Prediabetes and diabetes prevalence in the Workers’ Oral Health Study

Abstract

Objective

To examine the association between periodontitis, diabetes, and prediabetes, assessed by fasting plasma glucose (FPG).

Materials and methods

Workers' Oral Health Study is a cross-sectional survey conducted on a representative sample of the Spanish employed population including 5154 participants (59.5% men, aged 16–65). Examination of periodontal status assessed Community Periodontal Index (CPI) and clinical attachment levels (CAL). Biochemical determinations included fasting plasma glucose (FPG), triglycerides, and total cholesterol. Logistic regression analysis with adjustment for potential confounders was used to evaluate the association between periodontitis and abnormal glucose regulation.

Results

Ninety-five participants (2.2%) of the study population had diabetes, while 373 (8.8%) presented prediabetes. Prediabetes was not associated with CPI or CAL in fully adjusted multivariate logistic regressions models. Diabetes was significantly associated with subjects having a CPI 4 after adjustment for potential confounders (odds ratio OR = 1.9, 95% confidence interval (CI) 1.1–3.1). This association was stronger in subjects < 45 years (OR = 4.0, 95% CI 1.2–12.7).

Conclusion

Periodontitis was associated with diabetes mellitus, but not with prediabetes, in a representative sample of the Spanish employed population. The association was stronger for younger subjects, which emphasizes the need for early detection of diabetes in younger patients affected by periodontitis, particularly because periodontal therapy may help to improve glycemic control.

Clinical relevance

Periodontitis is associated with diabetes mellitus, having at the same time a negative effect on glycemic control. It is important to develop proper early diagnosis strategies for both conditions, particularly in young male adults.

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Einstein Adds Curriculum on Adults with Intellectual and Developmental Disabilities

BRONX, NY—(February 28, 2019)—Children with intellectual and developmental disabilities (IDD) have long benefited from the training pediatricians receive to treat autism, epilepsy, cerebral palsy, or other disorders. Their doctors often connect these young patients with many professionals—from physical, occupational, and speech therapists to psychologists, social workers, and special-care dentists. But as children grow up, they soon discover there are far fewer physicians aware of their unique needs. (Source: Einstein News)

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Retrospective Assessment of the Efficacy of Modified Progressive Tinnitus Management Skills Education in a Military Medical Treatment Facility.

CONCLUSIONS: The evidence supports the assumption that PTM is a flexible program of tinnitus management that even when modified to be suitable for use in a DOD medical treatment facility provides meaningful reductions in tinnitus awareness and annoyance and improves tinnitus coping ability among military beneficiaries. These findings should encourage audiologists to modify PTM to work within their military medical treatment facility. PMID: 30811536 [PubMed - as supplied by publisher] (Source: Military Medicine)

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Hearing Preservation Surgery via Retrosigmoid Approach with Retrolabyrinthine Meatotomy in Small Vestibular Schwannoma

Conclusions RLM via RS approach proved to be effective for HPS, enabling the full course of the facial and cochlear nerves through the IAC to be directly exposed.The link to the video can be found at: https://youtu.be/KC1S4pxpLCk. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Einstein Adds Curriculum on Adults with Intellectual and Developmental Disabilities

BRONX, NY—(February 28, 2019)—Children with intellectual and developmental disabilities (IDD) have long benefited from the training pediatricians receive to treat autism, epilepsy, cerebral palsy, or other disorders. Their doctors often connect these young patients with many professionals—from physical, occupational, and speech therapists to psychologists, social workers, and special-care dentists. But as children grow up, they soon discover there are far fewer physicians aware of their unique needs. (Source: Einstein News)

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Retrospective Assessment of the Efficacy of Modified Progressive Tinnitus Management Skills Education in a Military Medical Treatment Facility.

CONCLUSIONS: The evidence supports the assumption that PTM is a flexible program of tinnitus management that even when modified to be suitable for use in a DOD medical treatment facility provides meaningful reductions in tinnitus awareness and annoyance and improves tinnitus coping ability among military beneficiaries. These findings should encourage audiologists to modify PTM to work within their military medical treatment facility. PMID: 30811536 [PubMed - as supplied by publisher] (Source: Military Medicine)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Xx8i5E

Hearing Preservation Surgery via Retrosigmoid Approach with Retrolabyrinthine Meatotomy in Small Vestibular Schwannoma

Conclusions RLM via RS approach proved to be effective for HPS, enabling the full course of the facial and cochlear nerves through the IAC to be directly exposed.The link to the video can be found at: https://youtu.be/KC1S4pxpLCk. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Severe asthma ‐ A population study perspective

Abstract

Background

Severe asthma is a considerable challenge for patients, health care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study.

Objective

To describe characteristics and estimate the prevalence of severe asthma in a large adult population‐based asthma cohort followed for 10‐28 years.

Methods

N=1006 subjects with asthma participated in a follow‐up during 2012‐14, when 830 (mean age 59y, 56% women) still had current asthma. Severe asthma was defined according to three internationally well‐known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Program (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care, and were also contacted by telephone to verify treatment adherence.

Results

The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >40% had uncontrolled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma.

Conclusions and clinical relevance

Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4‐6%, corresponding to approximately 0.5% of the general population.

This article is protected by copyright. All rights reserved.

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Severe asthma ‐ A population study perspective

Abstract

Background

Severe asthma is a considerable challenge for patients, health care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study.

Objective

To describe characteristics and estimate the prevalence of severe asthma in a large adult population‐based asthma cohort followed for 10‐28 years.

Methods

N=1006 subjects with asthma participated in a follow‐up during 2012‐14, when 830 (mean age 59y, 56% women) still had current asthma. Severe asthma was defined according to three internationally well‐known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Program (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care, and were also contacted by telephone to verify treatment adherence.

Results

The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >40% had uncontrolled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma.

Conclusions and clinical relevance

Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4‐6%, corresponding to approximately 0.5% of the general population.

This article is protected by copyright. All rights reserved.

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Accurate Patient-Specific Machine Learning Models of Glioblastoma Invasion Using Transfer Learning [FUNCTIONAL]

BACKGROUND AND PURPOSE:

MR imaging–based modeling of tumor cell density can substantially improve targeted treatment of glioblastoma. Unfortunately, interpatient variability limits the predictive ability of many modeling approaches. We present a transfer learning method that generates individualized patient models, grounded in the wealth of population data, while also detecting and adjusting for interpatient variabilities based on each patient's own histologic data.

MATERIALS AND METHODS:

We recruited patients with primary glioblastoma undergoing image-guided biopsies and preoperative imaging, including contrast-enhanced MR imaging, dynamic susceptibility contrast MR imaging, and diffusion tensor imaging. We calculated relative cerebral blood volume from DSC-MR imaging and mean diffusivity and fractional anisotropy from DTI. Following image coregistration, we assessed tumor cell density for each biopsy and identified corresponding localized MR imaging measurements. We then explored a range of univariate and multivariate predictive models of tumor cell density based on MR imaging measurements in a generalized one-model-fits-all approach. We then implemented both univariate and multivariate individualized transfer learning predictive models, which harness the available population-level data but allow individual variability in their predictions. Finally, we compared Pearson correlation coefficients and mean absolute error between the individualized transfer learning and generalized one-model-fits-all models.

RESULTS:

Tumor cell density significantly correlated with relative CBV (r = 0.33, P < .001), and T1-weighted postcontrast (r = 0.36, P < .001) on univariate analysis after correcting for multiple comparisons. With single-variable modeling (using relative CBV), transfer learning increased predictive performance (r = 0.53, mean absolute error = 15.19%) compared with one-model-fits-all (r = 0.27, mean absolute error = 17.79%). With multivariate modeling, transfer learning further improved performance (r = 0.88, mean absolute error = 5.66%) compared with one-model-fits-all (r = 0.39, mean absolute error = 16.55%).

CONCLUSIONS:

Transfer learning significantly improves predictive modeling performance for quantifying tumor cell density in glioblastoma.

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Preoperative MR Imaging to Differentiate Chordoid Meningiomas from Other Meningioma Histologic Subtypes [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Chordoid meningiomas are uncommon WHO grade II primary intracranial neoplasms that possess unique chordoid histology and follow an aggressive clinical course. Our aim was to assess the utility of qualitative MR imaging features and quantitative apparent diffusion coefficient values as distinguishing preoperative MR imaging metrics to identify and differentiate chordoid histology from other meningioma histologic subtypes.

MATERIALS AND METHODS:

Twenty-one patients with meningiomas with chordoid histology, which included both chordoid meningiomas (>50% chordoid histology) and meningiomas with focal chordoid histology (<50% chordoid histology) with available preoperative MR imaging examinations, including diffusion-weighted imaging, were identified. Qualitative imaging features and quantitative ADC values were compared between meningiomas with chordoid histology and 42 nonchordoid meningiomas (29 WHO grade I, eleven WHO grade II, and 2 WHO grade III).

RESULTS:

The median ADC (10^–3mm²/s) of meningiomas with chordoid histology was significantly higher than nonchordoid meningiomas (1.16 versus 0.92, P < .001), as was the median normalized ADC (1.60 versus 1.19, P < .001). In subgroup analysis, the median and normalized ADC values of chordoid meningiomas (n = 11) were significantly higher than those in meningiomas with focal chordoid histology (n = 10, P < .001 and P < .001, respectively) or nonchordoid meningiomas (n = 42, P < .001 and <0.001, respectively). Median and normalized ADC values were not significantly different between the meningiomas with focal chordoid histology and nonchordoid meningiomas (P = .816 and .301, respectively). Among the qualitative imaging features, only DWI signal intensity was significantly associated with meningiomas with chordoid histology diagnosis.

