Quality Assurance in Interventional Radiology: Intra-procedural Care

Abstract

Purpose of Review

To highlight elements that potentially improve the quality of patient care during the Interventional Radiology procedure.

Recent Findings

The success of an interventional radiology procedure is not merely dependent on the skill of the operator. Many other factors considerably influence the safety and therefore the outcome of the procedure. The following elements are discussed in depth: universal protocol, preprocedural checklist, physical environment, communication during the procedure, preventing infection, planning and executing the procedure, and radiation safety.

Summary

Incorporating systems of safety and back-up plans during the procedure is essential in guaranteeing favorable results and decreasing complications.

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Quality Assurance in Interventional Radiology: Intra-procedural Care

Abstract

Purpose of Review

To highlight elements that potentially improve the quality of patient care during the Interventional Radiology procedure.

Recent Findings

The success of an interventional radiology procedure is not merely dependent on the skill of the operator. Many other factors considerably influence the safety and therefore the outcome of the procedure. The following elements are discussed in depth: universal protocol, preprocedural checklist, physical environment, communication during the procedure, preventing infection, planning and executing the procedure, and radiation safety.

Summary

Incorporating systems of safety and back-up plans during the procedure is essential in guaranteeing favorable results and decreasing complications.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CKgyFO

Maternal Sepsis: Recognition, Treatment, and Escalation of Care

Abstract

Purpose of Review

The purpose of this article is to provide a brief review of maternal sepsis and the supporting literature for recognition and management.

Recent Findings

Recent findings suggest that there is significant room for improvement in identifying patients at risk, expeditiously providing appropriate intervention, and developing action plans to best care for these patients and prevent morbidity and mortality.

Summary

Improved education and understanding of the unique presentation of sepsis during pregnancy may help to improve detection, timely treatment, and expedite appropriate transfer to higher levels of care.

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Maternal Sepsis: Recognition, Treatment, and Escalation of Care

Abstract

Purpose of Review

The purpose of this article is to provide a brief review of maternal sepsis and the supporting literature for recognition and management.

Recent Findings

Recent findings suggest that there is significant room for improvement in identifying patients at risk, expeditiously providing appropriate intervention, and developing action plans to best care for these patients and prevent morbidity and mortality.

Summary

Improved education and understanding of the unique presentation of sepsis during pregnancy may help to improve detection, timely treatment, and expedite appropriate transfer to higher levels of care.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G2NPPQ

IgE-mediated sensitization to galactose-alpha-1,3-galactose ( α-gal) in urticaria and anaphylaxis in Spain: geographical variations and risk factors.

CONCLUSIONS: Sensitization to α-gal in patients with urticaria or anaphylaxis differs considerably between the three geographical areas studied and is related to tick bites. PMID: 30676319 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

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Incidence and risk factors of low-osmolar iodinated contrast media related immediate hypersensitivity reactions: A longitudinal study based on a real-time monitoring system.

CONCLUSIONS: The incidence of HSR was not significantly different across the five LOCMs used in the study. Repeated exposure to LOCM did not increase the risk of HSR among subjects who never experienced HSR to LOCM. PMID: 30676320 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

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Relevance of Th2 markers in the assessment and therapeutic management of severe allergic asthma: a real life perspective.

CONCLUSIONS: According to our findings blood eosinophils do not represent a univocal marker of asthma severity, whilst a higher FeNO level is associated with more frequent hospital admissions and lost working days. Blood eosinophils seem to act as predictor of treatment responsiveness to omalizumab. PMID: 30676321 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

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IgE-mediated sensitization to galactose-alpha-1,3-galactose ( α-gal) in urticaria and anaphylaxis in Spain: geographical variations and risk factors.

CONCLUSIONS: Sensitization to α-gal in patients with urticaria or anaphylaxis differs considerably between the three geographical areas studied and is related to tick bites. PMID: 30676319 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DAwegg

Incidence and risk factors of low-osmolar iodinated contrast media related immediate hypersensitivity reactions: A longitudinal study based on a real-time monitoring system.

CONCLUSIONS: The incidence of HSR was not significantly different across the five LOCMs used in the study. Repeated exposure to LOCM did not increase the risk of HSR among subjects who never experienced HSR to LOCM. PMID: 30676320 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UfFvzP

Relevance of Th2 markers in the assessment and therapeutic management of severe allergic asthma: a real life perspective.

CONCLUSIONS: According to our findings blood eosinophils do not represent a univocal marker of asthma severity, whilst a higher FeNO level is associated with more frequent hospital admissions and lost working days. Blood eosinophils seem to act as predictor of treatment responsiveness to omalizumab. PMID: 30676321 [PubMed - as supplied by publisher] (Source: Journal of Investigational Allergology and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DzZ8wU

An SLP Shares Lessons Learned from the LA Teachers Union Strike

No one really walks in LA, and we usually stay indoors when it rains. So heads turned when tens of thousands took to the streets all over the city. We chanted with our colleagues, jammed the subways wearing red for education, and made signs with messages demanding funds for schools. Our cause? To get the Los Angeles United School District (LAUSD) to invest in our students, improve school safety, lower class sizes, cap charter school expansion, and provide a fair contract and wage. We were loud verbally and nonverbally. Speech-language pathologists like me joined the picket lines and marched alongside educators despite the pouring rain. The LA teachers union also represents us. Our district considers SLPs to be itinerant related service providers, a category that includes occupational t...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B05BQ3

