Resveratrol reverses the negative effect of smoking on peri‐implant repair in the tibia of rats

Abstract

Objectives

Innovative approaches capable to improve peri‐implant bone repair are relevant in the presence of smoking, a risk factor for healing around implants. This study investigated the effect of resveratrol (RESV) on peri‐implant repair and its influence on bone‐related markers in rats submitted to cigarette smoking inhalation (CSI).

Materials and Methods

One titanium implant was inserted in each tibiae of rats assigned to: CSI+RESV(n:18); CSI+ placebo(n:18); Non‐CSI(n:18). One implant was removed for counter‐torque and the peri‐implant tissue was collected for mRNA quantification of BMP‐2, OPN, Runx2, Lrp‐5, Osx, β‐catenin, Dkk1, OPG, and RANKL. The other tibia was submitted to MicroCT to measure: bone volume, bone porosity, trabecular spacing, trabecular thickness and bone‐implant contact (BIC).

Results

No differences were detected between counter‐torque in CSI+RESV and Non‐CSI group (p>0.05), whereas CSI+placebo group presented lower values when compared to the others (p<0.05). RESV improved the BIC in CSI rats without differences when compared to non‐CSI group (p>0.05), whereas CSI+placebo showed reduced BIC when compared to the other groups (p<0.05). RESV reduced RANKL/OPG and Lrp‐5 levels and increased β‐catenin in CSI rats when compared to CSI+placebo (p<0.05).

Conclusion

Although further investigations should be considered using oral models of dental implants, within the limits of the present study, it was concluded that RESV reverses the negative effects of smoking in the peri‐implant repair, benefiting the modulation of bone‐related markers.

This article is protected by copyright. All rights reserved.

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Resveratrol reverses the negative effect of smoking on peri‐implant repair in the tibia of rats

Abstract

Objectives

Innovative approaches capable to improve peri‐implant bone repair are relevant in the presence of smoking, a risk factor for healing around implants. This study investigated the effect of resveratrol (RESV) on peri‐implant repair and its influence on bone‐related markers in rats submitted to cigarette smoking inhalation (CSI).

Materials and Methods

One titanium implant was inserted in each tibiae of rats assigned to: CSI+RESV(n:18); CSI+ placebo(n:18); Non‐CSI(n:18). One implant was removed for counter‐torque and the peri‐implant tissue was collected for mRNA quantification of BMP‐2, OPN, Runx2, Lrp‐5, Osx, β‐catenin, Dkk1, OPG, and RANKL. The other tibia was submitted to MicroCT to measure: bone volume, bone porosity, trabecular spacing, trabecular thickness and bone‐implant contact (BIC).

Results

No differences were detected between counter‐torque in CSI+RESV and Non‐CSI group (p>0.05), whereas CSI+placebo group presented lower values when compared to the others (p<0.05). RESV improved the BIC in CSI rats without differences when compared to non‐CSI group (p>0.05), whereas CSI+placebo showed reduced BIC when compared to the other groups (p<0.05). RESV reduced RANKL/OPG and Lrp‐5 levels and increased β‐catenin in CSI rats when compared to CSI+placebo (p<0.05).

Conclusion

Although further investigations should be considered using oral models of dental implants, within the limits of the present study, it was concluded that RESV reverses the negative effects of smoking in the peri‐implant repair, benefiting the modulation of bone‐related markers.

This article is protected by copyright. All rights reserved.

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The relationship between the morphological axis and the kinematic axis of the proximal radius

Abstract

Purpose

Surgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT).

Methods

Ten healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated.

Results

The rotation axis of the forearm was positioned on the radial head 0.0 mm radial and 0.4 mm posterior to the center of the radial head proximally and 2.0 mm radial and 1.2 mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%).

Conclusion

Forearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause "rattling motion" of the radial head after reduction procedures.

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The relationship between the morphological axis and the kinematic axis of the proximal radius

Abstract

Purpose

Surgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT).

Methods

Ten healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated.

Results

The rotation axis of the forearm was positioned on the radial head 0.0 mm radial and 0.4 mm posterior to the center of the radial head proximally and 2.0 mm radial and 1.2 mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%).

Conclusion

Forearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause "rattling motion" of the radial head after reduction procedures.

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Natural killer cells might adapt their inhibitory receptors for memory [Immunology and Inflammation]

Traditional teaching in immunology tells us that antigen-specific recall responses are the realm of adaptive immunity. However, over the past decade, there has been increasing evidence and interest in the concept of innate immune memory. Natural killer (NK) cells are the founding member of the innate lymphocyte family, initially recognized... (Source: Proceedings of the National Academy of Sciences)

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Paracrine costimulation of IFN-{gamma} signaling by integrins modulates CD8 T cell differentiation [Immunology and Inflammation]

The cytokine IFN-γ is a critical regulator of immune system development and function. Almost all leukocytes express the receptor for IFN-γ, yet each cell type elicits a different response to this cytokine. Cell type-specific effects of IFN-γ make it difficult to predict the outcomes of the systemic IFN-γ blockade and... (Source: Proceedings of the National Academy of Sciences)

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Critical role for the Ly49 family of class I MHC receptors in adaptive natural killer cell responses [Immunology and Inflammation]

Adaptive natural killer (NK) cell memory represents a new frontier in immunology. Work over the last decade has discovered and confirmed the existence of NK cells with antigen-specific memories, which had previously been considered a unique property of T and B cells. These findings have shown that antigen-specific NK cells... (Source: Proceedings of the National Academy of Sciences)

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Identification and validation of a tumor-infiltrating Treg transcriptional signature conserved across species and tumor types [Immunology and Inflammation]

FoxP3+ T regulatory (Treg) cells are central elements of immunologic tolerance. They are abundant in many tumors, where they restrict potentially favorable antitumor responses. We used a three-pronged strategy to identify genes related to the presence and function of Tregs in the tumor microenvironment. Gene expression profiles were generated from... (Source: Proceedings of the National Academy of Sciences)

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Lipoteichoic acid anchor triggers Mincle to drive protective immunity against invasive group A Streptococcus infection [Immunology and Inflammation]

Group A Streptococcus (GAS) is a Gram-positive bacterial pathogen that causes a range of diseases, including fatal invasive infections. However, the mechanisms by which the innate immune system recognizes GAS are not well understood. We herein report that the C-type lectin receptor macrophage inducible C-type lectin (Mincle) recognizes GAS and... (Source: Proceedings of the National Academy of Sciences)

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Neutrophil progenitor populations of rhesus macaques.

In this study, we provided evidence for species-specific features of granulopoiesis that ultimately manifested in the divergent immunophenotypes of the fully differentiated segmented neutrophils of humans and rhesus macaques. Additionally, we found functional markers that can be used to accurately quantify neutrophil progenitors by flow cytometry. Although these markers do not coincide with the classical nuclear-morphology-based grading, they enable us to perform functional studies monitoring immunophenotypic markers. PMID: 30395351 [PubMed - as supplied by publisher] (Source: Journal of Leukocyte Biology)

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Natural killer cells might adapt their inhibitory receptors for memory [Immunology and Inflammation]

Traditional teaching in immunology tells us that antigen-specific recall responses are the realm of adaptive immunity. However, over the past decade, there has been increasing evidence and interest in the concept of innate immune memory. Natural killer (NK) cells are the founding member of the innate lymphocyte family, initially recognized... (Source: Proceedings of the National Academy of Sciences)

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Critical role for the Ly49 family of class I MHC receptors in adaptive natural killer cell responses [Immunology and Inflammation]

Adaptive natural killer (NK) cell memory represents a new frontier in immunology. Work over the last decade has discovered and confirmed the existence of NK cells with antigen-specific memories, which had previously been considered a unique property of T and B cells. These findings have shown that antigen-specific NK cells... (Source: Proceedings of the National Academy of Sciences)

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Identification and validation of a tumor-infiltrating Treg transcriptional signature conserved across species and tumor types [Immunology and Inflammation]

FoxP3+ T regulatory (Treg) cells are central elements of immunologic tolerance. They are abundant in many tumors, where they restrict potentially favorable antitumor responses. We used a three-pronged strategy to identify genes related to the presence and function of Tregs in the tumor microenvironment. Gene expression profiles were generated from... (Source: Proceedings of the National Academy of Sciences)

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Lipoteichoic acid anchor triggers Mincle to drive protective immunity against invasive group A Streptococcus infection [Immunology and Inflammation]

Group A Streptococcus (GAS) is a Gram-positive bacterial pathogen that causes a range of diseases, including fatal invasive infections. However, the mechanisms by which the innate immune system recognizes GAS are not well understood. We herein report that the C-type lectin receptor macrophage inducible C-type lectin (Mincle) recognizes GAS and... (Source: Proceedings of the National Academy of Sciences)

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Neutrophil progenitor populations of rhesus macaques.