CONCLUSIONS:

ADC values are higher in chordoid compared with nonchordoid meningiomas and may be used to discriminate the degree of chordoid histology in meningiomas. While qualitative MR imaging features do not strongly discriminate chordoid from nonchordoid meningiomas, DWI may allow preoperative identification of chordoid meningiomas.

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Decubitus CT Myelography for Detecting Subtle CSF Leaks in Spontaneous Intracranial Hypotension [SPINE]

SUMMARY:

Spontaneous intracranial hypotension is caused by spinal CSF leaks, but the site of the leak is not always detected on spinal imaging. We report on the additional value of decubitus positioning during CT myelography in enhancing the detection of subtle leaks.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJe8Di

A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Disappearance of T2 lesions into CSF spaces is frequently observed in patients with MS. Our aim was to investigate temporal changes of cumulative atrophied brain T2 lesion volume and 10-year confirmed disability progression.

MATERIALS AND METHODS:

We studied 176 patients with relapsing-remitting MS who underwent MR imaging at baseline, 6 months, and then yearly for 10 years. Occurrence of new/enlarging T2 lesions, changes in T2 lesion volume, and whole-brain, cortical and ventricle volumes were assessed yearly between baseline and 10 years. Atrophied T2 lesion volume was calculated by combining baseline lesion masks with follow-up CSF partial volume maps. Ten-year confirmed disability progression was confirmed after 48 weeks. ANCOVA detected MR imaging outcome differences in stable (n = 76) and confirmed disability progression (n = 100) groups at different time points; hierarchic regression determined the unique additive variance explained by atrophied T2 lesion volume regarding the association with confirmed disability progression, in addition to other MR imaging metrics. Cox regression investigated the association of early MR imaging outcome changes and time to development of confirmed disability progression.

RESULTS:

The separation of stable-versus-confirmed disability progression groups became significant even in the first 6 months for atrophied T2 lesion volume (140% difference, Cohen d = 0.54, P = .004) and remained significant across all time points (P ≤ .007). The hierarchic model, including all other MR imaging outcomes during 10 years predicting confirmed disability progression, improved significantly after adding atrophied T2 lesion volume (R² = 0.27, R² change 0.11, P = .009). In Cox regression, atrophied T2 lesion volume in 0–6 months (hazard ratio = 4.23, P = .04) and 0–12 months (hazard ratio = 2.41, P = .022) was the only significant MR imaging predictor of time to confirmed disability progression.

CONCLUSIONS:

Atrophied T2 lesion volume is a robust and early marker of disability progression in relapsing-remitting MS.

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Evaluation of the Implementation of the Response Assessment in Neuro-Oncology Criteria in the HERBY Trial of Pediatric Patients with Newly Diagnosed High-Grade Gliomas [PEDIATRICS]

BACKGROUND AND PURPOSE:

HERBY was a Phase II multicenter trial setup to establish the efficacy and safety of adding bevacizumab to radiation therapy and temozolomide in pediatric patients with newly diagnosed non–brain stem high-grade gliomas. This study evaluates the implementation of the radiologic aspects of HERBY.

MATERIALS AND METHODS:

We analyzed multimodal imaging compliance rates and scan quality for participating sites, adjudication rates and reading times for the central review process, the influence of different Response Assessment in Neuro-Oncology criteria in the final response, the incidence of pseudoprogression, and the benefit of incorporating multimodal imaging into the decision process.

RESULTS:

Multimodal imaging compliance rates were the following: diffusion, 82%; perfusion, 60%; and spectroscopy, 48%. Neuroradiologists' responses differed for 50% of scans, requiring adjudication, with a total average reading time per patient of approximately 3 hours. Pseudoprogression occurred in 10/116 (9%) cases, 8 in the radiation therapy/temozolomide arm and 2 in the bevacizumab arm (P < .01). Increased target enhancing lesion diameter was a reason for progression in 8/86 cases (9.3%) but never the only radiologic or clinical reason. Event-free survival was predicted earlier in 5/86 (5.8%) patients by multimodal imaging (diffusion, n = 4; perfusion, n = 1).

CONCLUSIONS:

The addition of multimodal imaging to the response criteria modified the assessment in a small number of cases, determining progression earlier than structural imaging alone. Increased target lesion diameter, accounting for a large proportion of reading time, was never the only reason to designate disease progression.

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Paranasal Sinus CT Is of Variable Value in Patients with Pediatric Cancer with Neutropenic Fever [LETTERS]

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Prevalence of Superior Semicircular Canal Dehiscence on High-Resolution CT Imaging in Patients without Vestibular or Auditory Abnormalities [HEAD & NECK]

BACKGROUND AND PURPOSE:

Prior studies of radiologic superior semicircular canal dehiscence have suggested that CT may overcall dehiscence. However, many of those studies were performed before the advent of multichannel helical CT. Furthermore, there are limited data investigating the prevalence of radiologic superior semicircular canal dehiscence in asymptomatic individuals. The purpose of this study was to determine the rate of radiologic superior semicircular canal dehiscence in an asymptomatic population using 64-channel helical CT.

MATERIALS AND METHODS:

We retrospectively enrolled 500 consecutive adult patients without symptoms of superior semicircular canal dehiscence who had undergone CT of the temporal bones in the emergency department of a tertiary academic center between February 2012 and June 2017. The superior semicircular canals were evaluated bilaterally by 2 dedicated head and neck radiologists and subjectively classified as either dehiscent or nondehiscent. A secondary group of 110 scans of patients with symptoms consistent with superior semicircular canal dehiscence was similarly interpreted, and the rate of radiologic superior semicircular canal dehiscence was calculated for each group.

RESULTS:

Ten of the 500 asymptomatic patients (2.0%; 95% CI, 1.1%–3.6%) had CT evidence of superior semicircular canal dehiscence, compared with 15 of 110 symptomatic patients (13.6%; 95% CI, 7.8%–21.5%). There was excellent interobserver agreement ( = 0.91).

CONCLUSIONS:

Only 2% of asymptomatic patients had radiologic evidence of superior semicircular canal dehiscence on 64–detector row helical CT. This is markedly lower than previous reports and approaches the postmortem rate of asymptomatic superior semicircular canal dehiscence. We therefore recommend that asymptomatic patients with CT evidence of superior semicircular canal dehiscence undergo audiologic evaluation because the rate of false-positive scans is extremely low.

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Accurate Patient-Specific Machine Learning Models of Glioblastoma Invasion Using Transfer Learning [FUNCTIONAL]

BACKGROUND AND PURPOSE:

MR imaging–based modeling of tumor cell density can substantially improve targeted treatment of glioblastoma. Unfortunately, interpatient variability limits the predictive ability of many modeling approaches. We present a transfer learning method that generates individualized patient models, grounded in the wealth of population data, while also detecting and adjusting for interpatient variabilities based on each patient's own histologic data.

MATERIALS AND METHODS:

We recruited patients with primary glioblastoma undergoing image-guided biopsies and preoperative imaging, including contrast-enhanced MR imaging, dynamic susceptibility contrast MR imaging, and diffusion tensor imaging. We calculated relative cerebral blood volume from DSC-MR imaging and mean diffusivity and fractional anisotropy from DTI. Following image coregistration, we assessed tumor cell density for each biopsy and identified corresponding localized MR imaging measurements. We then explored a range of univariate and multivariate predictive models of tumor cell density based on MR imaging measurements in a generalized one-model-fits-all approach. We then implemented both univariate and multivariate individualized transfer learning predictive models, which harness the available population-level data but allow individual variability in their predictions. Finally, we compared Pearson correlation coefficients and mean absolute error between the individualized transfer learning and generalized one-model-fits-all models.

RESULTS:

Tumor cell density significantly correlated with relative CBV (r = 0.33, P < .001), and T1-weighted postcontrast (r = 0.36, P < .001) on univariate analysis after correcting for multiple comparisons. With single-variable modeling (using relative CBV), transfer learning increased predictive performance (r = 0.53, mean absolute error = 15.19%) compared with one-model-fits-all (r = 0.27, mean absolute error = 17.79%). With multivariate modeling, transfer learning further improved performance (r = 0.88, mean absolute error = 5.66%) compared with one-model-fits-all (r = 0.39, mean absolute error = 16.55%).

CONCLUSIONS:

Transfer learning significantly improves predictive modeling performance for quantifying tumor cell density in glioblastoma.

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

Preoperative MR Imaging to Differentiate Chordoid Meningiomas from Other Meningioma Histologic Subtypes [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Chordoid meningiomas are uncommon WHO grade II primary intracranial neoplasms that possess unique chordoid histology and follow an aggressive clinical course. Our aim was to assess the utility of qualitative MR imaging features and quantitative apparent diffusion coefficient values as distinguishing preoperative MR imaging metrics to identify and differentiate chordoid histology from other meningioma histologic subtypes.

MATERIALS AND METHODS:

Twenty-one patients with meningiomas with chordoid histology, which included both chordoid meningiomas (>50% chordoid histology) and meningiomas with focal chordoid histology (<50% chordoid histology) with available preoperative MR imaging examinations, including diffusion-weighted imaging, were identified. Qualitative imaging features and quantitative ADC values were compared between meningiomas with chordoid histology and 42 nonchordoid meningiomas (29 WHO grade I, eleven WHO grade II, and 2 WHO grade III).

RESULTS:

The median ADC (10^–3mm²/s) of meningiomas with chordoid histology was significantly higher than nonchordoid meningiomas (1.16 versus 0.92, P < .001), as was the median normalized ADC (1.60 versus 1.19, P < .001). In subgroup analysis, the median and normalized ADC values of chordoid meningiomas (n = 11) were significantly higher than those in meningiomas with focal chordoid histology (n = 10, P < .001 and P < .001, respectively) or nonchordoid meningiomas (n = 42, P < .001 and <0.001, respectively). Median and normalized ADC values were not significantly different between the meningiomas with focal chordoid histology and nonchordoid meningiomas (P = .816 and .301, respectively). Among the qualitative imaging features, only DWI signal intensity was significantly associated with meningiomas with chordoid histology diagnosis.