An SLP Shares Lessons Learned from the LA Teachers Union Strike

No one really walks in LA, and we usually stay indoors when it rains. So heads turned when tens of thousands took to the streets all over the city. We chanted with our colleagues, jammed the subways wearing red for education, and made signs with messages demanding funds for schools. Our cause? To get the Los Angeles United School District (LAUSD) to invest in our students, improve school safety, lower class sizes, cap charter school expansion, and provide a fair contract and wage. We were loud verbally and nonverbally. Speech-language pathologists like me joined the picket lines and marched alongside educators despite the pouring rain. The LA teachers union also represents us. Our district considers SLPs to be itinerant related service providers, a category that includes occupational t...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B05BQ3

Immunogenicity and Safety Study of Inactivated Subunit H5N1 Influenza Vaccine in Prior Recipients of Live Attenuated H2N2, H6N1 and H9N2 Influenza Vaccines and in H5N1 and Live Attenuated Vaccine Na ïve Individuals

Condition:   Influenza Intervention:   Biological: H5N1 pISV Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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Iron and Pollen Allergy in Women

Conditions:   Allergy Pollen;   Healthy Interventions:   Dietary Supplement: ImmunoBon;   Dietary Supplement: Placebo Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

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Immunogenicity and Safety Study of Inactivated Subunit H5N1 Influenza Vaccine in Prior Recipients of Live Attenuated H2N2, H6N1 and H9N2 Influenza Vaccines and in H5N1 and Live Attenuated Vaccine Na ïve Individuals

Condition:   Influenza Intervention:   Biological: H5N1 pISV Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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Siderophore-profile in Allergic and Non-allergic Subjects

Conditions:   Allergy;   Healthy;   Allergic Sensitisation Intervention:   Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

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Iron and Pollen Allergy in Women

Conditions:   Allergy Pollen;   Healthy Interventions:   Dietary Supplement: ImmunoBon;   Dietary Supplement: Placebo Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXzjJ3

The Evaluation of Vitiligous lesions Repigmentation after the Administration of Atorvastatin calcium salt and Simvastatin-acid sodium salt in patients with active vitiligo (EVRAAS), a pilot study: study protocol for a randomized controlled trial

This study is the first to evaluate safety and efficacy of the topical use of statins in patients presenting with NSV.Trial registrationClinicaltrials.gov,NCT03247400. Registered on 05 August 2017. (Source: Trials)

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Siderophore-profile in Allergic and Non-allergic Subjects

Conditions:   Allergy;   Healthy;   Allergic Sensitisation Intervention:   Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FPa5x4

The Evaluation of Vitiligous lesions Repigmentation after the Administration of Atorvastatin calcium salt and Simvastatin-acid sodium salt in patients with active vitiligo (EVRAAS), a pilot study: study protocol for a randomized controlled trial

This study is the first to evaluate safety and efficacy of the topical use of statins in patients presenting with NSV.Trial registrationClinicaltrials.gov,NCT03247400. Registered on 05 August 2017. (Source: Trials)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G0epJd

Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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What is the Incidence of an Immune Disorder in Children With Invasive Pneumococcal Disease (IPD)?

Conditions:   Invasive Pneumococcal Disease, Recurrent Isolated, 1;   Invasive Pneumococcal Disease, Recurrent Isolated, 2;   Invasive Pneumococcal Disease, Protection Against;   Primary Immunodeficiency Intervention:   Other: Referral to Immunology Sponsor:   Murdoch Childrens Research Institute Recruiting (Source: ClinicalTrials.gov)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G1h6tV

What is the Incidence of an Immune Disorder in Children With Invasive Pneumococcal Disease (IPD)?

Conditions:   Invasive Pneumococcal Disease, Recurrent Isolated, 1;   Invasive Pneumococcal Disease, Recurrent Isolated, 2;   Invasive Pneumococcal Disease, Protection Against;   Primary Immunodeficiency Intervention:   Other: Referral to Immunology Sponsor:   Murdoch Childrens Research Institute Recruiting (Source: ClinicalTrials.gov)

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.

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Effects of Vaginal Seeding on Infants' Body Mass Index and Allergy Risk for Caesarean-delivered Children

Conditions:   Overweight and Obesity;   Allergy Intervention:   Procedure: Vaginal seeding Sponsors:   Peking University;   National Natural Science Foundation of China;   Liuyang Maternal and Child Health Care Hospital Recruiting (Source: ClinicalTrials.gov)

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.

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Effects of Vaginal Seeding on Infants' Body Mass Index and Allergy Risk for Caesarean-delivered Children

Conditions:   Overweight and Obesity;   Allergy Intervention:   Procedure: Vaginal seeding Sponsors:   Peking University;   National Natural Science Foundation of China;   Liuyang Maternal and Child Health Care Hospital Recruiting (Source: ClinicalTrials.gov)

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.

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Augmented reality for temporomandibular joint arthrocentesis: a cadaver study

Temporomandibular joint (TMJ) arthroscopic procedures require the identification of a skin puncture point. The puncture point is conventionally estimated using the surface anatomy of the canthal-tragus line. However, the conventional puncture technique has been reported to fail at the first attempt in 18% of cases. We propose an augmented reality (AR) system-based method to identify the puncture point on the skin. A three-dimensional virtual model was reconstructed from computed tomography images of a cadaver head, and its rendered image was superimposed on the cadaver head before skin puncture.

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Evaluation of the surface damage of dental implants caused by different surgical protocols: an in vitro study

The implant surface must withstand high insertion torque during implant insertion. The aim of this study was to investigate the damage to implant surfaces caused by two different insertion protocols in vitro. Fifteen titanium implants per group were inserted in standardized polyurethane foam models, group 1 according to a non-threaded surgical protocol and group 2 according to a threaded surgical protocol. Before and after insertion, the surfaces were visualized by scanning electron microscopy (SEM) and non-contact laser profilometry.