In this study, we provided evidence for species-specific features of granulopoiesis that ultimately manifested in the divergent immunophenotypes of the fully differentiated segmented neutrophils of humans and rhesus macaques. Additionally, we found functional markers that can be used to accurately quantify neutrophil progenitors by flow cytometry. Although these markers do not coincide with the classical nuclear-morphology-based grading, they enable us to perform functional studies monitoring immunophenotypic markers. PMID: 30395351 [PubMed - as supplied by publisher] (Source: Journal of Leukocyte Biology)

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Non-contrast three-dimensional gradient recalled echo Dixon-based magnetic resonance angiography/venography in children

Abstract

Magnetic resonance imaging (MRI) has been considered a valuable diagnostic tool for noninvasive imaging of the vasculature in children and adults for more than two decades. While a variety of non-contrast MRI methods have been described for imaging of both arteries and veins (e.g., time-of-flight, phase contrast, and balanced steady-state free precession imaging), contrast-enhanced magnetic resonance angiography/venography are the most commonly employed vascular imaging techniques due to their high spatial and contrast resolutions and general reliability. In this technical innovation article, we describe a novel 3-D respiratory-triggered gradient recalled echo Dixon-based MR angiography/MR venography technique that provides high-resolution anatomical imaging of the vasculature of the neck, body and extremities without the need for intravenous contrast material or breath-holding.

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Non-contrast three-dimensional gradient recalled echo Dixon-based magnetic resonance angiography/venography in children

Abstract

Magnetic resonance imaging (MRI) has been considered a valuable diagnostic tool for noninvasive imaging of the vasculature in children and adults for more than two decades. While a variety of non-contrast MRI methods have been described for imaging of both arteries and veins (e.g., time-of-flight, phase contrast, and balanced steady-state free precession imaging), contrast-enhanced magnetic resonance angiography/venography are the most commonly employed vascular imaging techniques due to their high spatial and contrast resolutions and general reliability. In this technical innovation article, we describe a novel 3-D respiratory-triggered gradient recalled echo Dixon-based MR angiography/MR venography technique that provides high-resolution anatomical imaging of the vasculature of the neck, body and extremities without the need for intravenous contrast material or breath-holding.

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Surrey teacher supports head and neck cancer campaign

Surrey teacher supports head and neck cancer campaign  Eagle RadioFull coverage

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Surrey teacher supports head and neck cancer campaign

Surrey teacher supports head and neck cancer campaign  Eagle RadioFull coverage

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Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps

Abstract

Background

Septal perforations consist in an anatomic defect of the mucosal, cartilaginous and/or bone tissues of the nasal septum. A huge variety of approaches and techniques for nasal perforation repair have been reported.

Methodology/principal

Between January 2008 and January 2017, 38 patients were treated for nasal septal perforation in Department of Otorhinolaryngology Head and Neck Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain. A novel approach is presented based on microscope. Septal perforation closure was performed with endonasal bilateral advancement flaps-established technique and autologous cartilage and muscle temporal fascia grafts. We performed a retrospective review of closure rates and complications.

Results

A postoperative follow-up of at least 12 months was performed in 37 patients. The mean size of perforation was 1.33 cm. After the withdrawal of the silicone splints, perforations were completely closed in all cases. However, during the follow-up, four patients resulted in a reperforation, so our closure rate was 89.19%. For all cases, symptoms related to septal defect were solved. Only one case was reported of local infections that was resolved with antibiotics in a few days.

Conclusions

Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.

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Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps

Abstract

Background

Septal perforations consist in an anatomic defect of the mucosal, cartilaginous and/or bone tissues of the nasal septum. A huge variety of approaches and techniques for nasal perforation repair have been reported.

Methodology/principal

Between January 2008 and January 2017, 38 patients were treated for nasal septal perforation in Department of Otorhinolaryngology Head and Neck Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain. A novel approach is presented based on microscope. Septal perforation closure was performed with endonasal bilateral advancement flaps-established technique and autologous cartilage and muscle temporal fascia grafts. We performed a retrospective review of closure rates and complications.

Results

A postoperative follow-up of at least 12 months was performed in 37 patients. The mean size of perforation was 1.33 cm. After the withdrawal of the silicone splints, perforations were completely closed in all cases. However, during the follow-up, four patients resulted in a reperforation, so our closure rate was 89.19%. For all cases, symptoms related to septal defect were solved. Only one case was reported of local infections that was resolved with antibiotics in a few days.

Conclusions

Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.

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Synthetic polymeric barrier membrane associated with blood coagulum, human allograft, or bovine bone substitute for ridge preservation: a randomized, controlled, clinical and histological trial

(Source: International Journal of Oral and Maxillofacial Surgery)

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An assessment and comparison of nasolabial aesthetics in bilateral clefts using the anatomical subunit-based scale: a nasoalveolar moulding versus non-nasoalveolar moulding study

In this study, a recently published anatomical subunit scale was used to evaluate and compare the early effects of nasoalveolar moulding. Two groups of similarly treated bilateral cleft patients were included: one in which patients underwent presurgical nasoalveolar moulding and one in which they did not. (Source: International Journal of Oral and Maxillofacial Surgery)

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Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 1 —host-derived immunological parameters

The purpose of this study was to assess host-derived parameters around dental zirconia and titanium implants and natural teeth during the occurrence of mucositis. After 4 weeks of perfect oral hygiene, 16 clinically profiled patients were asked to refrain from oral hygiene for 2 weeks, resulting in experimental plaque accumulation. This was followed by 4 weeks of perfect oral hygiene to reverse the inflammation. Immunological samples were analyzed for interleukin 6 (IL-6), tumour necrosis factor alpha (TNF- α), and interleukin 1β (IL-1β). (Source: International Journal of Oral and Maxillofacial Surgery)

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Synthetic polymeric barrier membrane associated with blood coagulum, human allograft, or bovine bone substitute for ridge preservation: a randomized, controlled, clinical and histological trial

(Source: International Journal of Oral and Maxillofacial Surgery)

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An assessment and comparison of nasolabial aesthetics in bilateral clefts using the anatomical subunit-based scale: a nasoalveolar moulding versus non-nasoalveolar moulding study

In this study, a recently published anatomical subunit scale was used to evaluate and compare the early effects of nasoalveolar moulding. Two groups of similarly treated bilateral cleft patients were included: one in which patients underwent presurgical nasoalveolar moulding and one in which they did not. (Source: International Journal of Oral and Maxillofacial Surgery)

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Health Tip: What's Ear Wax?

Title: Health Tip: What's Ear Wax?Category: Health NewsCreated: 10/30/2018 12:00:00 AMLast Editorial Review: 10/30/2018 12:00:00 AM (Source: MedicineNet Hearing General)

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Health Tip: What's Ear Wax?

Title: Health Tip: What's Ear Wax?Category: Health NewsCreated: 10/30/2018 12:00:00 AMLast Editorial Review: 10/30/2018 12:00:00 AM (Source: MedicineNet Hearing General)

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Prospective evaluation of psychological burden in patients with oral cancer

The high morbidity and mortality that is associated with oral cancer places a huge psychological burden on patients. The purpose of this prospective study was to evaluate levels of depression, anxiety, and stress, at three time points using DASS-21 (Depression, Anxiety and Stress Scale-21). We also compared DASS-21 with HADS (Hospital Anxiety and Depression Scale). A total of 111 patients were enrolled and 75 of them completed the questionnaires at diagnosis, one month after treatment, and three months after discharge. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Donor sites for radial forearm flaps: a direct comparison of closure with a local “hatchet” flap and split thickness skin grafts in a single patient

We read the article by Pabst et al1 with interest. Morbidity at the donor site of radial forearm flaps (RFF) has been the subject of much discussion, and we would like to describe a direct comparison of two techniques of closure in a single patient (Taylor et al. Radial forearm flap donor sites − A direct comparison of local hatchet flap closure versus split thickness skin grafting in a single patient. Presented at the British Association of Head and Neck Oncologists Annual Scientific Meeting, London, 2018). (Source: The British Journal of Oral and Maxillofacial Surgery)

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Global Head and Neck Cancer Treatment Market Report, Trends, Size, Share, Analysis, Estimations and Forecasts to ...