CONCLUSIONS:

ADC values are higher in chordoid compared with nonchordoid meningiomas and may be used to discriminate the degree of chordoid histology in meningiomas. While qualitative MR imaging features do not strongly discriminate chordoid from nonchordoid meningiomas, DWI may allow preoperative identification of chordoid meningiomas.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H6veTj

Decubitus CT Myelography for Detecting Subtle CSF Leaks in Spontaneous Intracranial Hypotension [SPINE]

SUMMARY:

Spontaneous intracranial hypotension is caused by spinal CSF leaks, but the site of the leak is not always detected on spinal imaging. We report on the additional value of decubitus positioning during CT myelography in enhancing the detection of subtle leaks.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJe8Di

Aneurysm Characteristics, Study Population, and Endovascular Techniques for the Treatment of Intracranial Aneurysms in a Large, Prospective, Multicenter Cohort: Results of the Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm Study [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm (ARETA) prospective study aims to determine factors predicting recurrence after endovascular treatment for intracranial aneurysms. In this publication, we review endovascular techniques and present the study population. Characteristics of treated and untreated unruptured aneurysms were analyzed.

MATERIALS AND METHODS:

Sixteen neurointerventional departments prospectively enrolled patients treated for ruptured and unruptured intracranial aneurysms between December 2013 and May 2015. Patient demographics, aneurysm characteristics, and endovascular techniques were recorded.

RESULTS:

A total of 1289 patients with 1761 intracranial aneurysms, 835 (47.4%) ruptured, were enrolled. Of these, 1359 intracranial aneurysms were treated by endovascular means. Ruptured intracranial aneurysms were treated by coiling and balloon-assisted coiling in 97.8% of cases. In unruptured intracranial aneurysms, the rates of flow diversion, flow disruption, and stent-assisted coiling were 11.6%, 6.9%, and 7.8%, respectively. Rupture status and aneurysm location, neck diameter, and sac size significantly influenced the chosen technique. Treated unruptured intracranial aneurysms, compared with untreated counterparts, had larger aneurysm sacs (7.6 ± 4.0 versus 3.4 ± 2.0 mm; P < 0.001) and neck dimensions (4.1 ± 2.2 versus 2.4 ± 1.3 mm; P < 0.001) and more frequently an irregular form (84.6% versus 44.4%; P < 0.001). Also, its location influenced whether an unruptured intracranial aneurysm was treated.

CONCLUSIONS:

Our study provides an overview of current neurointerventional practice in the ARETA cohort. The technique choice was influenced by aneurysm morphology, location, and rupture status. Flow diversion, flow disruption, and stent-assisted coiling were commonly used in unruptured intracranial aneurysms, while most ruptured intracranial aneurysms were treated with coiling and balloon-assisted coiling.

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A Serial 10-Year Follow-Up Study of Atrophied Brain Lesion Volume and Disability Progression in Patients with Relapsing-Remitting MS [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Disappearance of T2 lesions into CSF spaces is frequently observed in patients with MS. Our aim was to investigate temporal changes of cumulative atrophied brain T2 lesion volume and 10-year confirmed disability progression.

MATERIALS AND METHODS:

We studied 176 patients with relapsing-remitting MS who underwent MR imaging at baseline, 6 months, and then yearly for 10 years. Occurrence of new/enlarging T2 lesions, changes in T2 lesion volume, and whole-brain, cortical and ventricle volumes were assessed yearly between baseline and 10 years. Atrophied T2 lesion volume was calculated by combining baseline lesion masks with follow-up CSF partial volume maps. Ten-year confirmed disability progression was confirmed after 48 weeks. ANCOVA detected MR imaging outcome differences in stable (n = 76) and confirmed disability progression (n = 100) groups at different time points; hierarchic regression determined the unique additive variance explained by atrophied T2 lesion volume regarding the association with confirmed disability progression, in addition to other MR imaging metrics. Cox regression investigated the association of early MR imaging outcome changes and time to development of confirmed disability progression.

RESULTS:

The separation of stable-versus-confirmed disability progression groups became significant even in the first 6 months for atrophied T2 lesion volume (140% difference, Cohen d = 0.54, P = .004) and remained significant across all time points (P ≤ .007). The hierarchic model, including all other MR imaging outcomes during 10 years predicting confirmed disability progression, improved significantly after adding atrophied T2 lesion volume (R² = 0.27, R² change 0.11, P = .009). In Cox regression, atrophied T2 lesion volume in 0–6 months (hazard ratio = 4.23, P = .04) and 0–12 months (hazard ratio = 2.41, P = .022) was the only significant MR imaging predictor of time to confirmed disability progression.

CONCLUSIONS:

Atrophied T2 lesion volume is a robust and early marker of disability progression in relapsing-remitting MS.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H6v5zf

Evaluation of the Implementation of the Response Assessment in Neuro-Oncology Criteria in the HERBY Trial of Pediatric Patients with Newly Diagnosed High-Grade Gliomas [PEDIATRICS]

BACKGROUND AND PURPOSE:

HERBY was a Phase II multicenter trial setup to establish the efficacy and safety of adding bevacizumab to radiation therapy and temozolomide in pediatric patients with newly diagnosed non–brain stem high-grade gliomas. This study evaluates the implementation of the radiologic aspects of HERBY.

MATERIALS AND METHODS:

We analyzed multimodal imaging compliance rates and scan quality for participating sites, adjudication rates and reading times for the central review process, the influence of different Response Assessment in Neuro-Oncology criteria in the final response, the incidence of pseudoprogression, and the benefit of incorporating multimodal imaging into the decision process.

RESULTS:

Multimodal imaging compliance rates were the following: diffusion, 82%; perfusion, 60%; and spectroscopy, 48%. Neuroradiologists' responses differed for 50% of scans, requiring adjudication, with a total average reading time per patient of approximately 3 hours. Pseudoprogression occurred in 10/116 (9%) cases, 8 in the radiation therapy/temozolomide arm and 2 in the bevacizumab arm (P < .01). Increased target enhancing lesion diameter was a reason for progression in 8/86 cases (9.3%) but never the only radiologic or clinical reason. Event-free survival was predicted earlier in 5/86 (5.8%) patients by multimodal imaging (diffusion, n = 4; perfusion, n = 1).

CONCLUSIONS:

The addition of multimodal imaging to the response criteria modified the assessment in a small number of cases, determining progression earlier than structural imaging alone. Increased target lesion diameter, accounting for a large proportion of reading time, was never the only reason to designate disease progression.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tL8XCO

Prevalence of Superior Semicircular Canal Dehiscence on High-Resolution CT Imaging in Patients without Vestibular or Auditory Abnormalities [HEAD & NECK]

BACKGROUND AND PURPOSE:

Prior studies of radiologic superior semicircular canal dehiscence have suggested that CT may overcall dehiscence. However, many of those studies were performed before the advent of multichannel helical CT. Furthermore, there are limited data investigating the prevalence of radiologic superior semicircular canal dehiscence in asymptomatic individuals. The purpose of this study was to determine the rate of radiologic superior semicircular canal dehiscence in an asymptomatic population using 64-channel helical CT.

MATERIALS AND METHODS:

We retrospectively enrolled 500 consecutive adult patients without symptoms of superior semicircular canal dehiscence who had undergone CT of the temporal bones in the emergency department of a tertiary academic center between February 2012 and June 2017. The superior semicircular canals were evaluated bilaterally by 2 dedicated head and neck radiologists and subjectively classified as either dehiscent or nondehiscent. A secondary group of 110 scans of patients with symptoms consistent with superior semicircular canal dehiscence was similarly interpreted, and the rate of radiologic superior semicircular canal dehiscence was calculated for each group.

RESULTS:

Ten of the 500 asymptomatic patients (2.0%; 95% CI, 1.1%–3.6%) had CT evidence of superior semicircular canal dehiscence, compared with 15 of 110 symptomatic patients (13.6%; 95% CI, 7.8%–21.5%). There was excellent interobserver agreement ( = 0.91).

CONCLUSIONS:

Only 2% of asymptomatic patients had radiologic evidence of superior semicircular canal dehiscence on 64–detector row helical CT. This is markedly lower than previous reports and approaches the postmortem rate of asymptomatic superior semicircular canal dehiscence. We therefore recommend that asymptomatic patients with CT evidence of superior semicircular canal dehiscence undergo audiologic evaluation because the rate of false-positive scans is extremely low.