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The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated,...

The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated, "must have" text for junior maxillofacial trainees (particularly dental core trainees), senior house officers, students, or anyone who is thinking about a career in the specialty.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WlQGsv

Augmented reality for temporomandibular joint arthrocentesis: a cadaver study

Temporomandibular joint (TMJ) arthroscopic procedures require the identification of a skin puncture point. The puncture point is conventionally estimated using the surface anatomy of the canthal-tragus line. However, the conventional puncture technique has been reported to fail at the first attempt in 18% of cases. We propose an augmented reality (AR) system-based method to identify the puncture point on the skin. A three-dimensional virtual model was reconstructed from computed tomography images of a cadaver head, and its rendered image was superimposed on the cadaver head before skin puncture.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TgXk1i

Evaluation of the surface damage of dental implants caused by different surgical protocols: an in vitro study

The implant surface must withstand high insertion torque during implant insertion. The aim of this study was to investigate the damage to implant surfaces caused by two different insertion protocols in vitro. Fifteen titanium implants per group were inserted in standardized polyurethane foam models, group 1 according to a non-threaded surgical protocol and group 2 according to a threaded surgical protocol. Before and after insertion, the surfaces were visualized by scanning electron microscopy (SEM) and non-contact laser profilometry.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B7DNtf

The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated,...

The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated, "must have" text for junior maxillofacial trainees (particularly dental core trainees), senior house officers, students, or anyone who is thinking about a career in the specialty.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WlQGsv

MDCT evaluation of sternal development

Abstract

Background and purpose

Sternal ossification starts in utero, and continues throughout puberty in various patterns. In this study, our objective was to evaluate the correlation of ossification with age and to determine whether age can be predicted.

Materials and methods

Individuals younger than 30 years old without congenital anomalies, chronic disease, and history of long-term chemotherapy who had chest CT imaging with a slice thickness < 3 mm were retrospectively reviewed. Data of ossification centers, horizontal and vertical fusion were collected. Spearman correlation test and ROC analysis were performed to correlate age with fusion. Kruskal–Wallis test was used to perform gender wise comparisons. Sensitivity, specificity, positive predictive value and negative predictive value of cut-off points, estimated according to ROC analysis, were calculated.

Results

Segmented ossification centers were more common in males, with significant difference in third and fourth mesosternal ossification centers (p < 0.05). Females had more vertical fusion at each level (p < 0.05). Spearman correlation test showed significant correlation between age and horizontal and vertical fusion for both genders. ROC analysis was performed and cut-off values were estimated. Sensitivity was very high (84.6–100%) but specificity was low (43.3–79.9%) for horizontal fusion. Sensitivity of vertical fusion (64.8–100%) was similar but specificity was higher (74.7–100%).

Conclusions

Horizontal and vertical fusions of sternal ossification centers correlate with age significantly. Vertical fusion might be a better indicator of age with higher sensitivity and specificity, while horizontal fusion has lower accuracy. Large-scale studies should be conducted to confirm our results.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UjcO5k

MDCT evaluation of sternal development

Abstract

Background and purpose

Sternal ossification starts in utero, and continues throughout puberty in various patterns. In this study, our objective was to evaluate the correlation of ossification with age and to determine whether age can be predicted.

Materials and methods

Individuals younger than 30 years old without congenital anomalies, chronic disease, and history of long-term chemotherapy who had chest CT imaging with a slice thickness < 3 mm were retrospectively reviewed. Data of ossification centers, horizontal and vertical fusion were collected. Spearman correlation test and ROC analysis were performed to correlate age with fusion. Kruskal–Wallis test was used to perform gender wise comparisons. Sensitivity, specificity, positive predictive value and negative predictive value of cut-off points, estimated according to ROC analysis, were calculated.

Results

Segmented ossification centers were more common in males, with significant difference in third and fourth mesosternal ossification centers (p < 0.05). Females had more vertical fusion at each level (p < 0.05). Spearman correlation test showed significant correlation between age and horizontal and vertical fusion for both genders. ROC analysis was performed and cut-off values were estimated. Sensitivity was very high (84.6–100%) but specificity was low (43.3–79.9%) for horizontal fusion. Sensitivity of vertical fusion (64.8–100%) was similar but specificity was higher (74.7–100%).

Conclusions

Horizontal and vertical fusions of sternal ossification centers correlate with age significantly. Vertical fusion might be a better indicator of age with higher sensitivity and specificity, while horizontal fusion has lower accuracy. Large-scale studies should be conducted to confirm our results.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UjcO5k

Current Status and Growth of Nuclear Theranostics in Singapore

Abstract

The concept of theranostics, where individual patient-level biological information is used to choose the optimal therapy for that individual, has become more popular in the modern era of 'personalised' medicine. With the growth of theranostics, nuclear medicine as a specialty is uniquely poised to grow along with the ever-increasing number of concepts combining imaging and therapy. This special report summarises the status and growth of Theranostic Nuclear Medicine in Singapore. We will cover our experience with the use of radioiodine, radioiodinated metaiodobenzylguanidine, peptide receptor radionuclide therapy, prostate specific membrane antigen radioligand therapy, radium-223 and yttrium-90 selective internal radiation therapy. We also include a section on our radiopharmacy laboratory, crucial to our implementation of theranostic principles. Radionuclide theranostics has seen tremendous growth and we hope to be able to grow alongside to continue to serve the patients in Singapore and in the region.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXNspA

Current Status and Growth of Nuclear Theranostics in Singapore

Abstract

The concept of theranostics, where individual patient-level biological information is used to choose the optimal therapy for that individual, has become more popular in the modern era of 'personalised' medicine. With the growth of theranostics, nuclear medicine as a specialty is uniquely poised to grow along with the ever-increasing number of concepts combining imaging and therapy. This special report summarises the status and growth of Theranostic Nuclear Medicine in Singapore. We will cover our experience with the use of radioiodine, radioiodinated metaiodobenzylguanidine, peptide receptor radionuclide therapy, prostate specific membrane antigen radioligand therapy, radium-223 and yttrium-90 selective internal radiation therapy. We also include a section on our radiopharmacy laboratory, crucial to our implementation of theranostic principles. Radionuclide theranostics has seen tremendous growth and we hope to be able to grow alongside to continue to serve the patients in Singapore and in the region.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXNspA

Characterization of the early pathology of cochlear stereocilia in four inbred mouse strains with progressive hearing loss.

CONCLUSION: Early degeneration of stereocilia contributes to the functional impairment of hair cells and hearing loss in NOD/LtJ, A/J, DBA/2J and C57BL/6J mice. PMID: 30675896 [PubMed - as supplied by publisher] (Source: Histology and Histopathology)

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Subjective visual vertical in posterior canal benign paroxysmal positional vertigo patients before and after Canalith repositioning maneuvers

. (Source: Hearing, Balance and Communication)

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scRNA-Seq reveals distinct stem cell populations that drive hair cell regeneration after loss of Fgf and Notch signaling

Loss of sensory hair cells leads to deafness and balance deficiencies. In contrast to mammalian hair cells, zebrafish ear and lateral line hair cells regenerate from poorly characterized support cells. Equally ill-defined is the gene regulatory network underlying the progression of support cells to differentiated hair cells. scRNA-Seq of lateral line organs uncovered five different support cell types, including quiescent and activated stem cells. Ordering of support cells along a developmental trajectory identified self-renewing cells and genes required for hair cell differentiation. scRNA-Seq analyses offgf3 mutants, in which hair cell regeneration is increased, demonstrates that Fgf and Notch signaling inhibit proliferation of support cells in parallel by inhibiting Wnt signaling. Our sc...

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The hearing sciences

. (Source: International Journal of Audiology)

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Characterization of the early pathology of cochlear stereocilia in four inbred mouse strains with progressive hearing loss.

CONCLUSION: Early degeneration of stereocilia contributes to the functional impairment of hair cells and hearing loss in NOD/LtJ, A/J, DBA/2J and C57BL/6J mice. PMID: 30675896 [PubMed - as supplied by publisher] (Source: Histology and Histopathology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RTbXLF

Subjective visual vertical in posterior canal benign paroxysmal positional vertigo patients before and after Canalith repositioning maneuvers

. (Source: Hearing, Balance and Communication)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CGQ8Vg

scRNA-Seq reveals distinct stem cell populations that drive hair cell regeneration after loss of Fgf and Notch signaling

Loss of sensory hair cells leads to deafness and balance deficiencies. In contrast to mammalian hair cells, zebrafish ear and lateral line hair cells regenerate from poorly characterized support cells. Equally ill-defined is the gene regulatory network underlying the progression of support cells to differentiated hair cells. scRNA-Seq of lateral line organs uncovered five different support cell types, including quiescent and activated stem cells. Ordering of support cells along a developmental trajectory identified self-renewing cells and genes required for hair cell differentiation. scRNA-Seq analyses offgf3 mutants, in which hair cell regeneration is increased, demonstrates that Fgf and Notch signaling inhibit proliferation of support cells in parallel by inhibiting Wnt signaling. Our sc...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RNVcl6

The hearing sciences

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CI7kK4

Delayed Treatment (≥5 Days) by Flow Diversion of Ruptured Blister-Like Cerebral Aneurysms

Abstract

Background and Purpose

Ruptured blister-like aneurysms (BLAs) are challenging lesions to treat, without any consensus on their management. Few studies have evaluated the safety and effectiveness of flow diverter stents (FDS) for this indication, with promising results. The goal was to evaluate the safety and effectiveness of a delayed (≥5 days) flow diversion strategy for the treatment of ruptured intracranial BLAs.

Material and Methods

A monocentric retrospective analysis of a prospectively collected database of intracranial aneurysms was performed. Eight consecutive patients with 9 ruptured intracranial BLAs from November 2010 to June 2018 were included in the study. The BLA treatment with FDS was delayed from the rupture (minimum rupture to treatment delay = 5 days, mean = 16.9 ± 9.2 days). Procedure-related complications were systematically recorded. Rebleeding occurrences were systematically assessed. Long-term clinical and angiographic follow-ups were recorded.

Results

No procedure-related death was recorded. Neither early nor late rebleeding was observed and one (12.5%) major procedure-related complication occurred (ischemic stroke). Most of the patients (5/8; 62.5%) had an mRS <2 at discharge. The immediate periprocedural control angiogram showed a complete exclusion of the aneurysm in one patient (12.5%) but at follow-up (mean delay = 19.8 months) all patients had a complete aneurysm occlusion. All patients had a long-term mRS <2.

Conclusion

This case series suggests that a delayed treatment (≥5 days after the hemorrhagic event) of ruptured BLAs with FDS is feasible, and may be safe and effective in terms of rebleeding prevention and long-term angiographic outcome.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DwWuYP

Delayed Treatment (≥5 Days) by Flow Diversion of Ruptured Blister-Like Cerebral Aneurysms

Abstract

Background and Purpose

Ruptured blister-like aneurysms (BLAs) are challenging lesions to treat, without any consensus on their management. Few studies have evaluated the safety and effectiveness of flow diverter stents (FDS) for this indication, with promising results. The goal was to evaluate the safety and effectiveness of a delayed (≥5 days) flow diversion strategy for the treatment of ruptured intracranial BLAs.