Global Head and Neck Cancer Treatment Market Report, Trends, Size, Share, Analysis, Estimations and Forecasts to ...  Digital JournalHead and Neck Cancer Treatment Market by 2021 Types, Applications, Challenges, and Development Factors  And More NewsHead and Neck Cancer Treatment Market Competition by Key Manufacturers Analysis with Forecast to 2025  The RealZIMAFull coverage

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Prospective evaluation of psychological burden in patients with oral cancer

The high morbidity and mortality that is associated with oral cancer places a huge psychological burden on patients. The purpose of this prospective study was to evaluate levels of depression, anxiety, and stress, at three time points using DASS-21 (Depression, Anxiety and Stress Scale-21). We also compared DASS-21 with HADS (Hospital Anxiety and Depression Scale). A total of 111 patients were enrolled and 75 of them completed the questionnaires at diagnosis, one month after treatment, and three months after discharge. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Donor sites for radial forearm flaps: a direct comparison of closure with a local “hatchet” flap and split thickness skin grafts in a single patient

We read the article by Pabst et al1 with interest. Morbidity at the donor site of radial forearm flaps (RFF) has been the subject of much discussion, and we would like to describe a direct comparison of two techniques of closure in a single patient (Taylor et al. Radial forearm flap donor sites − A direct comparison of local hatchet flap closure versus split thickness skin grafting in a single patient. Presented at the British Association of Head and Neck Oncologists Annual Scientific Meeting, London, 2018). (Source: The British Journal of Oral and Maxillofacial Surgery)

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Surgical management of recurrent dislocation of the temporomandibular joint: a new treatment protocol

Recurrent dislocation of the temporomandibular joint (TMJ) is rare. It is distinct from acute or chronic dislocation and is associated with considerable morbidity and deterioration in quality of life. To formulate a practical surgical treatment algorithm, we retrospectively reviewed the management and long-term outcomes of 14 patients who presented to a single hospital department over a period of six years (2010 –2016), and collected data on demographics, clinical features, operation, and outcome. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Global Head and Neck Cancer Treatment Market Report, Trends, Size, Share, Analysis, Estimations and Forecasts to ...

Global Head and Neck Cancer Treatment Market Report, Trends, Size, Share, Analysis, Estimations and Forecasts to ...  Digital JournalHead and Neck Cancer Treatment Market by 2021 Types, Applications, Challenges, and Development Factors  And More NewsHead and Neck Cancer Treatment Market Competition by Key Manufacturers Analysis with Forecast to 2025  The RealZIMAFull coverage

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Research Report and Overview on Anti-Neoplastic Pharmaceutical Agents Market, 2016-2026

Research Report and Overview on Anti-Neoplastic Pharmaceutical Agents Market, 2016-2026  PMLiVEFull coverage

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Medications With Depression as an Adverse Effect

To the Editor In a cross-sectional survey study, Dr Qato and colleagues found that the use of prescription medications with depression as a potential adverse effect was common. However, the authors did not take into account that most of the drugs described are used to treat conditions already linked to an increased risk of depressive symptoms. Although they investigated the relationship between hypertension and depression, they did not account for the association of depressive symptoms with pain (and subsequent use of pain killers), gastroesophageal reflux disorder (and subsequent use of gastrointestinal agents), or atopic disorders, such as asthma or allergic rhinitis (and the use of montelukast and antihistamines). Interestingly, these conditions are related to persistent low-grade infla...

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Medications With Depression as an Adverse Effect

To the Editor In a cross-sectional survey study, Dr Qato and colleagues found that the use of prescription medications with depression as a potential adverse effect was common. However, the authors did not take into account that most of the drugs described are used to treat conditions already linked to an increased risk of depressive symptoms. Although they investigated the relationship between hypertension and depression, they did not account for the association of depressive symptoms with pain (and subsequent use of pain killers), gastroesophageal reflux disorder (and subsequent use of gastrointestinal agents), or atopic disorders, such as asthma or allergic rhinitis (and the use of montelukast and antihistamines). Interestingly, these conditions are related to persistent low-grade infla...

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Impact of age on elderly patients with oral cancer

Abstract

Introduction

In this study we have tried to analyze the impact of age on various clinico-pathological parameters, treatment completion and subsequent survival in older patients.

Materials and methods

This is a retrospective analysis of 140 elderly (> 65 years) patients of oral cancer operated between January 2012 and December 2013. The patients were divided into two groups based upon their age that ≤ 70 years and > 70 years.Association of distribution of various clinico-pathological factors between different groups was assessed by using Chi-square test. Survival analysis was done using Kaplan Meir analysis. Univariate and multivariate analysis were performed.

Results

The two groups had similar distribution of various clinico-pathological factors. Disease free survival for the group ≤ 70 and > 70 years was 37.6 months and 36.4 months (p < 0.594). 13.5% and 7.8% patients > 70 years and ≤ 70 years were either advised or received sub-optimal adjuvant therapy (p < 0.002).

Conclusion

There is no difference distribution of various clinico-pathological factors and survival in patients of oral cancer ≤ 70 and > 70 years of age. Age did not affect survival. Majority of patients could complete the adjuvant therapy advised. Still, significantly more number of patients > 70 years could not receive/complete appropriate adjuvant therapy. Thus treatment needs to be tailored keeping in mind the individual's performance status and the co-morbidities.

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Tranexamic acid and post-tonsillectomy hemorrhage: propensity score and instrumental variable analyses

Abstract

Purpose

Although post-tonsillectomy hemorrhage occurs rarely, it can be life-threatening. Previous studies showed that tranexamic acid (TXA) had insignificant association with the rate of post-tonsillectomy hemorrhage, but those findings were limited by small sample sizes. The purpose of this study was to examine the effectiveness of TXA in preventing post-tonsillectomy hemorrhage using nationwide database.

Methods

Data of a retrospective cohort of 117,598 patients from 750 hospitals, who had undergone tonsillectomy between 2010 and 2016, were drawn from the Diagnosis Procedure Combination database in Japan and studied.

Results

Propensity score-matched analysis showed no significant differences in proportions of reoperation or blood transfusion after tonsillectomy between the treatment (TXA from the day of tonsillectomy) and control groups (1.50% vs. 1.47%, p = 0.64). Instrumental variable analysis also showed no significant differences (odds ratio, 0.98; 95% confidence interval, 0.86–1.13; p = 0.82). Higher proportions of reoperation or blood transfusion were significantly associated with male sex, older age, emergency hospitalization, prolonged anesthesia, and medium hospital volume (annual number of tonsillectomies).

Conclusions

Administration of TXA from the day of tonsillectomy is not associated with reduction in reoperation or blood transfusion rates.

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DIPHENHYDRAMINE HCL ALLERGY ANTIHISTAMINE (Diphenhydramine Hcl) Tablet [Medline Industries]

Updated Date: Nov 1, 2018 EST (Source: DailyMed Drug Label Updates)

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ALLERGY (Loratadine) Tablet [Major Pharmaceuticals]

Updated Date: Nov 1, 2018 EST (Source: DailyMed Drug Label Updates)

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Impact of age on elderly patients with oral cancer

Abstract

Introduction

In this study we have tried to analyze the impact of age on various clinico-pathological parameters, treatment completion and subsequent survival in older patients.

Materials and methods

This is a retrospective analysis of 140 elderly (> 65 years) patients of oral cancer operated between January 2012 and December 2013. The patients were divided into two groups based upon their age that ≤ 70 years and > 70 years.Association of distribution of various clinico-pathological factors between different groups was assessed by using Chi-square test. Survival analysis was done using Kaplan Meir analysis. Univariate and multivariate analysis were performed.

Results

The two groups had similar distribution of various clinico-pathological factors. Disease free survival for the group ≤ 70 and > 70 years was 37.6 months and 36.4 months (p < 0.594). 13.5% and 7.8% patients > 70 years and ≤ 70 years were either advised or received sub-optimal adjuvant therapy (p < 0.002).

Conclusion

There is no difference distribution of various clinico-pathological factors and survival in patients of oral cancer ≤ 70 and > 70 years of age. Age did not affect survival. Majority of patients could complete the adjuvant therapy advised. Still, significantly more number of patients > 70 years could not receive/complete appropriate adjuvant therapy. Thus treatment needs to be tailored keeping in mind the individual's performance status and the co-morbidities.