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AAAAI: Small Amounts of Dietary Peanuts Beneficial After Immunotherapy

THURSDAY, Feb. 28, 2019 -- Most individuals who complete peanut immunotherapy trials continue peanut consumption with few reports of reactions, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma&... (Source: Drugs.com - Pharma News)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tHkMd3

Exosomes that fatten immune cells

(Source: ScienceNOW)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2HafVJ9

Stressed gut epithelium gets some relief

(Source: ScienceNOW)

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.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tIeBW4

Epithelial endoplasmic reticulum stress orchestrates a protective IgA response

We report that IEC endoplasmic reticulum (ER) stress induces a polyreactive IgA response, which is protective against enteric inflammation. IEC ER stress causes TI and microbiota-independent expansion and activation of peritoneal B1b cells, which culminates in increased lamina propria and luminal IgA. Increased numbers of IgA-producing plasma cells were observed in healthy humans with defective autophagy, who are known to exhibit IEC ER stress. Upon ER stress, IECs communicate signals to the peritoneum that induce a barrier-protective TI IgA response. (Source: ScienceNOW)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H8UNmU

A lipase-independent pathway of lipid release and immune modulation by adipocytes

To meet systemic metabolic needs, adipocytes release fatty acids and glycerol through the action of neutral lipases. Here, we describe a secondary pathway of lipid release from adipocytes that is independent of canonical lipolysis. We found that adipocytes release exosome-sized, lipid-filled vesicles (AdExos) that become a source of lipid for local macrophages. Adipose tissue from lean mice released ~1% of its lipid content per day via exosomes ex vivo, a rate that more than doubles in obese animals. AdExos and associated factors were sufficient to induce in vitro differentiation of bone marrow precursors into adipose tissue macrophage–like cells. Thus, AdExos are both an alternative pathway of local lipid release and a mechanism by which parenchymal cells can modulate tissue macroph...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJ4YGM

Single Suture Synostosis and Isolated Cleft Palate in Non-Apert Syndrome Patients

Conclusion: Examination of 6 patients with SSC and ICP suggests the presence of both conditions does not adversely impact management or outcome for each condition, or increase perioperative risk. (Source: Journal of Craniofacial Surgery)

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AAAAI: Small Amounts of Dietary Peanuts Beneficial After Immunotherapy

THURSDAY, Feb. 28, 2019 -- Most individuals who complete peanut immunotherapy trials continue peanut consumption with few reports of reactions, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma&... (Source: Drugs.com - Pharma News)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tHkMd3

Exosomes that fatten immune cells

(Source: ScienceNOW)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2HafVJ9

Epithelial endoplasmic reticulum stress orchestrates a protective IgA response

We report that IEC endoplasmic reticulum (ER) stress induces a polyreactive IgA response, which is protective against enteric inflammation. IEC ER stress causes TI and microbiota-independent expansion and activation of peritoneal B1b cells, which culminates in increased lamina propria and luminal IgA. Increased numbers of IgA-producing plasma cells were observed in healthy humans with defective autophagy, who are known to exhibit IEC ER stress. Upon ER stress, IECs communicate signals to the peritoneum that induce a barrier-protective TI IgA response. (Source: ScienceNOW)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H8UNmU

A lipase-independent pathway of lipid release and immune modulation by adipocytes

To meet systemic metabolic needs, adipocytes release fatty acids and glycerol through the action of neutral lipases. Here, we describe a secondary pathway of lipid release from adipocytes that is independent of canonical lipolysis. We found that adipocytes release exosome-sized, lipid-filled vesicles (AdExos) that become a source of lipid for local macrophages. Adipose tissue from lean mice released ~1% of its lipid content per day via exosomes ex vivo, a rate that more than doubles in obese animals. AdExos and associated factors were sufficient to induce in vitro differentiation of bone marrow precursors into adipose tissue macrophage–like cells. Thus, AdExos are both an alternative pathway of local lipid release and a mechanism by which parenchymal cells can modulate tissue macroph...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJ4YGM

Single Suture Synostosis and Isolated Cleft Palate in Non-Apert Syndrome Patients

Conclusion: Examination of 6 patients with SSC and ICP suggests the presence of both conditions does not adversely impact management or outcome for each condition, or increase perioperative risk. (Source: Journal of Craniofacial Surgery)

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AAAAI: Small Amounts of Dietary Peanuts Beneficial After Immunotherapy

THURSDAY, Feb. 28, 2019 -- Most individuals who complete peanut immunotherapy trials continue peanut consumption with few reports of reactions, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma&... (Source: Drugs.com - Pharma News)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tHkMd3

Stressed gut epithelium gets some relief

(Source: ScienceNOW)

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.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tIeBW4

Epithelial endoplasmic reticulum stress orchestrates a protective IgA response

We report that IEC endoplasmic reticulum (ER) stress induces a polyreactive IgA response, which is protective against enteric inflammation. IEC ER stress causes TI and microbiota-independent expansion and activation of peritoneal B1b cells, which culminates in increased lamina propria and luminal IgA. Increased numbers of IgA-producing plasma cells were observed in healthy humans with defective autophagy, who are known to exhibit IEC ER stress. Upon ER stress, IECs communicate signals to the peritoneum that induce a barrier-protective TI IgA response. (Source: ScienceNOW)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H8UNmU

A lipase-independent pathway of lipid release and immune modulation by adipocytes

To meet systemic metabolic needs, adipocytes release fatty acids and glycerol through the action of neutral lipases. Here, we describe a secondary pathway of lipid release from adipocytes that is independent of canonical lipolysis. We found that adipocytes release exosome-sized, lipid-filled vesicles (AdExos) that become a source of lipid for local macrophages. Adipose tissue from lean mice released ~1% of its lipid content per day via exosomes ex vivo, a rate that more than doubles in obese animals. AdExos and associated factors were sufficient to induce in vitro differentiation of bone marrow precursors into adipose tissue macrophage–like cells. Thus, AdExos are both an alternative pathway of local lipid release and a mechanism by which parenchymal cells can modulate tissue macroph...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJ4YGM

AAAAI: Small Amounts of Dietary Peanuts Beneficial After Immunotherapy

THURSDAY, Feb. 28, 2019 -- Most individuals who complete peanut immunotherapy trials continue peanut consumption with few reports of reactions, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma&... (Source: Drugs.com - Pharma News)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tHkMd3

Stressed gut epithelium gets some relief

(Source: ScienceNOW)

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.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tIeBW4

A lipase-independent pathway of lipid release and immune modulation by adipocytes

To meet systemic metabolic needs, adipocytes release fatty acids and glycerol through the action of neutral lipases. Here, we describe a secondary pathway of lipid release from adipocytes that is independent of canonical lipolysis. We found that adipocytes release exosome-sized, lipid-filled vesicles (AdExos) that become a source of lipid for local macrophages. Adipose tissue from lean mice released ~1% of its lipid content per day via exosomes ex vivo, a rate that more than doubles in obese animals. AdExos and associated factors were sufficient to induce in vitro differentiation of bone marrow precursors into adipose tissue macrophage–like cells. Thus, AdExos are both an alternative pathway of local lipid release and a mechanism by which parenchymal cells can modulate tissue macroph...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tJ4YGM

Severe asthma in children: therapeutic considerations

Purpose of review Children with poor asthma control despite maximal maintenance therapy have problematic severe asthma (PSA). A step-wise approach including objective adherence monitoring and a detailed multidisciplinary team assessment to identify modifiable factors contributing to poor control is needed prior to considering therapy escalation. Pathophysiological phenotyping in those with true severe therapy-resistant asthma (STRA) and the current array of add-on therapies will be discussed. Recent findings Adherence monitoring using electronic devices has shown that only 20–30% of children with PSA have STRA and need additional therapies. Omalizumab and mepolizumab are licensed for children with STRA aged 6 years and older. Although robust safety and efficacy data, with reduced ex...

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Diagnosis of occupational hypersensitivity pneumonitis

Purpose of review To discuss the diagnostic methods currently used in the study of patients with hypersensitivity pneumonitis, with special emphasis on the most recent contributions published in the medical literature regarding the diagnosis of occupational hypersensitivity pneumonitis (OHP). This review presents an update of the use of these diagnostic tests, a controversial issue among experts. Recent findings In spite of the multiple attempts at systematization and the publication of expert consensus statements, standardizing and diagnostic methods and criteria remain particularly difficult. As a result, centers tend to rely on their own experience and establish diagnosis by consensus among their multidisciplinary teams. Though recommendable in many ways, this method presents signi...

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Symptom-based patient-reported outcomes in adults with eosinophilic esophagitis: value for treatment monitoring and randomized controlled trial design

Purpose of review In adults with eosinophilic esophagitis (EoE), a chronic, inflammatory immune-mediated condition of the esophagus, both inflammation and fibrosis are likely associated with symptom generation. Therefore, assessing symptom-based patient-reported outcomes (PROs), defined by US Food and Drug Administration as 'any report of the status of a patient's health condition that comes directly from the patients, without interpretation of the patient's response by a clinician or anyone else', is important in the context of trials and observational studies of emerging therapies. Recent findings For purposes of treatment monitoring, lack of symptoms does not predict the absence of biologic inflammation; hence, endoscopy with esophageal biopsies should be performed to check for...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NAXr5P

The impact of exercise on asthma

Purpose of review Asthma is one of the most common chronic diseases in children and adults in developed countries around the world. Despite international treatment guidelines, poor asthma control remains a frequent problem leading to missed school and work, and emergency room visits and hospitalizations. Many patients with asthma report exercise as a trigger for their asthma, which likely leads to exercise avoidance as a means to control symptoms. Evolving research has suggested that routine exercise may actually help improve some aspects of asthma control. This review discusses the recent research addressing how routine exercise affects important asthma-related outcomes including symptoms, lung function and quality of life. Recent findings Several systematic reviews and meta-analyses...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GORd1X

Preventing the development of asthma: stopping the allergic march

Purpose of review To describe important precipitants of asthma and allergic disease, to highlight the links between these triggers and modifications within the immune system, and to examine innovative research regarding asthma prevention with focus on attenuating the atopic march. Recent findings Allergen avoidance, allergen immunotherapy, IgE antagonists, prevention and treatment of respiratory infections, as well as management of gastrointestinal and respiratory dysbiosis have been considered as strategies in asthma prevention. Antenatal vitamin D supplementation in expectant mothers and aggressive control of atopic dermatitis to prevent the development of other allergic conditions were carefully studied as well. Summary Asthma is a major cause of morbidity and lost productivity....