Material and Methods

A monocentric retrospective analysis of a prospectively collected database of intracranial aneurysms was performed. Eight consecutive patients with 9 ruptured intracranial BLAs from November 2010 to June 2018 were included in the study. The BLA treatment with FDS was delayed from the rupture (minimum rupture to treatment delay = 5 days, mean = 16.9 ± 9.2 days). Procedure-related complications were systematically recorded. Rebleeding occurrences were systematically assessed. Long-term clinical and angiographic follow-ups were recorded.

Results

No procedure-related death was recorded. Neither early nor late rebleeding was observed and one (12.5%) major procedure-related complication occurred (ischemic stroke). Most of the patients (5/8; 62.5%) had an mRS <2 at discharge. The immediate periprocedural control angiogram showed a complete exclusion of the aneurysm in one patient (12.5%) but at follow-up (mean delay = 19.8 months) all patients had a complete aneurysm occlusion. All patients had a long-term mRS <2.

Conclusion

This case series suggests that a delayed treatment (≥5 days after the hemorrhagic event) of ruptured BLAs with FDS is feasible, and may be safe and effective in terms of rebleeding prevention and long-term angiographic outcome.

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The effectiveness of high-resolution ultrasound in the assessment of the carotid intima–media thickness for postirradiated neck

Abstract

Objective

The carotid intimal–medial thickness (CIMT) is a strong predictor of future cardiovascular events. We assessed the mean CIMT and evaluated associated factors in head and neck cancer (HNC) patients.

Materials and methods

Between January 2016 and March 2018, 70 volunteers underwent automatic ultrasound measurement of the common carotid artery CIMT. A mean CIMT ≥ 1.0 mm was regarded as an elevated risk for cardiovascular disease (CVD). We aimed to investigate the risk factors for an increased mean CIMT.

Results

We recruited 20 HNC survivors and 50 noncancer control individuals. Multiple linear regression analysis showed that old age (β = 0.006, 95% confidence interval, CI 0.004–0.008), increased weight (β = 0.003, 95% CI 0.001–0.005), hypertension (β = 0.10, 95% CI 0.03–0.17), and prior irradiation (β = 0.13, 95% CI 0.08–0.19) were positively correlated with the mean CIMT. From logistic regression analysis, it was shown that patients who underwent radiotherapy (OR 13.5, 95% CI 1.48–122.8) and who had higher bodyweight (OR 1.09, 95% CI 1.01–1.18) had a significantly higher risk of developing CVD.

Conclusion

Measurement of the mean CIMT using ultrasound could be useful for assessing CVD risk in HNC survivors after neck irradiation.

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The effectiveness of high-resolution ultrasound in the assessment of the carotid intima–media thickness for postirradiated neck

Abstract

Objective

The carotid intimal–medial thickness (CIMT) is a strong predictor of future cardiovascular events. We assessed the mean CIMT and evaluated associated factors in head and neck cancer (HNC) patients.

Materials and methods

Between January 2016 and March 2018, 70 volunteers underwent automatic ultrasound measurement of the common carotid artery CIMT. A mean CIMT ≥ 1.0 mm was regarded as an elevated risk for cardiovascular disease (CVD). We aimed to investigate the risk factors for an increased mean CIMT.

Results

We recruited 20 HNC survivors and 50 noncancer control individuals. Multiple linear regression analysis showed that old age (β = 0.006, 95% confidence interval, CI 0.004–0.008), increased weight (β = 0.003, 95% CI 0.001–0.005), hypertension (β = 0.10, 95% CI 0.03–0.17), and prior irradiation (β = 0.13, 95% CI 0.08–0.19) were positively correlated with the mean CIMT. From logistic regression analysis, it was shown that patients who underwent radiotherapy (OR 13.5, 95% CI 1.48–122.8) and who had higher bodyweight (OR 1.09, 95% CI 1.01–1.18) had a significantly higher risk of developing CVD.

Conclusion

Measurement of the mean CIMT using ultrasound could be useful for assessing CVD risk in HNC survivors after neck irradiation.

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Benign osteoblastoma of the palate: a rare clinical presentation

Abstract

Osteoblastoma is a rare, benign type of osteoblastic tumor. It constitutes approximately 1% of all primary bone tumors. Osteoblastoma most commonly affects the long bones; it very rarely affects the jaw bones. Because of its clinical and histological similarity with other bony tumors, such as osteoid osteoma and fibro-osseous lesions, osteoblastoma is a diagnostic challenge. Very few cases of osteoblastoma involving the maxillofacial region have been reported to date. We herein describe a 15-year-old female patient with osteoblastoma that presented as a palatal swelling of 6 months' duration.

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Benign osteoblastoma of the palate: a rare clinical presentation

Abstract

Osteoblastoma is a rare, benign type of osteoblastic tumor. It constitutes approximately 1% of all primary bone tumors. Osteoblastoma most commonly affects the long bones; it very rarely affects the jaw bones. Because of its clinical and histological similarity with other bony tumors, such as osteoid osteoma and fibro-osseous lesions, osteoblastoma is a diagnostic challenge. Very few cases of osteoblastoma involving the maxillofacial region have been reported to date. We herein describe a 15-year-old female patient with osteoblastoma that presented as a palatal swelling of 6 months' duration.