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Tranexamic acid and post-tonsillectomy hemorrhage: propensity score and instrumental variable analyses

Abstract

Purpose

Although post-tonsillectomy hemorrhage occurs rarely, it can be life-threatening. Previous studies showed that tranexamic acid (TXA) had insignificant association with the rate of post-tonsillectomy hemorrhage, but those findings were limited by small sample sizes. The purpose of this study was to examine the effectiveness of TXA in preventing post-tonsillectomy hemorrhage using nationwide database.

Methods

Data of a retrospective cohort of 117,598 patients from 750 hospitals, who had undergone tonsillectomy between 2010 and 2016, were drawn from the Diagnosis Procedure Combination database in Japan and studied.

Results

Propensity score-matched analysis showed no significant differences in proportions of reoperation or blood transfusion after tonsillectomy between the treatment (TXA from the day of tonsillectomy) and control groups (1.50% vs. 1.47%, p = 0.64). Instrumental variable analysis also showed no significant differences (odds ratio, 0.98; 95% confidence interval, 0.86–1.13; p = 0.82). Higher proportions of reoperation or blood transfusion were significantly associated with male sex, older age, emergency hospitalization, prolonged anesthesia, and medium hospital volume (annual number of tonsillectomies).

Conclusions

Administration of TXA from the day of tonsillectomy is not associated with reduction in reoperation or blood transfusion rates.

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MUCINEX SINUS-MAX SEVERE CONGESTION RELIEF SINUS AND ALLERGY (Oxymetazoline Hydrochloride) Solution [RB Health (US) LLC]

Updated Date: Nov 1, 2018 EST (Source: DailyMed Drug Label Updates)

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DIPHENHYDRAMINE HCL ALLERGY ANTIHISTAMINE (Diphenhydramine Hcl) Tablet [Medline Industries]

Updated Date: Nov 1, 2018 EST (Source: DailyMed Drug Label Updates)

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ALLERGY (Loratadine) Tablet [Major Pharmaceuticals]

Updated Date: Nov 1, 2018 EST (Source: DailyMed Drug Label Updates)

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Health Tip: What's Ear Wax?

Title: Health Tip: What's Ear Wax?Category: Health NewsCreated: 10/30/2018 12:00:00 AMLast Editorial Review: 10/30/2018 12:00:00 AM (Source: MedicineNet Hearing General)

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Health Tip: What's Ear Wax?

Title: Health Tip: What's Ear Wax?Category: Health NewsCreated: 10/30/2018 12:00:00 AMLast Editorial Review: 10/30/2018 12:00:00 AM (Source: MedicineNet Hearing General)

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The effect of differences in the number of fiber bundles of the anterior tibial ligament on ankle braking function: a simulation study

Abstract

Purpose

The aim was to clarify the effect of differences in the number of fiber bundles of the anterior tibial ligament (ATFL) on ankle braking function.

Methods

The study sample included 81Japanese cadavers. ATFLs were categorized as: Type I with one fiber bundle; Type II with two fiber bundles that were completely separated; and Type III with three fiber bundles. Three-dimensional reconstructions of a single specimen from each category were then created. These were used to simulate and calculate ATFL strain during dorsiflexion (20°) and plantarflexion (30°) on the talocrural joint axis and inversion (20°) on the subtalar joint axis.

Results

Almost all types of superior fiber lines were stretched with dorsiflexion and plantarflexion. Regardless of Type, the inferior fiber line was shortened with plantarflexion and stretched with dorsiflexion. The inferior fiber bundle of Type III was shortened only at plantarflexion 30° and inversion 20°, but in all others it was stretched.

Conclusions

The results suggest that Type III was weaker than Type I and Type II in terms of ankle plantarflexion and inversion braking function.

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Adult presentation of asymptomatic right lung agenesis: a rare anatomical variation

Abstract

Pulmonary agenesis is a very rare congenital anomaly characterized by the absence of pulmonary parenchyma and its vasculature. The diagnosis is usually during childhood. Herein, we report a case of incidental discover right pulmonary agenesis in adulthood male. A 30-year-old male presented with pre-operative medical evaluation for varicocele. There was no complaining from respiratory symptoms. He underwent plain chest X-ray and post-contrast CT scanning was performed using 64 multi-detector CT scanner. Chest Plain X-ray revealed cardiac and mediastinal shift to right side with hyper-inflated left lung crosses to right side. Multi-detector computed tomography examination revealed total absence of right lung with compensatory hyperinflation and increase volume of left lung. Hyper-inflated left lung extended to right hemithorax. Mediastinal structures including heart and great vessels were displaced to middle and lower parts of right hemithorax. Descending aorta located to anterior to thoracic vertebrae. Right pulmonary artery was absent. Right main bronchus was rudimentary. No detected other organ anomalies. No detected bony thoracic cage abnormalities.

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The effect of differences in the number of fiber bundles of the anterior tibial ligament on ankle braking function: a simulation study

Abstract

Purpose

The aim was to clarify the effect of differences in the number of fiber bundles of the anterior tibial ligament (ATFL) on ankle braking function.

Methods

The study sample included 81Japanese cadavers. ATFLs were categorized as: Type I with one fiber bundle; Type II with two fiber bundles that were completely separated; and Type III with three fiber bundles. Three-dimensional reconstructions of a single specimen from each category were then created. These were used to simulate and calculate ATFL strain during dorsiflexion (20°) and plantarflexion (30°) on the talocrural joint axis and inversion (20°) on the subtalar joint axis.

Results

Almost all types of superior fiber lines were stretched with dorsiflexion and plantarflexion. Regardless of Type, the inferior fiber line was shortened with plantarflexion and stretched with dorsiflexion. The inferior fiber bundle of Type III was shortened only at plantarflexion 30° and inversion 20°, but in all others it was stretched.

Conclusions

The results suggest that Type III was weaker than Type I and Type II in terms of ankle plantarflexion and inversion braking function.

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Adult presentation of asymptomatic right lung agenesis: a rare anatomical variation

Abstract

Pulmonary agenesis is a very rare congenital anomaly characterized by the absence of pulmonary parenchyma and its vasculature. The diagnosis is usually during childhood. Herein, we report a case of incidental discover right pulmonary agenesis in adulthood male. A 30-year-old male presented with pre-operative medical evaluation for varicocele. There was no complaining from respiratory symptoms. He underwent plain chest X-ray and post-contrast CT scanning was performed using 64 multi-detector CT scanner. Chest Plain X-ray revealed cardiac and mediastinal shift to right side with hyper-inflated left lung crosses to right side. Multi-detector computed tomography examination revealed total absence of right lung with compensatory hyperinflation and increase volume of left lung. Hyper-inflated left lung extended to right hemithorax. Mediastinal structures including heart and great vessels were displaced to middle and lower parts of right hemithorax. Descending aorta located to anterior to thoracic vertebrae. Right pulmonary artery was absent. Right main bronchus was rudimentary. No detected other organ anomalies. No detected bony thoracic cage abnormalities.

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Hemorrhage within the tympanic membrane without perforation

Hemotympanum refers to both the presence of blood in the middle ear cavity and to ecchymosis of the tympanic membrane (TM), and a systematic study of intra-TM (iTM) hemorrhage without bleeding in the middle ea...

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Hemorrhage within the tympanic membrane without perforation

Hemotympanum refers to both the presence of blood in the middle ear cavity and to ecchymosis of the tympanic membrane (TM), and a systematic study of intra-TM (iTM) hemorrhage without bleeding in the middle ea...

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An interview with Sunil Krishnan, new co-EiC of Cancer Nanotechnology

As you can read about here, we are delighted to welcome Sunil Krishnan of MD Anderson, Tyler, Texas, as a new co-Editor-in-Chief of Cancer Nanotechnology. Sunil will join existing Editors-in-Chief Fred Currell, Dalton Cumbrian Facility, University of Manchester, UK, and Steve Curley, CHRISTUS Trinity Mother Frances, Texas, in helping to make Cancer Nanotechnology a premiere venue for research of its kind. We caught up with Sunil to find out a bit more about him, his research and how he feels about his new role on the journal. Sunil Krishnan; image courtesy of MD Anderson Sunil, congratulations on becoming an EiC of Cancer Nanotechnology! How do you feel about your new position? I'm excited to take on this new role on the editorial board and to join two friends and colleagues. I hope t...