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NzXM93

Basophil activation testing in occupational respiratory allergy to low molecular weight compounds

Purpose of review There is an unmet need for better immunological tests in cases of suspected occupational asthma to many workplace chemicals; here we consider the basophil activation test (BAT), a potential alternative to the detection of specific IgE antibodies. Recent findings BAT is fairly widely used in general allergy services; and there is increasing experience of its use in the diagnosis of occupational allergy to low molecular weight agents and chemicals including wood dusts, persulphates, antibiotics and latex. Summary There is potential for BAT to become a useful tool in the clinical consideration of occupational asthma and of its mechanisms, and even to take a place in a Bayesian-based diagnostic algorithm. Further development will only occur if specialist centres with ...

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

Management of acute loss of asthma control: yellow zone strategies

This article reviews the evidence behind various recommended yellow zone intervention strategies. Recent findings There are many potential methods of delivering yellow zone therapy, and recent studies have assessed preventive efficacy of a scheduled increase in controller medication(s), reliever medication(s), or a symptom-driven combination of both. The literature suggests that, in certain asthma subpopulations, some methods may be more efficacious than others. Summary Multiple yellow zone approaches may be beneficial, and the yellow zone is not a 'one size fits all' narrative. (Source: Current Opinion in Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NA3A2h

Vitamin D and childhood asthma: causation and contribution to disease activity

Purpose of review To review the literature of the past 18 months (April 2017 through September, 2018) relating to vitamin D and childhood asthma. Recent findings A combined analysis of two clinical trials of maternal vitamin D supplementation trials showed a significant protective effect of vitamin D supplementation trials in the primary prevention of asthma and recurrent wheeze up to age 3 years. Secondary analyses from these trials have also suggested that initial maternal vitamin D status could affect the response to supplementation during pregnancy, with the biggest protective effect in children born to mothers with initial 25hydroxyvitamin D (25OHD) levels of at least 30 ng/ml. A postnatal, 6-month vitamin D supplementation trial in black, premature babies showed a 34% decrease...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GRQn4e

Single inhaler maintenance and reliever therapy in pediatric asthma

Purpose of review Asthma affects more than 25 million people worldwide and continues to grow in prevalence. According to a center for disease control and prevention (CDC) report, the total annual cost of asthma in the United States between 2008 and 2013, including medical care, absenteeism, and mortality, was $81.9 billion. Although the National Institute of Health guidelines recommend fixed inhaled corticosteroid (ICS) dosing, the 2008–2010 Medical Expenditure Panel Survey showed that asthma is still poorly controlled. Single inhaler maintenance and reliever therapy (SMART) offers a possible alternative management plan. This is a review of SMART vs. current treatment guidelines. Recent findings SMART addresses variable inflammation with symptom-driven dosing of ICS. It relies on a ...

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

Precision medicine in childhood asthma

Purpose of review Childhood asthma is a heterogeneous disease and many children have uncontrolled disease. Therefore an individualized approach is needed to improve asthma outcomes in children. Precision medicine using clinical characteristics, biomarkers, and the rapidly involving field of genomics and pharmacogenomics aims to achieve asthma control and reduce future risks with less side-effects in individual children with asthma. Recent findings It is not yet possible to select treatment options on clinical characteristics. Novel monoclonal antibodies are efficacious in patients with severe, eosinophilic asthma. Reduced lung function growth and early decline is a prevalent finding in children with persistent asthma. Pharmacogenetic studies have identified children at risk for cortis...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NyMFx0

Use of population data for assessing trends in work-related asthma mortality

Purpose of review Work-related asthma has been associated with poorer asthma control and frequent unscheduled healthcare visits, and can be fatal. Case reports of work-related asthma deaths are rare, but can initiate efforts to prevent additional cases. We reviewed relevant literature and data sources to evaluate whether analyzing mortality data at the population level can help identify potential sources of exposures that contribute to work-related asthma. Recent findings A limited number of population-based studies have addressed work-related asthma mortality. Data on asthma mortality are derived from death certificates using the International Classification of Diseases (ICD) as a standard for coding cause. However, no discrete code for work-related asthma is available. Analysis of a...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GSh8pq

Phenotypes of wheezing and asthma in preschool children

Purpose of review The purpose of this review is to provide an overview of the identified phenotypes of preschool wheezing. Recent findings Early life wheezing patterns have been described in multiple populations, with several commonalities found between cohorts. Early life environmental exposures have been found to be differentially associated with preschool wheezing phenotypes and their future trajectories. These include allergen and microbe exposure, environmental tobacco smoke exposure, and maternal stress and depression. Elevated IgE in early life may also influence future asthma risk. Summary Preschool wheezing phenotypes are heterogeneous and complex, with trajectories that are related to factors including environmental exposures. More research is needed to characterize these...

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Contributions of innate lymphocytes to allergic responses

Purpose of review Allergic diseases represent a growing global health concern, especially among pediatric populations. Current strategies for the treatment of allergies and asthma focus on limiting the severity of the symptoms; however, additional research investigating the mechanisms promoting inflammation in the context of allergic reactions may lead to the development of more effective therapeutic strategies. Recent findings Novel studies have highlighted the contributions of innate lymphocytes to the induction of inflammatory responses to allergens. Remarkably, neuron-derived signals, hormones, and even vitamins have been suggested to modulate the activity of innate lymphocytes, opening new windows of opportunity for the treatment of allergic inflammation. Summary These studies...

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

Symptom-based patient-reported outcomes in adults with eosinophilic esophagitis: value for treatment monitoring and randomized controlled trial design

Purpose of review In adults with eosinophilic esophagitis (EoE), a chronic, inflammatory immune-mediated condition of the esophagus, both inflammation and fibrosis are likely associated with symptom generation. Therefore, assessing symptom-based patient-reported outcomes (PROs), defined by US Food and Drug Administration as 'any report of the status of a patient's health condition that comes directly from the patients, without interpretation of the patient's response by a clinician or anyone else', is important in the context of trials and observational studies of emerging therapies. Recent findings For purposes of treatment monitoring, lack of symptoms does not predict the absence of biologic inflammation; hence, endoscopy with esophageal biopsies should be performed to check for...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NAXr5P

The impact of exercise on asthma

Purpose of review Asthma is one of the most common chronic diseases in children and adults in developed countries around the world. Despite international treatment guidelines, poor asthma control remains a frequent problem leading to missed school and work, and emergency room visits and hospitalizations. Many patients with asthma report exercise as a trigger for their asthma, which likely leads to exercise avoidance as a means to control symptoms. Evolving research has suggested that routine exercise may actually help improve some aspects of asthma control. This review discusses the recent research addressing how routine exercise affects important asthma-related outcomes including symptoms, lung function and quality of life. Recent findings Several systematic reviews and meta-analyses...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GORd1X

Preventing the development of asthma: stopping the allergic march

Purpose of review To describe important precipitants of asthma and allergic disease, to highlight the links between these triggers and modifications within the immune system, and to examine innovative research regarding asthma prevention with focus on attenuating the atopic march. Recent findings Allergen avoidance, allergen immunotherapy, IgE antagonists, prevention and treatment of respiratory infections, as well as management of gastrointestinal and respiratory dysbiosis have been considered as strategies in asthma prevention. Antenatal vitamin D supplementation in expectant mothers and aggressive control of atopic dermatitis to prevent the development of other allergic conditions were carefully studied as well. Summary Asthma is a major cause of morbidity and lost productivity....

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NzXM93

Basophil activation testing in occupational respiratory allergy to low molecular weight compounds

Purpose of review There is an unmet need for better immunological tests in cases of suspected occupational asthma to many workplace chemicals; here we consider the basophil activation test (BAT), a potential alternative to the detection of specific IgE antibodies. Recent findings BAT is fairly widely used in general allergy services; and there is increasing experience of its use in the diagnosis of occupational allergy to low molecular weight agents and chemicals including wood dusts, persulphates, antibiotics and latex. Summary There is potential for BAT to become a useful tool in the clinical consideration of occupational asthma and of its mechanisms, and even to take a place in a Bayesian-based diagnostic algorithm. Further development will only occur if specialist centres with ...

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

Management of acute loss of asthma control: yellow zone strategies

This article reviews the evidence behind various recommended yellow zone intervention strategies. Recent findings There are many potential methods of delivering yellow zone therapy, and recent studies have assessed preventive efficacy of a scheduled increase in controller medication(s), reliever medication(s), or a symptom-driven combination of both. The literature suggests that, in certain asthma subpopulations, some methods may be more efficacious than others. Summary Multiple yellow zone approaches may be beneficial, and the yellow zone is not a 'one size fits all' narrative. (Source: Current Opinion in Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NA3A2h

Vitamin D and childhood asthma: causation and contribution to disease activity

Purpose of review To review the literature of the past 18 months (April 2017 through September, 2018) relating to vitamin D and childhood asthma. Recent findings A combined analysis of two clinical trials of maternal vitamin D supplementation trials showed a significant protective effect of vitamin D supplementation trials in the primary prevention of asthma and recurrent wheeze up to age 3 years. Secondary analyses from these trials have also suggested that initial maternal vitamin D status could affect the response to supplementation during pregnancy, with the biggest protective effect in children born to mothers with initial 25hydroxyvitamin D (25OHD) levels of at least 30 ng/ml. A postnatal, 6-month vitamin D supplementation trial in black, premature babies showed a 34% decrease...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GRQn4e

Precision medicine in childhood asthma

Purpose of review Childhood asthma is a heterogeneous disease and many children have uncontrolled disease. Therefore an individualized approach is needed to improve asthma outcomes in children. Precision medicine using clinical characteristics, biomarkers, and the rapidly involving field of genomics and pharmacogenomics aims to achieve asthma control and reduce future risks with less side-effects in individual children with asthma. Recent findings It is not yet possible to select treatment options on clinical characteristics. Novel monoclonal antibodies are efficacious in patients with severe, eosinophilic asthma. Reduced lung function growth and early decline is a prevalent finding in children with persistent asthma. Pharmacogenetic studies have identified children at risk for cortis...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NyMFx0