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Artificial Intelligence in Radiology: Resident Recruitment Help or Hindrance?

Publication date: Available online 24 January 2019

Source: Academic Radiology

Author(s): Allison Grayev

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Artificial Intelligence in Radiology: Resident Recruitment Help or Hindrance?

Publication date: Available online 24 January 2019

Source: Academic Radiology

Author(s): Allison Grayev

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Headache deteriorates the quality of life in children with chronic spontaneous urticaria

Publication date: Available online 25 January 2019

Source: Allergologia et Immunopathologia

Author(s): S. Filiz, M.G. Kutluk, D.F.K. Uygun

Abstract

Background

Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.

Objectives

To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.

Methods

A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.

Results

CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.

Conclusion

Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria.

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Headache deteriorates the quality of life in children with chronic spontaneous urticaria

Publication date: Available online 25 January 2019

Source: Allergologia et Immunopathologia

Author(s): S. Filiz, M.G. Kutluk, D.F.K. Uygun

Abstract

Background

Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.

Objectives

To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.

Methods

A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.

Results

CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.

Conclusion

Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria.

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Bacteremia after professional mechanical plaque removal in patients with chronic periodontitis

Abstract

Objective

The aim of this study was to investigate the characteristics of bacteremia caused by professional mechanical plaque removal (PMPR) in 2 groups of patients with generalized moderate chronic periodontitis.

Material and Methods

Venous blood samples were taken at multiple time points for one hour following PMPR in fifty patients with generalized moderate chronic periodontitis. Subjects consisted of two groups, one group was receiving supportive periodontal therapy (SPT, n = 25) and the other group was receiving initial periodontal therapy (IPT, n = 25). Blood samples were processed and analyzed for cultivable microflora. Pertinent clinical parameters were recorded for each patient in both groups.

Results

Bacteremia was detected in 10/25 SPT and 8/25 IPT patients (p = 0.796).

In both groups, the prevalence of bacteremia was dependent on the time of blood sampling and varied in magnitude between < 10² CFU/ml and 10⁶ CFU/ml.

Sixteen different bacterial species were identified in both groups, mostly Actinomyces naeslundii

(SPT n = 3, IPT n = 4) and Streptococcus spp. (SPT n = 6, IPT n = 2).

In regression models, furcation involvement Grade II (p = 0.004) and Gingival Bleeding Index

(p = 0.036) had affected the occurrence of bacteremia but in the SPT group only.

Conclusions

PMPR was associated with bacteremia regardless of whether a patient was receiving SPT or IPT.

This article is protected by copyright. All rights reserved.

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Bacteremia after professional mechanical plaque removal in patients with chronic periodontitis

Abstract

Objective

The aim of this study was to investigate the characteristics of bacteremia caused by professional mechanical plaque removal (PMPR) in 2 groups of patients with generalized moderate chronic periodontitis.

Material and Methods

Venous blood samples were taken at multiple time points for one hour following PMPR in fifty patients with generalized moderate chronic periodontitis. Subjects consisted of two groups, one group was receiving supportive periodontal therapy (SPT, n = 25) and the other group was receiving initial periodontal therapy (IPT, n = 25). Blood samples were processed and analyzed for cultivable microflora. Pertinent clinical parameters were recorded for each patient in both groups.

Results

Bacteremia was detected in 10/25 SPT and 8/25 IPT patients (p = 0.796).

In both groups, the prevalence of bacteremia was dependent on the time of blood sampling and varied in magnitude between < 10² CFU/ml and 10⁶ CFU/ml.

Sixteen different bacterial species were identified in both groups, mostly Actinomyces naeslundii

(SPT n = 3, IPT n = 4) and Streptococcus spp. (SPT n = 6, IPT n = 2).

In regression models, furcation involvement Grade II (p = 0.004) and Gingival Bleeding Index

(p = 0.036) had affected the occurrence of bacteremia but in the SPT group only.

Conclusions

PMPR was associated with bacteremia regardless of whether a patient was receiving SPT or IPT.

This article is protected by copyright. All rights reserved.

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MRI findings in Parinaud’s syndrome: a closer look at pineal masses

Abstract

Purpose

The association between MRI findings in patients with pineal lesions and the presence or absence of Parinaud's syndrome (PS) remains poorly described. We sought to better understand what MRI characteristics of a pineal lesion make PS more likely. Can these features predict prognosis for clinical resolution? Based on the anatomical relationship of the pineal gland and midbrain, we hypothesized that the degree of midbrain injury by a pineal mass as assessed by abutment, displacement, or intrinsic midbrain signal abnormality (IMSA) may predict PS.

Methods

We reviewed our institution's databases to find patients with MRI evidence of an intrinsic lesion of the pineal gland. Seventy-seven patients with intrinsic pineal gland lesions, 26 with PS and 51 without PS (NPS), were identified. Data regarding clinical history were collected, and an experienced neuroradiologist reviewed all MRI studies and recorded mass size, midbrain abutment, displacement by the pineal lesion, and presence or absence of IMSA.

Results

IMSA occurred with increased frequency in pineal lesions with PS (85%) when compared with NPS (39.2%) (p = 0.0001). Midbrain abutment, compression, and displacement occurred with similar frequencies in both groups, with no statistically significant difference. Hydrocephalus was present in 80.8% of patients with PS and 84% without PS (p = 0.75).

Conclusion

IMSA in a patient with an intrinsic pineal gland mass is associated with PS. Other findings such as hydrocephalus and midbrain displacement are common in patients with pineal masses both with and without PS and do not have any predictive value.