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An interview with Sunil Krishnan, new co-EiC of Cancer Nanotechnology

As you can read about here, we are delighted to welcome Sunil Krishnan of MD Anderson, Tyler, Texas, as a new co-Editor-in-Chief of Cancer Nanotechnology. Sunil will join existing Editors-in-Chief Fred Currell, Dalton Cumbrian Facility, University of Manchester, UK, and Steve Curley, CHRISTUS Trinity Mother Frances, Texas, in helping to make Cancer Nanotechnology a premiere venue for research of its kind. We caught up with Sunil to find out a bit more about him, his research and how he feels about his new role on the journal. Sunil Krishnan; image courtesy of MD Anderson Sunil, congratulations on becoming an EiC of Cancer Nanotechnology! How do you feel about your new position? I'm excited to take on this new role on the editorial board and to join two friends and colleagues. I hope t...

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Osteomyelitis des Gesichtsschädels

Laryngo-Rhino-Otol
DOI: 10.1055/a-0762-3967

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Osteomyelitis des Gesichtsschädels

Laryngo-Rhino-Otol
DOI: 10.1055/a-0762-3967

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Inhibiting Inflammation with Myeloid Cell-Specific Nanobiologics Promotes Organ Transplant Acceptance

An unresolved problem in organ transplantation is to establish graft acceptance in the absence of long-term immunosuppressive therapy. Braza et  al. unravel important molecular mechanisms underlying myeloid cell activation in an experimental organ transplantation model and develop a combined nanoimmunotherapy that targets myeloid cells in hematopoietic organs and the allograft. Short-term nanobiologic immunotherapy prevents inflammation an d induces indefinite allograft survival. (Source: Immunity)

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High-Dimensional Single-Cell Analysis Identifies Organ-Specific Signatures and Conserved NK Cell Subsets in Humans and Mice

Several NK cell subsets have been reported in humans and mice, but their heterogeneity remains poorly characterized. Using high-throughput single-cell RNA-seq, Crinier et  al. provide conserved tissue-specific gene signatures of NK cells from spleen and blood and identified two major NK cell subsets transcriptionally similar across organs and species. (Source: Immunity)

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Front cover story: Eur. J. Immunol. 11'18

Our front cover features a Masson staining of lung sections from ovalbumin (OVA) ‐induced asthmatic wild type mouse. Allergic airway inflammation is apparent with collagen fibrils deposition around the airways where immune cells, mainly eosinophils, accumulate and where airway epithelial cells had an abnormal morphology showing little or single thick epithelial microvilli. The image was a part of research article by Jiajia et al. (pp. 1838–1850), where the authors discovered an asthmatic pathogenesis in a murine model that is mediated by the TLR2‐TSLP signaling axis. (Source: European Journal of Immunology)

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Journal roundup

European Journal of Immunology, Volume 48, Issue 11, Page 1775-1775, November 2018. (Source: European Journal of Immunology)

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Editorial Board: Eur. J. Immunol. 11'18

European Journal of Immunology, Volume 48, Issue 11, November 2018. (Source: European Journal of Immunology)

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Impressum

European Journal of Immunology, Volume 48, Issue 11, Page 1918-1918, November 2018. (Source: European Journal of Immunology)

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Men and Women in Immunology: Closing the gap on gender parity?

European Journal of Immunology, Volume 48, Issue 11, Page 1776-1779, November 2018. (Source: European Journal of Immunology)

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In this issue

European Journal of Immunology, Volume 48, Issue 11, Page 1773-1775, November 2018. (Source: European Journal of Immunology)

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Women in Science Awards

European Journal of Immunology, Volume 48, Issue 11, Page 1780-1784, November 2018. (Source: European Journal of Immunology)

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Inhibiting Inflammation with Myeloid Cell-Specific Nanobiologics Promotes Organ Transplant Acceptance

An unresolved problem in organ transplantation is to establish graft acceptance in the absence of long-term immunosuppressive therapy. Braza et  al. unravel important molecular mechanisms underlying myeloid cell activation in an experimental organ transplantation model and develop a combined nanoimmunotherapy that targets myeloid cells in hematopoietic organs and the allograft. Short-term nanobiologic immunotherapy prevents inflammation an d induces indefinite allograft survival. (Source: Immunity)

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High-Dimensional Single-Cell Analysis Identifies Organ-Specific Signatures and Conserved NK Cell Subsets in Humans and Mice

Several NK cell subsets have been reported in humans and mice, but their heterogeneity remains poorly characterized. Using high-throughput single-cell RNA-seq, Crinier et  al. provide conserved tissue-specific gene signatures of NK cells from spleen and blood and identified two major NK cell subsets transcriptionally similar across organs and species. (Source: Immunity)

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Hippo Kinases Mst1 and Mst2 Sense and Amplify IL-2R −STAT5 Signaling in Regulatory T Cells to Establish Stable Regulatory Activity

Treg cells respond to low IL-2 levels, but how STAT5 is activated under these conditions remains uncertain. Shi et  al. demonstrate that the serine/threonine kinases Mst1 and Mst2 sense IL-2 signals to promote STAT5 activation to maintain Treg cell homeostasis, lineage stability, and the highly suppressive phosphorylated-STAT5+ Treg cell subpopulation. Therefore, a non-canonical Hippo pathway orchestrates IL-2− STAT5 signaling selectively in Treg cells. (Source: Immunity)

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Back cover story: Eur. J. Immunol. 11'18

Our back cover features H&E staining of a section from a mouse eye with experimental autoimmune uveitis (EAU), induced by immunization with IRBP, a retinal ‐specific antigen. The image shows a portion of the retina, adjacent to the optic nerve head, with changes typical for EAU, namely, retinal folding, loss of photoreceptor cells and intense infiltration of inflammatory cells. The image is taken from Lyu et al. (pp. 1810–1816), where the authors show that treatment with the compound TMP778 inhibited the development of EAU. TMP778 is a specific inhibitor of RORγt, the transcription factor for IL‐17, but unexpectedly, the treatment inhibited the production of both IL‐17 and IFN‐γ. (Source: European Journal of Immunology)

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Front cover story: Eur. J. Immunol. 11'18

Our front cover features a Masson staining of lung sections from ovalbumin (OVA) ‐induced asthmatic wild type mouse. Allergic airway inflammation is apparent with collagen fibrils deposition around the airways where immune cells, mainly eosinophils, accumulate and where airway epithelial cells had an abnormal morphology showing little or single thick epithelial microvilli. The image was a part of research article by Jiajia et al. (pp. 1838–1850), where the authors discovered an asthmatic pathogenesis in a murine model that is mediated by the TLR2‐TSLP signaling axis. (Source: European Journal of Immunology)

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Contents: Eur. J. Immunol. 11'18

European Journal of Immunology, Volume 48, Issue 11, Page 1769-1772, November 2018. (Source: European Journal of Immunology)

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Journal roundup

European Journal of Immunology, Volume 48, Issue 11, Page 1775-1775, November 2018. (Source: European Journal of Immunology)

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Editorial Board: Eur. J. Immunol. 11'18

European Journal of Immunology, Volume 48, Issue 11, November 2018. (Source: European Journal of Immunology)

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Impressum

European Journal of Immunology, Volume 48, Issue 11, Page 1918-1918, November 2018. (Source: European Journal of Immunology)

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Men and Women in Immunology: Closing the gap on gender parity?

European Journal of Immunology, Volume 48, Issue 11, Page 1776-1779, November 2018. (Source: European Journal of Immunology)

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In this issue

European Journal of Immunology, Volume 48, Issue 11, Page 1773-1775, November 2018. (Source: European Journal of Immunology)

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Editorial introductions

No abstract available

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The long and winding road

No abstract available

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Recurrent respiratory papillomatosis: update 2018

Purpose of review Recurrent respiratory papillomatosis (RRP) is the most common as well as the costliest benign airway neoplasm in the United States [Ivancic et al. (2018). Laryngoscope Investig Otolaryngol 3:22; Derkay (1995). Arch Otolaryngol Head Neck Surg 121:1386]. In addition, it is potentially deadly, with risk of airway obstruction as well as a 3–7% risk of malignant conversion [Schraff et al. (2004). Arch Otolaryngol Head Neck Surg 130:1039]. This review highlights exciting advancements over the past 1–2 years in scientific understanding of the pathophysiology, epidemiology, natural history, prevention, and treatment of this difficult disease. Recent findings Recent studies have yielded the following findings: The primary quality of life reduction that patients perceive is voice-related; the membranous vocal folds are the most frequently involved anatomic subsite in adult-onset RRP; there may be a correlation between laryngopharyngeal reflux, herpes simplex virus type 2, and adult-onset RRP; there has been a decline in RRP incidence in Australia following the implementation of a national vaccination program; addition of educational audiovisual aids assists in vaccine acceptance rates; preventive vaccination can be used as treatment for pediatric as well as adult RRP patients with demonstrable effects on antibody titers and reoperation rates; calreticulin-linked DNA vaccines show promise in reducing the growth rate of human papilloma virus (HPV)11 E6/E7-expressing tumors in mice; injection of bevacizumab is associated with no adverse tissue affects; systemic bevacizumab is effective as a treatment for severe uncontrolled disease; pegylated interferon treatment is effective in select severe pediatric RRP disease; and finally, increased rates of programed death 1 T-lymphocyte infiltration and programed death-ligand 1 expression are seen on both papilloma and infiltrating immune cells. Summary RRP is declining in incidence but remains a challenging disease to treat with great costs to patients, families, and the healthcare system. As the disease continues to be better understood, new frontiers are opening in treatment, particularly for severe or poorly controlled disease. Until the disease can be eradicated, it remains a vital area of research to help prevent new cases and treat afflicted patients.