Use of population data for assessing trends in work-related asthma mortality

Purpose of review Work-related asthma has been associated with poorer asthma control and frequent unscheduled healthcare visits, and can be fatal. Case reports of work-related asthma deaths are rare, but can initiate efforts to prevent additional cases. We reviewed relevant literature and data sources to evaluate whether analyzing mortality data at the population level can help identify potential sources of exposures that contribute to work-related asthma. Recent findings A limited number of population-based studies have addressed work-related asthma mortality. Data on asthma mortality are derived from death certificates using the International Classification of Diseases (ICD) as a standard for coding cause. However, no discrete code for work-related asthma is available. Analysis of a...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2GSh8pq

Impact of occupational exposure on human microbiota

Purpose of review Recent evidence suggests that environmental exposures change the adult human microbiome. Here, we review recent evidence on the impact of the work microbiome and work-related chemical, metal and particulate exposures on the human microbiome. Recent findings Prior literature on occupational microbial exposures has focused mainly on the respiratory effects of endotoxin, but a recent study suggests that not all endotoxin is the same; endotoxin from some species is proinflammatory, whereas endotoxin from other species is anti-inflammatory. Work with animals can change the adult human microbiome, likely through colonization. Early studies in military personnel and animal models of gulf war illness show that military exposures change the gut microbiome and increase gut per...

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Editorial introductions

No abstract available (Source: Current Opinion in Allergy and Clinical Immunology)

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Neutrophil activation in occupational asthma

Purpose of review The aim of this review is to emphasize the role of neutrophils in patients with occupational asthma. This review facilitates a better understanding, accurate diagnosis, and proper management of asthmatic reactions provoked at the workplace. Recent findings Increased recruitment and infiltration of neutrophils are found in patients with occupational asthma. Activated neutrophils release several mediators including pro-inflammatory cytokines and extracellular traps, leading to stimulation of airway epithelium and other inflammatory cells. Summary New insights into neutrophils in the pathogenesis of occupational asthma may provide a novel approach to the individual patient with occupational asthma. (Source: Current Opinion in Allergy and Clinical Immunology)

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

How guideline can shape clinical practice globally: the diagnosis and rationale for action against cow's milk allergy experience

We report here the main international allergy guidelines with a more focused look on the Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines and their effect on clinical practice. Recent findings DRACMA guidelines have clearly modified the approach to cow's milk allergy (CMA) from its diagnosis to treatment tailoring the choices for each patient. Although they strongly recommend oral food challenge for diagnosing CMA, they also indicate that it may not be necessary in many cases with the introduction of the pretest probability of CMA. Studies on the implementation of DRACMA guidelines show how they influenced the formula market, making appropriate treatments more affordable. Summary DRACMA reconciled international differences in the diagnosis and managem...

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

Neutrophil activation in occupational asthma

Purpose of review The aim of this review is to emphasize the role of neutrophils in patients with occupational asthma. This review facilitates a better understanding, accurate diagnosis, and proper management of asthmatic reactions provoked at the workplace. Recent findings Increased recruitment and infiltration of neutrophils are found in patients with occupational asthma. Activated neutrophils release several mediators including pro-inflammatory cytokines and extracellular traps, leading to stimulation of airway epithelium and other inflammatory cells. Summary New insights into neutrophils in the pathogenesis of occupational asthma may provide a novel approach to the individual patient with occupational asthma. (Source: Current Opinion in Allergy and Clinical Immunology)

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

How guideline can shape clinical practice globally: the diagnosis and rationale for action against cow's milk allergy experience

We report here the main international allergy guidelines with a more focused look on the Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines and their effect on clinical practice. Recent findings DRACMA guidelines have clearly modified the approach to cow's milk allergy (CMA) from its diagnosis to treatment tailoring the choices for each patient. Although they strongly recommend oral food challenge for diagnosing CMA, they also indicate that it may not be necessary in many cases with the introduction of the pretest probability of CMA. Studies on the implementation of DRACMA guidelines show how they influenced the formula market, making appropriate treatments more affordable. Summary DRACMA reconciled international differences in the diagnosis and managem...

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

Repair of Cerebrospinal Fluid Leak in Cochlear Implantation

Conclusion: Cerebrospinal fluid leakage may occur in cochlear implantation patients with inner ear anomalies postoperatively. Sealing of the cochleostomy with fat tissue is more useful than muscle intraoperatively. (Source: Journal of Craniofacial Surgery)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BZP5A8

Einstein Adds Curriculum on Adults with Intellectual and Developmental Disabilities

BRONX, NY—(February 28, 2019)—Children with intellectual and developmental disabilities (IDD) have long benefited from the training pediatricians receive to treat autism, epilepsy, cerebral palsy, or other disorders. Their doctors often connect these young patients with many professionals—from physical, occupational, and speech therapists to psychologists, social workers, and special-care dentists. But as children grow up, they soon discover there are far fewer physicians aware of their unique needs. (Source: Einstein News)

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Repair of Cerebrospinal Fluid Leak in Cochlear Implantation

Conclusion: Cerebrospinal fluid leakage may occur in cochlear implantation patients with inner ear anomalies postoperatively. Sealing of the cochleostomy with fat tissue is more useful than muscle intraoperatively. (Source: Journal of Craniofacial Surgery)

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Einstein Adds Curriculum on Adults with Intellectual and Developmental Disabilities

BRONX, NY—(February 28, 2019)—Children with intellectual and developmental disabilities (IDD) have long benefited from the training pediatricians receive to treat autism, epilepsy, cerebral palsy, or other disorders. Their doctors often connect these young patients with many professionals—from physical, occupational, and speech therapists to psychologists, social workers, and special-care dentists. But as children grow up, they soon discover there are far fewer physicians aware of their unique needs. (Source: Einstein News)

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Exploring the “Preterm Behavioral Phenotype” in Children Born Extremely Preterm

ABSTRACT: Objective: To examine whether difficulties in emotional, attention, and peer or social functioning (a proposed "preterm behavioral phenotype") co-occur within individual children born extremely preterm (EP;

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Exploring the “Preterm Behavioral Phenotype” in Children Born Extremely Preterm

ABSTRACT: Objective: To examine whether difficulties in emotional, attention, and peer or social functioning (a proposed "preterm behavioral phenotype") co-occur within individual children born extremely preterm (EP;

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Mechanisms Underlying the Contribution of Sleep Disturbances to Pain (R21 Clinical Trial Optional)

Funding Opportunity PA-19-201 from the NIH Guide for Grants and Contracts. The purpose of this FOAs are to encourage mechanistic research to investigate the impact of sleep disturbances on chronic pain. The mechanisms and processes underlying the contribution of sleep disturbances to chronic pain development and maintenance may be very broad. This FOA encourages interdisciplinary collaborations by experts from multiple fieldsneuroscientists, psychologists,endocrinologists, immunologists, geneticists, pharmacologists, chemists, physicists, behavioral scientists, clinicians, caregivers, and others in relevant fields of inquiry. (Source: NIH Funding Opportunities (Notices, PA, RFA))

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Mechanisms Underlying the Contribution of Sleep Disturbances to Pain (R01 Clinical Trial Optional)

Funding Opportunity PA-19-200 from the NIH Guide for Grants and Contracts. The purpose of this FOA is to encourage mechanistic research to investigate the impact of sleep disturbances on pain. The mechanisms and processes underlying the contribution of sleep and sleep disturbances to pain perception and the development and maintenance of chronic pain may be very broad. This FOA encourages interdisciplinary research collaborations by experts from multiple fieldsneuroscientists, psychologists, endocrinologists, immunologists, geneticists, pharmacologists, chemists, physicists, behavioral scientists, clinicians, caregivers, and others in relevant fields of inquiry. (Source: NIH Funding Opportunities (Notices, PA, RFA))

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Microbial-based Cancer Therapy -Bugs as Drugs (R21 Clinical Trial Not Allowed)

Funding Opportunity PAR-19-194 from the NIH Guide for Grants and Contracts. The overall purpose of this funding opportunity announcement (FOA) is to stimulate the development of novel microbial-based cancer therapies, especially for conditions where conventional cancer therapies are inadequate, such as poorly vascularized, hypoxic, solid tumors, dormant or slowly dividing cells resistant to current interventions, and brain tumors. Utilizing bacteria, archaebacteria, bacteriophages and other non-virus microorganisms, this initiative will support research projects designed to study the underlying mechanisms of the complex interactions between microorganisms, tumor, and immune system. The FOA also aims to support research into the use of microorganisms as delivery vehicles for cancer treatme...

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Microbial-based Cancer Therapy -Bugs as Drugs (R01 Clinical Trial Not Allowed)

Funding Opportunity PAR-19-193 from the NIH Guide for Grants and Contracts. The overall purpose of this funding opportunity announcement (FOA) is to stimulate the development of novel microbial-based cancer therapies, especially for conditions where conventional cancer therapies are inadequate, such as poorly vascularized, hypoxic, solid tumors, dormant or slowly dividing cells resistant to current interventions, and brain tumors. Utilizing bacteria, archaebacteria, bacteriophages and other non-virus microorganisms, this initiative will support research projects designed to study the underlying mechanisms of the complex interactions between microorganisms, tumor, and immune system. The FOA also aims to support research into the use of microorganisms as delivery vehicles for cancer treatme...