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MRI findings in Parinaud’s syndrome: a closer look at pineal masses

Abstract

Purpose

The association between MRI findings in patients with pineal lesions and the presence or absence of Parinaud's syndrome (PS) remains poorly described. We sought to better understand what MRI characteristics of a pineal lesion make PS more likely. Can these features predict prognosis for clinical resolution? Based on the anatomical relationship of the pineal gland and midbrain, we hypothesized that the degree of midbrain injury by a pineal mass as assessed by abutment, displacement, or intrinsic midbrain signal abnormality (IMSA) may predict PS.

Methods

We reviewed our institution's databases to find patients with MRI evidence of an intrinsic lesion of the pineal gland. Seventy-seven patients with intrinsic pineal gland lesions, 26 with PS and 51 without PS (NPS), were identified. Data regarding clinical history were collected, and an experienced neuroradiologist reviewed all MRI studies and recorded mass size, midbrain abutment, displacement by the pineal lesion, and presence or absence of IMSA.

Results

IMSA occurred with increased frequency in pineal lesions with PS (85%) when compared with NPS (39.2%) (p = 0.0001). Midbrain abutment, compression, and displacement occurred with similar frequencies in both groups, with no statistically significant difference. Hydrocephalus was present in 80.8% of patients with PS and 84% without PS (p = 0.75).

Conclusion

IMSA in a patient with an intrinsic pineal gland mass is associated with PS. Other findings such as hydrocephalus and midbrain displacement are common in patients with pineal masses both with and without PS and do not have any predictive value.

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A qualitative study on the design and development of an mHealth app to facilitate communication with the Deaf community: perspective of community pharmacists

(Source: Patient Preference and Adherence)

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A qualitative study on the design and development of an mHealth app to facilitate communication with the Deaf community: perspective of community pharmacists

(Source: Patient Preference and Adherence)

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A within‐subject clinical trial on the conversion of mandibular 2‐implant to 3‐implant overdenture: Patient‐centered outcomes and willingness to pay

Abstract

Objectives

To examine the impact of adding a third midline implant with stud attachment to a mandibular 2‐implant overdenture on patient‐oriented outcomes.

Methods

In this pre–post design clinical trial, following the standard procedures, mandibular 2‐implant overdentures of 17 edentulous individuals (61.9 ± 6.6 years) were converted to 3‐implant overdentures by adding a stud attachment to an unloaded midline implant. Patient‐oriented outcomes included patient expectations and satisfaction with implant overdenture as well as willingness to pay the cost of conversion. Data were collected at baseline and at the 6‐week follow‐up using visual analog and binary scales as well as open‐ended questions. Statistical analysis included descriptive statistics, Spearman's correlation, Fisher exact test, Mann‐Whitney U, and the exact sign test.

Results

After connecting the third midline implant to the mandibular 2‐implant overdenture, there was a statistically significant decrease in the anteroposterior movement (p = 0.005) as evaluated by clinicians. Moreover, study participants reported an increase in perceived stability of the overdenture (95% CI 0.68‐1.00, p = 0.002), and in their ability to speak (95% CI 0.63‐1.00, p = 0.008). The addition of a third implant met the expectations of 94% of patients in regard to lower denture stability, 100% for retention, and 82.4% for comfort. The mandibular 3‐implant overdenture increased patient general satisfaction over a short period of time, but this improvement was not statistically significant. About 80% of patients would recommend this type of prosthesis to their peers but only 47% of them would agree to pay a large increase in the cost of treatment compared to a 2‐implant overdenture.

Conclusions

The addition of a midline third implant to an existing mandibular 2‐ implant overdenture resulted in several improved patient reported outcomes.

This article is protected by copyright. All rights reserved.

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West Nile virus encephalitis in GATA2 deficiency

We report a male with longstanding warts who presented with severe West Nile virus encephalitis (WNVE) and recovered after interferon alfa-2b and intravenous immunoglobulin. He was later found to have GATA2 de...

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From the pages of AllergyWatch

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): John J. Oppenheimer, David Michael Lang, Stanley M. Fineman

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Chronic Itch Management: Therapies Beyond Those Targeting the Immune System

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Emilie Fowler, Gil Yosipovitch

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Pattern of Medication Use in Children with Very Poorly Controlled Asthma

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Arlene M. Butz, Tricia Morphew, Melissa Bellin, Mary Elizabeth Bollinger, Mona Tsoukleris

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A within‐subject clinical trial on the conversion of mandibular 2‐implant to 3‐implant overdenture: Patient‐centered outcomes and willingness to pay

Abstract

Objectives

To examine the impact of adding a third midline implant with stud attachment to a mandibular 2‐implant overdenture on patient‐oriented outcomes.

Methods

In this pre–post design clinical trial, following the standard procedures, mandibular 2‐implant overdentures of 17 edentulous individuals (61.9 ± 6.6 years) were converted to 3‐implant overdentures by adding a stud attachment to an unloaded midline implant. Patient‐oriented outcomes included patient expectations and satisfaction with implant overdenture as well as willingness to pay the cost of conversion. Data were collected at baseline and at the 6‐week follow‐up using visual analog and binary scales as well as open‐ended questions. Statistical analysis included descriptive statistics, Spearman's correlation, Fisher exact test, Mann‐Whitney U, and the exact sign test.

Results

After connecting the third midline implant to the mandibular 2‐implant overdenture, there was a statistically significant decrease in the anteroposterior movement (p = 0.005) as evaluated by clinicians. Moreover, study participants reported an increase in perceived stability of the overdenture (95% CI 0.68‐1.00, p = 0.002), and in their ability to speak (95% CI 0.63‐1.00, p = 0.008). The addition of a third implant met the expectations of 94% of patients in regard to lower denture stability, 100% for retention, and 82.4% for comfort. The mandibular 3‐implant overdenture increased patient general satisfaction over a short period of time, but this improvement was not statistically significant. About 80% of patients would recommend this type of prosthesis to their peers but only 47% of them would agree to pay a large increase in the cost of treatment compared to a 2‐implant overdenture.