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Current approaches to instrumental assessment of swallowing in children

Purpose of the review This article reviews recent developments in the instrumental assessment of swallowing in children with a specific focus on research published between January 2017 and June 2018. Recent findings Instrumental swallowing assessments reported in the time period included: videofluoroscopic study of swallowing, digital cervical auscultation, dynamic ultrasound, high-resolution impedance manometry, nasal airflow thermistry and respiratory inductance plethysmography. Several studies were found exploring tools to objectively quantify videofluoroscopic study of swallowing data; swallowing from the mouth through to stomach was addressed including approaches to analysing mastication as well as evaluating oesophageal motility disorders. Summary Even though a vast range of instrumentation were studied, lack of clarity on clinical feasibility and objective measures that facilitate medical decision-making in practice mean further research is required to provide guidance on implementation. Promising novel approaches to aid the quantification of swallowing physiology from the mouth, pharynx and through to the oesophagus are emerging.

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Velopharyngeal incompetence: role in paediatric swallowing deficits

Purpose of review The purpose of this manuscript is to highlight the latest advances in diagnosis and management of velopharyngeal incompetence (VPI) as it pertains to swallowing deficits in children. This is timely and relevant as otolaryngologists are often amongst the first to diagnose and treat VPI. Although nasal regurgitation of a bolus is frequently transient, persistent problems can be associated with other swallowing problems and other significant medical problems. Furthermore, velopharyngeal incompetence has implications for speech production. Recent findings Persistent VPI associated with a swallowing deficit can be an isolated anomaly with or without a cleft palate or submucous cleft palate. VPI may be secondary to a cranial neuropathy, esophageal abnormality or associated with another airway anomaly, any of which may further contribute to dysphagia. Findings of additional anomalies may be suggestive of a syndrome. Workup should explore these potential causes. When velopharyngeal incompetence is associated with dysphagia, fiberoptic endoscopic evaluation of swallow (FEES) and videofluoroscopic swallow study (VFSS) can be helpful in diagnosis and management. The advantages and disadvantages of FEES and VFSS have been well delineated over the past few years. Similarly, nasopharyngoscopy and fluoroscopy are increasingly used in diagnosis and management of VPI that is associated with hypernasal resonance disorders. Summary Concurrent medical diagnoses or syndrome manifestations are often associated with or contribute significantly to the cause of dysphagia in children with VPI. As VPI can be a sign of brainstem vagal neuropathy, the clinician should investigate by imaging the CNS if other correlative symptoms of dysphagia and examination findings are present. Endoscopy is advocated for evaluation of vocal fold function. Fluoroscopy is best for further assessment of airway protection or safety of swallow. And, whenever indicated, additional workup is recommended to determine an underlying cause of the swallowing disorder.

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Recurrent laryngeal nerve reinnervation: is this the standard of care for pediatric unilateral vocal cord paralysis?

Purpose of review Ansa to recurrent laryngeal nerve reinnervation, otherwise known as a nonselective laryngeal reinnervation (NSLR), is growing in popularity for the management of pediatric unilateral neuronal vocal fold movement impairment (VFMI). In this chapter, we will review the current treatment options for neuronal VFMI and role that NSLR plays in the treatment algorithm. Recent findings In 2018, Bouhabel and Hartnick published a survey of fellowship trained pediatric otolaryngologists and found an increasing comfort level with NSLR. Respondents felt that NSLR resulted in favorable subjective and objective postsurgical voice outcomes. Furthermore, NSLR may decrease the risk of aspiration in children with neuronal VFMI. Although NSLR appears to work, the voice results are not perfect for all children. Further work is being done to understand which preoperative variables, such as age, time from injury, and preop laryngeal electromyography, may predict a better voice outcome. Summary A variety of treatment options exist for unilateral neuronal VFMI. Recent data and developments demonstrate the effectiveness of reinnervation as a potential first-line surgical intervention in children with unilateral neuronal VFMI.

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Swallowing function in advanced age

Purpose of review To present current literature regarding swallowing function in advanced age, including healthy ageing, dysphagia and trends in multidisciplinary team service delivery. Recent findings Normative studies support swallowing efficiency but greater variability in healthy advanced age, through to 100 years old. Deviations from normative data and symptoms of dysphagia leading to aspiration or nutritional risk, imply swallowing disorder, rather than simply the ageing process. Quantitative and qualitative studies are emerging that promote management of swallow dysfunction for an ageing society, including innovative assessment, home treatment, swallowing exercise and optimized mealtimes. Summary Current literature on swallowing function in advanced age provides multidisciplinary perspectives and initiatives, with clear commitment to improving quality of life for older adults. The diversity of the older population and serious consequences of swallowing difficulties calls for routine screening tools for swallowing impairment and malnutrition risk. Representation of 'oldest old' in future normative studies is essential to guide swallowing management in adults over 85 years old.

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IgG4-related disease in the head and neck

Purpose of review To summarize current evidence regarding the pathophysiology, diagnostic criteria, and management of IgG4 disease in the head and neck. Recent findings The anti-CD20 antibody, rituximab is being used increasingly as a primary treatment modality in cases with a definitive diagnosis. Despite the favorable prognosis, it is now recognized that the incidence of cancer development within 3 years of diagnosis is higher than that of the general population. Summary IgG4-related disease is a sclerosing, chronic inflammatory disease, that is benign, and usually occurs in middle-aged to elderly individuals. Definitive diagnosis of IgG4-related disease requires radiological confirmation of enlargement of the affected organ, elevated serum IgG4 levels, and characteristic histopathological findings. Treatment is primarily with systemic corticosteroids or the monoclonal anti-CD20 antibody rituximab, surgical excision, or a combination of treatment modalities. Prognosis is good with complete remission in up to 90% of patients.

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Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms

Purpose of review The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia. Recent findings Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3–C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter. Summary Cervical osteophytosis and abnormal cervical curvature may be overlooked by the Otolaryngologists as causes of swallowing disorders. The diagnosis is usually confirmed by radiologic study for the cervical spine. Cervical abnormality should be kept in mind while we are investigating patients with swallowing problem, and postural modification may help in treatment of such cases.

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Vocal fold nodules in children

Purpose of review Vocal nodules are a common presentation in children, representing the most common cause of dysphonia. Recent findings Children with siblings, ADHD, and of male sex are most likely to be affected. Female children, however, tend to have more likely progression into adolescence. Quality-of-life indices can aid in screening for vocal nodules whereas stroboscopy, and possibly, ultrasound are required for definitive diagnosis. Summary Management has not significantly changed over time and should begin with conservative behavioral and environmental modifications along with voice therapy in those more severely impacted. Though immediate outcomes vary somewhat depending on management direction, the overall prognosis seems to be good even with lack of intervention. It is most critical to ensure a definitive diagnosis, and offer management therapies that are appropriate for the level of impact the vocal nodules have on communication and voice production in the child.

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Laryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018

Purpose of review To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux. Recent findings Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association between symptoms, signs, impedance-pH studies and pepsin detection could be the most accurate way for a clear diagnosis. 'Reflux profiling' is also important for the administration of a personalized treatment based on diet, proton pump inhibitors, alginate, magaldrate and other second-line drugs. There are only a handful of studies focusing on the addition of alginate or magaldrate to the treatment of laryngopharyngeal reflux, although their contribution has extensively been demonstrated. Summary Diagnosis remains controversial despite improvement in impedance and availability of pepsin detection in daily practice. With recent studies exhibiting a significant prevalence of nonacid or mixed refluxes, the addition of alginate or magaldrate to proton pump inhibitors should be considered. Future studies are needed to assess these new therapeutic schemes in moderate and severe laryngopharyngeal reflux.