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MicroRNA-1297 inhibits proliferation and promotes apoptosis in gastric cancer cells by downregulating CDC6 expression

Gastric cancer (GC), one of the most common malignant tumors and the second most common leading cause of cancer-related death worldwide, is a biologically heterogeneous disease accompanied by various genetic and epigenetic alterations. However, the molecular mechanisms underlying this disease are complex and not completely understood. Increasing studies have shown that aberrant microRNA (miRNA) expression is associated with GC tumorigenesis and growth. MiR-1297 has been confirmed to be a cancer suppressor in diverse tumors in humans. However, to date, the function and mechanism of miR-1297 in GC have not been determined. Here, we found that the expression of miR-1297 was significantly reduced in GC tissues or GC cell lines compared with paracarcinoma normal tissue or normal cell lines. Exogenic overexpression of miR-1297 in GC cell lines can inhibit cell proliferation and colony formation and induce apoptosis, and inhibition of miR-1297 in GC cell lines can promote cell proliferation and colony formation, and reduce apoptosis in vitro. We further confirmed that miR-1297 acted as a tumor suppressor through targeting cell division control protein 6 (CDC6) in GC. Moreover, the inverse relationship between miR-1297 and CDC6 was verified in GC cell lines. Our results indicated that miR-1297 is a potent tumor suppressor in GC, and its antiproliferative and gene-regulatory effects are, in part, mediated through its downstream target gene, CDC6. These findings implied that miR-1297 might be used as a novel therapeutic target of GC. Correspondence to Chen Huang, PhD, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76# Yanta West Road, Xi'an, Shaanxi Province 710049, China Tel/fax: +86 029 8265 7723; e-mail: hchen@mail.xjtu.edu.cn Received October 29, 2018 Accepted February 11, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Evaluation of the antileukemic effects of neurokinin-1 receptor antagonists, aprepitant, and L-733,060, in chronic and acute myeloid leukemic cells

Neurokinin-1 receptor (NK1R) antagonists are known for their anxiolytic, antiemetic, anticancer, and anti-inflammatory effects. Aprepitant is used in vomiting and nausea, which are the most common side-effects of patients undergoing chemotherapy for cancer. L-733,060 has been shown to have anxiolytic and antidepressant effects in animal studies and anticancer effect in in-vitro studies. Previous anticancer activity studies with NK1R antagonists have reported that NK-1 antagonists have an antitumoral activity on gastric carcinoma, larynx carcinoma, retinoblastoma, hepatocarcinoma, glioma, neuroblastoma, and osteoblastoma cells. In this study, we have aimed to show and compare the antileukemic effects of aprepitant and L-733,060 on acute and chronic myeloid leukemic cells by using in-vitro experiments, such as WST-1, cell imaging, annexin-V binding, soft agar colony formation, and Hoescht staining. As a result, we have determined that both aprepitant and L-733,060 had strong antiproliferative effects on K562 and HL-60 cells. Moreover, the two drugs caused significant apoptosis and decreased colony forming depending on concentration increase. These findings suggested that NK1R antagonists exhibited antileukemic activities and may be considered to have a novel therapeutic potential for acute and chronic myeloid leukemia. Correspondence to Miriş Dikmen, PhD, Department of Pharmacology, Faculty of Pharmacy, Anadolu Universty, Eskisehir, Centrum TR-26470, Turkey Tel: +90 222 335 0580 x3748; fax: +90 222 335 0750; e-mail: mirisd@anadolu.edu.tr Received October 7, 2018 Accepted January 29, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Andrographolide sensitizes Hep-2 human laryngeal cancer cells to carboplatin-induced apoptosis by increasing reactive oxygen species levels

Andrographolide is a natural diterpenoid from Andrographis paniculata that has been proposed as an anticancer agent as well as a chemosensitizer for use in combination with anticancer drugs. Carboplatin is the first-line chemotherapeutic agent for advanced laryngeal carcinoma. However, the clinical efficacy of carboplatin is limited by drug resistance and side effects. The aim of this study was to investigate whether andrographolide has a synergistic antitumor effect with carboplatin on human laryngeal cancer cells. Hep-2 cells were exposed to andrographolide with or without carboplatin. The effects of indicated therapies were examined using the Cell Counting Kit-8 assay, the colony-forming assay, the Hoechst 33342/PI double staining, and flow cytometry analysis. The molecular mechanism was assessed by reactive oxygen species (ROS) detection and western blot. At the sublethal concentration, andrographolide increased carboplatin sensitivity of Hep-2 cells by increasing carboplatin-induced apoptosis and inhibiting cell viability. Moreover, we found that andrographolide sensitized carboplatin mainly through the induction of ROS generation and apoptotic signaling. Taken together, these results indicate that andrographolide, along with carboplatin, synergistically inhibited cell proliferation and induced mitochondrial apoptosis of Hep-2 cells by increasing the intracellular ROS, regulating the mitogen-activated protein kinase and phosphatidylinositol 3-kinase (PI3K/AKT) pathways, altering the BCL2/BAX ratio, and ultimately activating the cleavage of Caspase-3 and PARP. These results suggest that andrographolide sensitizes human laryngeal cancer cells to carboplatin-induced apoptosis by increasing ROS levels. *Wenjing Mao and Peijie He contributed equally to the writing of this article. Correspondence to Chunsheng Wei, PhD, Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, No. 83, Fenyang Road, Shanghai 200031, China Tel/fax: +86 21 6437 7134; e-mail: weics2003@163.com Received October 2, 2018 Accepted February 7, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Talazoparib has no clinically relevant effect on QTc interval in patients with advanced solid tumors

The aims of this study were (i) to evaluate the effect of talazoparib (1 mg once daily) on cardiac repolarization in patients with advanced solid tumors by assessing corrected QT interval (QTc) and (ii) to examine the relationship between plasma talazoparib concentration and QTc. In this open-label phase 1 study, patients had continuous 12-lead ECG recordings at baseline followed by time-matched continuous ECG recordings and collection of talazoparib plasma pharmacokinetic samples predose and at 1, 2, 4, and 6 h postdose on treatment days 1 and 22 and before talazoparib administration on day 2. ECG recordings were submitted for independent central review where triplicate 10-s ECGs, extracted up to 15 min before pharmacokinetic samples, were assessed for RR, PR, QRS, and QT intervals and ECG morphology. QT interval was corrected for heart rate using Fridericia's (QTcF) and Bazett's (QTcB) formulae. Linear mixed-effects modeling was used to examine the relationship between QTc and RR interval change from baseline and plasma talazoparib concentration. Thirty-seven patients received talazoparib. Mean change in QTcF from time-matched baseline ranged from −3.5 to 6.9 ms, with the greatest change 1 h postdose on day 22. No clinically relevant changes in PR, QRS, QTcB, QTcF, or RR intervals, heart rate, or ECG morphology were observed. No concentration-dependent effect on heart rate or QTc was observed. No deaths, permanent treatment discontinuations due to adverse events were reported. Talazoparib (1 mg once daily) had no clinically relevant effects on cardiac repolarization. * Justin Hoffman and Jayeta Chakrabarti contributed equally to the writing of this article. Correspondence to Diane Wang, PhD, 10555 Science Center Drive, San Diego, CA 92130, USA Tel: +1 858 622 3000; fax: +1 858 678 8263; e-mail: diane.wang@pfizer.com Received December 13, 2018 Accepted February 2, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Microbial-based Cancer Therapy -Bugs as Drugs (R21 Clinical Trial Not Allowed)

Funding Opportunity PAR-19-194 from the NIH Guide for Grants and Contracts. The overall purpose of this funding opportunity announcement (FOA) is to stimulate the development of novel microbial-based cancer therapies, especially for conditions where conventional cancer therapies are inadequate, such as poorly vascularized, hypoxic, solid tumors, dormant or slowly dividing cells resistant to current interventions, and brain tumors. Utilizing bacteria, archaebacteria, bacteriophages and other non-virus microorganisms, this initiative will support research projects designed to study the underlying mechanisms of the complex interactions between microorganisms, tumor, and immune system. The FOA also aims to support research into the use of microorganisms as delivery vehicles for cancer treatme...

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Microbial-based Cancer Therapy -Bugs as Drugs (R01 Clinical Trial Not Allowed)

Funding Opportunity PAR-19-193 from the NIH Guide for Grants and Contracts. The overall purpose of this funding opportunity announcement (FOA) is to stimulate the development of novel microbial-based cancer therapies, especially for conditions where conventional cancer therapies are inadequate, such as poorly vascularized, hypoxic, solid tumors, dormant or slowly dividing cells resistant to current interventions, and brain tumors. Utilizing bacteria, archaebacteria, bacteriophages and other non-virus microorganisms, this initiative will support research projects designed to study the underlying mechanisms of the complex interactions between microorganisms, tumor, and immune system. The FOA also aims to support research into the use of microorganisms as delivery vehicles for cancer treatme...

