/96) of non-ovarian tumors (p < 0.001). The ipsilateral ovary was detectable in 38% (69/183) of benign tumors, 35% (42/120) of borderline tumors, and 11% (22/193) of malignant tumors (p < 0.001); in 24% (24/101) of cystic tumors, 27% (49/179) of mixed cystic-solid tumors and 28% (60/216) of solid tumors (p = 0.737); and in 40% (120/303) of adnexal tumors in premenopausal patients and 7% (13/193) of adnexal tumors in postmenopausal patients (p < 0.001).
Detection of the ipsilateral ovary contributes to the localization and characterization of adnexal tumors. The ipsilateral ovary can be detected more frequently in non-ovarian tumors and in benign or borderline ovarian tumors.
Publication date: December 2018
Source: Oral Oncology, Volume 87
Author(s): Alberto Schreiber, Marco Ferrari, Davide Mattavelli, Vittorio Rampinelli, Stefano Taboni, Alperen Vural, Maurizio Bignami, Paolo Castelnuovo, Piero Nicolai
Intestinal-type adenocarcinoma (ITAC) of the ethmoid mostly affects patients exposed to wood dust and has been traditionally treated with bilateral resection. The aim of the present study was to validate unilateral endoscopic resection with transnasal craniectomy (uERTC) in selected ITACs.
Patients affected by ITAC receiving uERTC from 2004 to 2017 at two tertiary referral centers were retrospectively analyzed. A control group of patients treated with bilateral endoscopic resection with transnasal craniectomy (bERTC) was selected. Olfaction, taste, and quality of life were evaluated. Survival and functional outcomes in the two groups were compared.
Fifty-four patients who underwent uERTC (case group: 27/54) or bERTC (control group: 27/54) were enrolled. The two groups were statistically comparable. Five-year overall (OS), disease-specific (DSS), recurrence-free (RFS) survivals, and local recurrence rates were not significantly different between groups. Hospitalization time was significantly shorter in the uERTC group (p = 0.0004) and no significant difference in terms of complications was demonstrated. The rate of subjective olfaction preservation was significantly higher in the uERTC group (45.5%) than in the bERTC group (0.0%) (p = 0.0007). Median 22-Items Sinonasal Outcome Test (SNOT-22) values were not significantly different between groups. No significant association of olfaction and taste preservation/worsening with reconstructive technique, radiation therapy, and chemotherapy was observed.
uERTC is an adequate surgical procedure for selected unilateral ITAC with similar survival rates and lower morbidity compared to bERTC. A rigorous follow-up of patients with ITAC is crucial and strongly recommended independently of the extent of resection.
Publication date: December 2018
Source: Oral Oncology, Volume 87
Author(s): Mijin Kim, Hye In Kim, Min Ji Jeon, Hee Kyung Kim, Eun Heui Kim, Hyon-Seung Yi, Eun Sook Kim, Hosu Kim, Bo Hyun Kim, Tae Yong Kim, Sun Wook Kim, Ho-Cheol Kang, Won Bae Kim, Jae Hoon Chung, Young Kee Shong, Tae Hyuk Kim, Won Gu Kim
This study aimed to evaluate the proposed changes in the eighth edition of the tumor-node-metastasis staging system (TNM-8) compared with the seventh edition (TNM-7) in terms of pathologic subtypes, using a large multicenter thyroid cancer cohort.
We retrospectively reviewed 7717 patients with papillary (PTC) and 273 with follicular thyroid carcinoma (FTC) who underwent thyroid surgery between 1996 and 2005. We assessed the proportion of variation explained (PVE) to compare the predictive accuracy of disease-specific survival (DSS).
During a median 11.3 years of follow-up, 169 (2%) disease-specific deaths were recorded. In patients with PTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 99.6%, 95.7%, 81.5%, and 54.8%, respectively; the corresponding rates in TNM-7 were 99.6%, 98.4%, 98.4%, and 90.1%, respectively. In patients with FTC, the 10-year DSS rates of stages I, II, III, and IV disease in TNM-8 were 97.2%, 69.8%, 50.0%, and 45.5%, respectively; the corresponding rates in TNM-7 were 98.3%, 90.0%, 92.3%, and 42.1%, respectively. Comparing TNM-7 and TNM-8, the PVE values increased from 3.4% to 4.7% in the PTC group, whereas they decreased from 17.5% to 14.5% in the FTC group.
Our study suggests that the changes in TNM-8 have improved the clinical usefulness of the TNM staging system in terms of predicting DSS in patients with PTC but not FTC. Further studies to establish a more predictable TNM staging system that focuses on patients with FTC are necessary.
Publication date: Available online 27 October 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Jason K. Lam, Stephen R. Braddock, Charles B. Huddleston, Alan P. Knutsen
Publication date: Available online 27 October 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Costner McKenzie, Jonathan I. Silverberg
Publication date: Available online 27 October 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Tricia Morphew, Stanley P Galant
Obesity is thought to be associated with poor asthma control, increased health resource utilization, and reduced responsiveness to inhaled corticosteroids.
Based on previous experience our hypothesis was that by improved access to comprehensive guideline care that outcomes in normal weight would be comparable in obese asthmatic children.
This was a retrospective cohort study of predominately Hispanic children (3-18 years of age), in underserved areas of Orange County, CA, who enrolled in the Breathmobile Program from 2003 -2012. Outcomes were examined using Cox regression and generalized estimating equations analyses, adjusted for potential confounding factors.
Clinical outcomes in over 1200 children followed for a mean of 6 visits (SD=2.2) across 403 days (SD=112) were improved, on average, regardless of BMI. MOB patients were able to achieve significant reductions of approximately 60% or more in report of ED visits, hospitalizations, school absenteeism, usual exercise limitations, and exacerbations to levels that were comparable to NW patients. The importance of close follow-up, particularly for the MOB patient, was evidenced by achieving 80% cumulative probability of well control asthma by visit 3, similar to patients in lower BMI risk groups with good adherence, when the visit interval did not exceed 90 days. These outcomes were achieved across all BMI groups with similar mean step of therapy, adjusted for severity (p<.001).
Access to effective community-based care where trust, education, and continuity of care consistent with NAEPP guidelines is possible, as demonstrated by the Breathmobile Program, can provide an opportunity for asthmatic children in all BMI categories to achieve well controlled disease.
Publication date: Available online 26 October 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Dinah Foer, Kathleen M. Buchheit
To review the published medical literature on the clinical presentation, risk factors, and natural history of hypersensitivity reactions to progestogens.
Through the use of PubMed, we conducted a review of allergy, dermatology, and obstetric literature for cases and case series of patients with hypersensitivity reactions to exogenous or endogenous progestogens. There are no longitudinal, prospective studies related to progestogen hypersensitivity.
Publications were selected that described cases that were clinically consistent with progesterone hypersensitivity with positive testing or clear symptoms with exposure to progestogens to confirm the diagnosis.
Progestogen hypersensitivity symptoms can be triggered by endogenous progesterone or by exogenous progestins used for contraception or fertility treatments. Symptoms are varied and include dermatitis, urticaria, asthma, and anaphylaxis.
While the medical literature of progestogen hypersensitivity is limited to case reports and small case series, there exists significant heterogeneity in clinical presentation between patients.