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Tympanostomy tube otorrhea in children: prevention and treatment

Purpose of review One in two children treated with tympanostomy tubes, experience episodes of otorrhea whilst their tubes are in place. In this review, we present the results of the most recent publications on prevention and treatment of tympanostomy tube otorrhea (TTO). Recent findings Recent systematic reviews on water precautions for children with tympanostomy tubes support the American Academy of Otolaryngology – Head and Neck Surgery guideline recommendation against such preventive measures as there is no evidence that it protects against TTO. Studies on tympanostomy tube design and material suggest that silicone tubes have a lower TTO risk and that biofilms appear to be mainly located in the perpendicular junction of the T-tubes and the round rims of the Paparella-type tubes. Another study shows that the biofilm-component DNAB-II protein is present in otorrhea of half of children with TTO. Targeting this protein could lead to a collapse of the biofilm structure and as such a potential new treatment for chronic TTO. New systematic reviews show that antibiotic eardrops are the most effective first-line treatment of acute TTO and suggest that an antibiotic–corticosteroid combination is more effective than antibiotic only. Although in many countries, quinolone eardrops are the preferred choice because of being non-ototoxic, one study found a higher risk of persistent perforation after tube extrusion in children treated with quinolone eardrops as compared with children treated with aminoglycoside eardrops. Summary Recent evidence confirms that water precautions for children with tympanostomy tubes are not effective in preventing TTO. Antibiotic–corticosteroid eardrops are the most effective treatment of acute TTO.

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Editorial introductions

No abstract available

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The long and winding road

No abstract available

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Recurrent respiratory papillomatosis: update 2018

Purpose of review Recurrent respiratory papillomatosis (RRP) is the most common as well as the costliest benign airway neoplasm in the United States [Ivancic et al. (2018). Laryngoscope Investig Otolaryngol 3:22; Derkay (1995). Arch Otolaryngol Head Neck Surg 121:1386]. In addition, it is potentially deadly, with risk of airway obstruction as well as a 3–7% risk of malignant conversion [Schraff et al. (2004). Arch Otolaryngol Head Neck Surg 130:1039]. This review highlights exciting advancements over the past 1–2 years in scientific understanding of the pathophysiology, epidemiology, natural history, prevention, and treatment of this difficult disease. Recent findings Recent studies have yielded the following findings: The primary quality of life reduction that patients perceive is voice-related; the membranous vocal folds are the most frequently involved anatomic subsite in adult-onset RRP; there may be a correlation between laryngopharyngeal reflux, herpes simplex virus type 2, and adult-onset RRP; there has been a decline in RRP incidence in Australia following the implementation of a national vaccination program; addition of educational audiovisual aids assists in vaccine acceptance rates; preventive vaccination can be used as treatment for pediatric as well as adult RRP patients with demonstrable effects on antibody titers and reoperation rates; calreticulin-linked DNA vaccines show promise in reducing the growth rate of human papilloma virus (HPV)11 E6/E7-expressing tumors in mice; injection of bevacizumab is associated with no adverse tissue affects; systemic bevacizumab is effective as a treatment for severe uncontrolled disease; pegylated interferon treatment is effective in select severe pediatric RRP disease; and finally, increased rates of programed death 1 T-lymphocyte infiltration and programed death-ligand 1 expression are seen on both papilloma and infiltrating immune cells. Summary RRP is declining in incidence but remains a challenging disease to treat with great costs to patients, families, and the healthcare system. As the disease continues to be better understood, new frontiers are opening in treatment, particularly for severe or poorly controlled disease. Until the disease can be eradicated, it remains a vital area of research to help prevent new cases and treat afflicted patients.

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Current approaches to instrumental assessment of swallowing in children

Purpose of the review This article reviews recent developments in the instrumental assessment of swallowing in children with a specific focus on research published between January 2017 and June 2018. Recent findings Instrumental swallowing assessments reported in the time period included: videofluoroscopic study of swallowing, digital cervical auscultation, dynamic ultrasound, high-resolution impedance manometry, nasal airflow thermistry and respiratory inductance plethysmography. Several studies were found exploring tools to objectively quantify videofluoroscopic study of swallowing data; swallowing from the mouth through to stomach was addressed including approaches to analysing mastication as well as evaluating oesophageal motility disorders. Summary Even though a vast range of instrumentation were studied, lack of clarity on clinical feasibility and objective measures that facilitate medical decision-making in practice mean further research is required to provide guidance on implementation. Promising novel approaches to aid the quantification of swallowing physiology from the mouth, pharynx and through to the oesophagus are emerging.

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Techniques for evaluation and management of tongue-base obstruction in pediatric obstructive sleep apnea

Purpose of review Tongue-base obstruction (TBO) is a common cause of persistent obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy in children. This review discusses available diagnostic modalities and surgical treatment options for the management of TBO. Recent findings Recently, a systematic review that included nine studies using drug-induced sleep endoscopy (DISE) in the evaluation of children with persistent OSA after tonsillectomy and adenoidectomy identified the tongue-base as the most common site of obstruction. Summary TBO is a common and correctable cause of persistent OSA in children. Diagnostic modalities include awake flexible laryngoscopy, plain neck films, DISE, and cine MRI. Because DISE and cine MRI are performed in a sleep-like state, they are fairly reliable in identifying the site of obstruction. As continuous positive airway pressure is often poorly tolerated in the pediatric population, there is considerable interest in surgical options for TBO. Depending on the location and the severity of the obstruction, interventions such as lingual tonsillectomy, posterior midline glossectomy, tongue suspension suture, epiglottopexy, hypoglossal nerve stimulation, tongue–lip adhesion, and hyoid suspension may play a role in management.

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Recurrent laryngeal nerve reinnervation: is this the standard of care for pediatric unilateral vocal cord paralysis?

Purpose of review Ansa to recurrent laryngeal nerve reinnervation, otherwise known as a nonselective laryngeal reinnervation (NSLR), is growing in popularity for the management of pediatric unilateral neuronal vocal fold movement impairment (VFMI). In this chapter, we will review the current treatment options for neuronal VFMI and role that NSLR plays in the treatment algorithm. Recent findings In 2018, Bouhabel and Hartnick published a survey of fellowship trained pediatric otolaryngologists and found an increasing comfort level with NSLR. Respondents felt that NSLR resulted in favorable subjective and objective postsurgical voice outcomes. Furthermore, NSLR may decrease the risk of aspiration in children with neuronal VFMI. Although NSLR appears to work, the voice results are not perfect for all children. Further work is being done to understand which preoperative variables, such as age, time from injury, and preop laryngeal electromyography, may predict a better voice outcome. Summary A variety of treatment options exist for unilateral neuronal VFMI. Recent data and developments demonstrate the effectiveness of reinnervation as a potential first-line surgical intervention in children with unilateral neuronal VFMI.

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Swallowing function in advanced age

Purpose of review To present current literature regarding swallowing function in advanced age, including healthy ageing, dysphagia and trends in multidisciplinary team service delivery. Recent findings Normative studies support swallowing efficiency but greater variability in healthy advanced age, through to 100 years old. Deviations from normative data and symptoms of dysphagia leading to aspiration or nutritional risk, imply swallowing disorder, rather than simply the ageing process. Quantitative and qualitative studies are emerging that promote management of swallow dysfunction for an ageing society, including innovative assessment, home treatment, swallowing exercise and optimized mealtimes. Summary Current literature on swallowing function in advanced age provides multidisciplinary perspectives and initiatives, with clear commitment to improving quality of life for older adults. The diversity of the older population and serious consequences of swallowing difficulties calls for routine screening tools for swallowing impairment and malnutrition risk. Representation of 'oldest old' in future normative studies is essential to guide swallowing management in adults over 85 years old.

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IgG4-related disease in the head and neck

Purpose of review To summarize current evidence regarding the pathophysiology, diagnostic criteria, and management of IgG4 disease in the head and neck. Recent findings The anti-CD20 antibody, rituximab is being used increasingly as a primary treatment modality in cases with a definitive diagnosis. Despite the favorable prognosis, it is now recognized that the incidence of cancer development within 3 years of diagnosis is higher than that of the general population. Summary IgG4-related disease is a sclerosing, chronic inflammatory disease, that is benign, and usually occurs in middle-aged to elderly individuals. Definitive diagnosis of IgG4-related disease requires radiological confirmation of enlargement of the affected organ, elevated serum IgG4 levels, and characteristic histopathological findings. Treatment is primarily with systemic corticosteroids or the monoclonal anti-CD20 antibody rituximab, surgical excision, or a combination of treatment modalities. Prognosis is good with complete remission in up to 90% of patients.