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Evaluation of the antileukemic effects of neurokinin-1 receptor antagonists, aprepitant, and L-733,060, in chronic and acute myeloid leukemic cells

Neurokinin-1 receptor (NK1R) antagonists are known for their anxiolytic, antiemetic, anticancer, and anti-inflammatory effects. Aprepitant is used in vomiting and nausea, which are the most common side-effects of patients undergoing chemotherapy for cancer. L-733,060 has been shown to have anxiolytic and antidepressant effects in animal studies and anticancer effect in in-vitro studies. Previous anticancer activity studies with NK1R antagonists have reported that NK-1 antagonists have an antitumoral activity on gastric carcinoma, larynx carcinoma, retinoblastoma, hepatocarcinoma, glioma, neuroblastoma, and osteoblastoma cells. In this study, we have aimed to show and compare the antileukemic effects of aprepitant and L-733,060 on acute and chronic myeloid leukemic cells by using in-vitro experiments, such as WST-1, cell imaging, annexin-V binding, soft agar colony formation, and Hoescht staining. As a result, we have determined that both aprepitant and L-733,060 had strong antiproliferative effects on K562 and HL-60 cells. Moreover, the two drugs caused significant apoptosis and decreased colony forming depending on concentration increase. These findings suggested that NK1R antagonists exhibited antileukemic activities and may be considered to have a novel therapeutic potential for acute and chronic myeloid leukemia. Correspondence to Miriş Dikmen, PhD, Department of Pharmacology, Faculty of Pharmacy, Anadolu Universty, Eskisehir, Centrum TR-26470, Turkey Tel: +90 222 335 0580 x3748; fax: +90 222 335 0750; e-mail: mirisd@anadolu.edu.tr Received October 7, 2018 Accepted January 29, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Andrographolide sensitizes Hep-2 human laryngeal cancer cells to carboplatin-induced apoptosis by increasing reactive oxygen species levels

Andrographolide is a natural diterpenoid from Andrographis paniculata that has been proposed as an anticancer agent as well as a chemosensitizer for use in combination with anticancer drugs. Carboplatin is the first-line chemotherapeutic agent for advanced laryngeal carcinoma. However, the clinical efficacy of carboplatin is limited by drug resistance and side effects. The aim of this study was to investigate whether andrographolide has a synergistic antitumor effect with carboplatin on human laryngeal cancer cells. Hep-2 cells were exposed to andrographolide with or without carboplatin. The effects of indicated therapies were examined using the Cell Counting Kit-8 assay, the colony-forming assay, the Hoechst 33342/PI double staining, and flow cytometry analysis. The molecular mechanism was assessed by reactive oxygen species (ROS) detection and western blot. At the sublethal concentration, andrographolide increased carboplatin sensitivity of Hep-2 cells by increasing carboplatin-induced apoptosis and inhibiting cell viability. Moreover, we found that andrographolide sensitized carboplatin mainly through the induction of ROS generation and apoptotic signaling. Taken together, these results indicate that andrographolide, along with carboplatin, synergistically inhibited cell proliferation and induced mitochondrial apoptosis of Hep-2 cells by increasing the intracellular ROS, regulating the mitogen-activated protein kinase and phosphatidylinositol 3-kinase (PI3K/AKT) pathways, altering the BCL2/BAX ratio, and ultimately activating the cleavage of Caspase-3 and PARP. These results suggest that andrographolide sensitizes human laryngeal cancer cells to carboplatin-induced apoptosis by increasing ROS levels. *Wenjing Mao and Peijie He contributed equally to the writing of this article. Correspondence to Chunsheng Wei, PhD, Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, No. 83, Fenyang Road, Shanghai 200031, China Tel/fax: +86 21 6437 7134; e-mail: weics2003@163.com Received October 2, 2018 Accepted February 7, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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A randomized phase II study to determine the efficacy and tolerability of two doses of eribulin plus lapatinib in trastuzumab-pretreated patients with HER-2-positive metastatic breast cancer (E-VITA)

The E-VITA study evaluated the efficacy and tolerability of two schedules of eribulin and lapatinib in patients with trastuzumab-pretreated HER-2-positive metastatic breast cancer. This multicenter, open-label phase II trial, randomly assigned patients with trastuzumab-pretreated HER-2-positive metastatic breast cancer to lapatinib 1000 mg daily with eribulin 1.23 mg/m2 (equivalent to 1.4 mg/m2 eribulin mesylate) days 1+8 every 21 days (split-dose arm) or eribulin 1.76 mg/m2 (equivalent to 2.0 mg/m2 eribulin mesylate) day 1 every 21 days (3-weekly arm). Time to progression and tolerability were defined as primary end points; no sample size calculation for formal comparison of efficacy data has been performed. Secondary end points included objective response rate, clinical benefit rate, and overall survival. Overall, 43 patients of a planned number of 80 patients were recruited. At a median follow-up of 28.7 months, the median time to progression was 8.1 months [95% confidence interval (CI): 4.8–9.4] in the split-dose arm and 6.5 months (95% CI: 4.6–13.4) in the 3-weekly arm. Objective response rate was 52.4% (95% CI: 31.0–73.7) in the split-dose arm and 45.0% (95% CI: 23.2–66.8) in the 3-weekly arm, and clinical benefit rate was 71.4% (95% CI: 52.1–90.8) and 75.0% (95% CI: 56.0–94.0), respectively. Overall survival was also similar in both arms. The most frequent grade 3–4 adverse events were neutropenia (58.5%) and leukopenia (39.0%). The combination of eribulin and lapatinib showed an acceptable safety profile with less toxicity observed in the eribulin 1.23 mg/m2 day 1+8 group. This might be an alternative regimen when other treatment options are exhausted. Therefore, further clinical studies are warranted. Presented in part at the 2016 ESMO meeting, Copenhagen, 7–11 October 2016. Correspondence to Sibylle Loibl, MD, German Breast Group, Martin-Behaim-Strasse 12, 63263 Neu-Isenburg, Germany Tel: +49 610 274 800; fax: +49 610 2748 0440; e-mail: sibylle.loibl@gbg.de Received April 17, 2018 Accepted November 3, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Talazoparib has no clinically relevant effect on QTc interval in patients with advanced solid tumors

The aims of this study were (i) to evaluate the effect of talazoparib (1 mg once daily) on cardiac repolarization in patients with advanced solid tumors by assessing corrected QT interval (QTc) and (ii) to examine the relationship between plasma talazoparib concentration and QTc. In this open-label phase 1 study, patients had continuous 12-lead ECG recordings at baseline followed by time-matched continuous ECG recordings and collection of talazoparib plasma pharmacokinetic samples predose and at 1, 2, 4, and 6 h postdose on treatment days 1 and 22 and before talazoparib administration on day 2. ECG recordings were submitted for independent central review where triplicate 10-s ECGs, extracted up to 15 min before pharmacokinetic samples, were assessed for RR, PR, QRS, and QT intervals and ECG morphology. QT interval was corrected for heart rate using Fridericia's (QTcF) and Bazett's (QTcB) formulae. Linear mixed-effects modeling was used to examine the relationship between QTc and RR interval change from baseline and plasma talazoparib concentration. Thirty-seven patients received talazoparib. Mean change in QTcF from time-matched baseline ranged from −3.5 to 6.9 ms, with the greatest change 1 h postdose on day 22. No clinically relevant changes in PR, QRS, QTcB, QTcF, or RR intervals, heart rate, or ECG morphology were observed. No concentration-dependent effect on heart rate or QTc was observed. No deaths, permanent treatment discontinuations due to adverse events were reported. Talazoparib (1 mg once daily) had no clinically relevant effects on cardiac repolarization. * Justin Hoffman and Jayeta Chakrabarti contributed equally to the writing of this article. Correspondence to Diane Wang, PhD, 10555 Science Center Drive, San Diego, CA 92130, USA Tel: +1 858 622 3000; fax: +1 858 678 8263; e-mail: diane.wang@pfizer.com Received December 13, 2018 Accepted February 2, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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A Rare Case of Vocal Cord Aspergillosis

AbstractPrimary aspergillosis of larynx is very rare. Till now only 28 cases of isolated laryngeal aspergillosis are documented in the English literature. In the field of otorhinolaryngology, aspergillosis most frequently affects external auditory canal or nasal sinuses and larynx is usually secondarily involved. It usually affects the patients with immunocompromised state and usually presents with hoarseness of voice. Laryngeal lesions usually mimics malignancy, so accurate diagnosis with direct laryngoscopy and biopsy is needed for further management. As these lesions responds very well to antifungal therapy, early diagnosis and starting antifungal therapy is important. Here we are presenting a case report of 67  years old male with aspergillosis of vocal folds without any immunodeficie...

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A Rare Case of Vocal Cord Aspergillosis

AbstractPrimary aspergillosis of larynx is very rare. Till now only 28 cases of isolated laryngeal aspergillosis are documented in the English literature. In the field of otorhinolaryngology, aspergillosis most frequently affects external auditory canal or nasal sinuses and larynx is usually secondarily involved. It usually affects the patients with immunocompromised state and usually presents with hoarseness of voice. Laryngeal lesions usually mimics malignancy, so accurate diagnosis with direct laryngoscopy and biopsy is needed for further management. As these lesions responds very well to antifungal therapy, early diagnosis and starting antifungal therapy is important. Here we are presenting a case report of 67  years old male with aspergillosis of vocal folds without any immunodeficie...

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Real-Time Ultrasound Improves Accuracy of Caudal Block in Children

BACKGROUND: Caudal block, the most common regional anesthetic in children, is predominantly performed using palpation to determine placement. The efficacy of the palpation technique is unknown with respect to block success. While ultrasound has been suggested for use during caudal block, its use is infrequent. METHODS: A single-blinded prospective observational trial was performed evaluating provider success rate of caudal blocks placed by palpation alone. After needle insertion and partial local anesthetic injection, an ultrasound was performed to confirm correct location. RESULTS: A total of 109 caudal blocks were performed during the prospective observational study. Success rate for caudal blocks done by palpation alone was 78.9% as confirmed by ultrasound. In 21.1% of caudal blocks, the provider incorrectly judged the needle to be in the caudal space as confirmed with ultrasound. CONCLUSIONS: Real-time ultrasound visualization of local anesthetic injection provides reliable and immediate confirmation during caudal block in children. Accepted for publication January 8, 2019. Funding: Departmental. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). This work was presented in abstract form at the 43rd Annual Regional Anesthesiology and Acute Pain Medicine Meeting, New York, NY, April 21, 2018. Reprints will not be available from the authors. Address correspondence to Adam C. Adler, MD, MS, FAAP, FASE, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin St, Suite #A3300, Houston, TX 77030. Address e-mail to adam.adler@bcm.edu. © 2019 International Anesthesia Research Society

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