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Cervical osteophytosis and spine posture: contribution to swallow disorders and symptoms

Purpose of review The article reviews the effects of cervical osteophytosis and spine posture on swallowing, and how they can cause dysphagia. Recent findings Cerivical osteophytosis which is a bony overgrowth of the cervical spines, it affects the swallowing through different mechanisms, including direct mechanical compression of the pharynx and esophagus, disturbances of normal epiglottic tilt over the inlet of the larynx by the osteophytes at C3–C4 level, inflammatory reactions in the tissues around the esophagus and cricopharyngeal spasm. Also, cervical spine posture in normal individuals could affect the swallowing mechanism by disturbance of the sphincteric action of the larynx and upper esophageal sphincter. Summary Cervical osteophytosis and abnormal cervical curvature may be overlooked by the Otolaryngologists as causes of swallowing disorders. The diagnosis is usually confirmed by radiologic study for the cervical spine. Cervical abnormality should be kept in mind while we are investigating patients with swallowing problem, and postural modification may help in treatment of such cases.

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Update on sinus disease in children with cystic fibrosis: advances in treatment modalities, microbiology, and health-related quality-of-life instruments

Purpose of review There is a lack of consensus with regards to the diagnosis and treatment of sinus disease in children with cystic fibrosis. Here, we review literature from the past 18 months in order to highlight the way forward in this contentious field. Recent findings Most of the literature (from the past 18 months) on sinus disease in pediatric cystic fibrosis focused on treatment approaches, bacteriology and immunology, and health-related quality-of-life (HRQOL) instruments. Quality studies have demonstrated that functional endoscopic sinus surgery (FESS) is as safe in children with or without cystic fibrosis; that the microbiology of the paranasal sinus in children with cystic fibrosis is different than that of their lungs; and, that HRQOL instruments may prove useful in determining sinonasal disease severity in children with cystic fibrosis. Summary Medical and surgical approaches appear to be viable in the treatment of sinonasal disease in pediatric cystic fibrosis; the microbiology and immunology of pediatric cystic fibrosis is proving more complex and nuanced than initially believed; and, HRQOL instruments show promise in reconciling differences between observable and clinically relevant sinus disease in pediatric cystic fibrosis patients.

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High-resolution manometry: what about the pharynx?

Purpose of review High-resolution pharyngeal manometry (HRPM) is a well tolerated, catheter-based, method for recording the pressures and bolus flow generated by the pharyngeal muscles during swallowing. Despite a body of published evidence and a critical mass of investigators in the field, there is a lack of consensus surrounding what biomechanical phenomena to measure. The purpose of this review is to provide some insights into the information on swallowing physiology that can be gathered using HRPM. Recent findings HRPM literature has focused on measuring biomechanical phenomena that may be relevant to measure in relation to dysphagia research. This review focuses on the measurement of pharyngeal luminal occlusive forces, intrabolus distension pressure, bolus presence and bolus flow timing as key features of pharyngeal swallowing that require measurement and allow for derivation of the Swallow Risk Index, a global measure of swallow function indicative of swallowing functional reserve. Summary HRPM allows objective derivation of measures of swallow function that may have value for diagnosis and research in relation to swallowing disorders. HRPM has demonstrated clinical applicability in specific patient populations and offers unique advantages that compliment current assessment methods.

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Tympanostomy tube otorrhea in children: prevention and treatment

Purpose of review One in two children treated with tympanostomy tubes, experience episodes of otorrhea whilst their tubes are in place. In this review, we present the results of the most recent publications on prevention and treatment of tympanostomy tube otorrhea (TTO). Recent findings Recent systematic reviews on water precautions for children with tympanostomy tubes support the American Academy of Otolaryngology – Head and Neck Surgery guideline recommendation against such preventive measures as there is no evidence that it protects against TTO. Studies on tympanostomy tube design and material suggest that silicone tubes have a lower TTO risk and that biofilms appear to be mainly located in the perpendicular junction of the T-tubes and the round rims of the Paparella-type tubes. Another study shows that the biofilm-component DNAB-II protein is present in otorrhea of half of children with TTO. Targeting this protein could lead to a collapse of the biofilm structure and as such a potential new treatment for chronic TTO. New systematic reviews show that antibiotic eardrops are the most effective first-line treatment of acute TTO and suggest that an antibiotic–corticosteroid combination is more effective than antibiotic only. Although in many countries, quinolone eardrops are the preferred choice because of being non-ototoxic, one study found a higher risk of persistent perforation after tube extrusion in children treated with quinolone eardrops as compared with children treated with aminoglycoside eardrops. Summary Recent evidence confirms that water precautions for children with tympanostomy tubes are not effective in preventing TTO. Antibiotic–corticosteroid eardrops are the most effective treatment of acute TTO.

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In vivo Raman spectroscopic characteristics of different sites of the oral mucosa in healthy volunteers

Abstract

Objectives

Investigate the biochemistry of in vivo healthy oral tissues through Raman spectroscopy. We aimed to characterize the biochemical features of healthy condition in oral subsites (buccal mucosa, lip, tongue, and gingiva) of healthy subjects. More specifically, we investigated Raman spectral characteristics and biochemical content of in vivo healthy tissues on Brazilian population. This characterization can be used to better define normal tissue and improve the detection of oral premalignant conditions in future studies.

Materials and methods

For spectroscopic analysis a Raman spectrometer (Kaiser Optical Systems imaging spectrograph Holospec, f / 1.8i-NIR) coupled with a laser 785 nm, 60 mW was used. Raman measurements were obtained by means of an optical fiber (EMVision fiber optic probe) coupled between the laser and the spectrometer. Three spectra per site were acquired from the lip, buccal mucosa, tongue, and gingiva of ten healthy volunteers. This resulted in 30 spectra per oral sub-site and in total 120 spectra.

Results

We report detailed biochemical information on these subsites and their relative composition based on deconvolution studies of their spectra. Finally, we also report classification efficiency of 61, 83, 41, and 93% for buccal, gingiva, lip, and tongue respectively after applying multivariate statistical tools.

Conclusions

We quantitated the contribution of various biochemicals in terms of percentage, and this will enable comparison not only across anatomical sites but also across studies. Raman spectroscopy can rapidly probe tissue biochemistry of healthy oral regions. Moreover, the study suggests the possibility of using Raman spectroscopy combined with signal processing and multivariate analysis methods to differentiate the oral sites in healthy conditions and compare with pathological conditions in future studies.

Clinical relevance

The spectral characterization of the healthy condition of oral tissues by a noninvasive, label-free, and real-time analytical techniques is important to create a spectral reference for future diagnosis of pathological conditions.

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Low wintertime pre-diagnostic vitamin D status is associated with an increased risk of internal malignancies in kidney transplant recipients

Photochem. Photobiol. Sci., 2018, Advance Article
DOI: 10.1039/C7PP00404D, Paper

Frank R. de Gruijl, Ron Wolterbeek, Stan Pavel, Johan W. de Fijter, Neveen A. T. Hamdy, Jan Nico Bouwes Bavinck
Kidney transplant recipients with the lowest wintertime vitamin D levels appear to run the highest risk of internal malignancies. The effect was strongest in women.
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Scope of surface-modified molecular and nanomaterials in gel/liquid forms for developing mechanically flexible DSSCs/QDSSCs

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00293B, Perspective

Soorya Sasi, Sunish K. Sugunan, P. Radhakrishnan Nair, K. R. V. Subramanian, Suresh Mathew
In this perspective article, we discuss the possibilities of integrating liquefied organic and inorganic semiconducting materials with tunable optoelectronic properties into solvent-free fluidic systems of functional optoelectronic materials to generate flexible DSSCs/QDSSCs.
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A multiple target chemosensor for the sequential fluorescence detection of Zn2+ and S2− and the colorimetric detection of Fe3+/2+ in aqueous media and living cells

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00408K, Paper

Jin Yeong Yun, Ju Byeong Chae, Mingeun Kim, Mi Hee Lim, Cheal Kim
A novel multiple target sensor DHIC was developed for the fluorescence detection of Zn²⁺ and S²⁻ and colorimetric detection of Fe^3+/2+. Moreover, DHIC could image sequentially Zn²⁺ and S²⁻ in living cells.
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