Conclusions

The addition of a midline third implant to an existing mandibular 2‐ implant overdenture resulted in several improved patient reported outcomes.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WhTR4M

West Nile virus encephalitis in GATA2 deficiency

We report a male with longstanding warts who presented with severe West Nile virus encephalitis (WNVE) and recovered after interferon alfa-2b and intravenous immunoglobulin. He was later found to have GATA2 de...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Re7VIP

From the pages of AllergyWatch

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): John J. Oppenheimer, David Michael Lang, Stanley M. Fineman

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MwzqMO

Chronic Itch Management: Therapies Beyond Those Targeting the Immune System

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Emilie Fowler, Gil Yosipovitch

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sLkCAR

Pattern of Medication Use in Children with Very Poorly Controlled Asthma

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Arlene M. Butz, Tricia Morphew, Melissa Bellin, Mary Elizabeth Bollinger, Mona Tsoukleris

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MyTo9A

Differentiation between intraspinal schwannoma and meningioma by MR characteristics and clinic features

Abstract

Objectives

To retrospectively review the MRI characteristics and clinic features and evaluate the effectiveness of MR imaging in differentiating intraspinal schwannomas and meningiomas, with the excised histopathologic findings as the reference standard.

Materials and methods

One hundred and four schwannomas (M/F, 57:47) and 53 meningiomas (M/F, 13:40) underwent MR examinations before surgical treatment. Simple clinic data and imaging findings were considered:(a) location (craniocaudal and axial), (b) size, (c) morphology, (d) dural contact, (e) signal characteristics, (f) enhancement degree and patterns. The usefulness of the algorithm for differential diagnosis was examined between the two tumors.

Results

Interobserver agreement was good (κ = 0.7–0.9). Ten cases meningiomas demonstrated multiple lesions. There was a female predominance in the meningiomas (P < 0.001). Meningiomas predominantly were located in the ventral or anterolateral areas of thoracic regions, while schwannomas in the posterolateral areas of the thoracic and the lumbar regions (P < 0.001). Mean size of the lesions was 1.47 ± 0.36 cm for meningioma, and 2.02 ± 1.13 cm for schwannoma (P < 0.001). A dumbbell shape with intervertebral foramen widening could detect schwannomas, while the "dural tail sign" did meningiomas (P < 0.001). Hypointense and miscellaneous signal implied meningioma on T₁WIs (P < 0.001). Isointense was more frequently observed in the meningiomas, while the fluid signal intensity and miscellaneous signal in the schwannomas on T₂WIs (P < 0.001). Schwannomas usually manifested rim enhancement, while meningiomas diffuse enhancement (P = 0.005). There were six variables including the logistic equation (age, size, dural tail sign, morphology, T₂WI, and axial location). The accuracy of the algorithm in diagnosis of schwannomas was 87.1%.

Conclusions

Combination of clinic data and MRI performs significantly for differentiating between intraspinal meningiomas and schwannomas.

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Contact dermatitis to homemade “slime”: Report of two cases with chemical analysis

Homemade slime is a new growing toy trend among children. We report 2 cases of hand dermatitis due to slime with analytical detection of isothiazolinones in slime and glue.

This article is protected by copyright. All rights reserved.

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Using health insurance administrative data to explore patching testing utilization in Ontario, Canada – An untapped resource

Background

Patch testing is the key diagnostic test for diagnosing allergic contact dermatitis, but there is limited information about the use of patch testing at the population level.

Objectives

To utilize Ontario Health Insurance Plan (OHIP) data to analyse trends in the rate of patch testing in Ontario.

Methods

Patch test billing data submitted to the OHIP between 1992 and 2014 was analysed. Two patch test billing codes were investigated, one for work‐related testing (G198) and one for non‐work‐related testing (G206). Rates of patch testing overall were calculated and trends over time were described.

Results

There were 51576 patch test billings, 48416 non‐work‐related and 3160 work‐related. The annual rate of non‐work‐related PT (G206) ranged from 11.9 per 100000 people to 25.9 per 100000 people, increasing over time. The rate for work‐related PT (G198) ranged from 0.17 to 2.32 per 1000000 people and was relatively stable. The overall distribution of billing by specialty was 70% dermatology, 19% other medical subspecialties, 10% paediatrics and family medicine.

Conclusions

Administrative health data can contribute to a more complete understanding of patch test utilization at the population level and, over time, can be used to track patch testing practices.

This article is protected by copyright. All rights reserved.

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Screening for hand dermatitis in healthcare workers: Comparing workplace screening with dermatologist photo screening

Background

Healthcare workers are at an increased risk for occupational contact dermatitis due to wet work exposure. Early detection and management improves outcomes. While several diagnostic tools are available, none are appropriate for rapid screening.

Objectives

To assess the validity and feasibility of the Hand Dermatitis Screening Tool in the acute healthcare sector.

Methods

Screening of 508 employees at three hospitals in Ontario, Canada was done using the Hand Dermatitis Screening Tool either by an occupational health nurse (OHN, N=225) or by self‐administration (N=283). Two occupational dermatologists rated photos of participants' hands.

Results

30.5% of participants screened positive for hand dermatitis. A positive screen was associated with wet work, history of eczema, dermatitis, or other rash, and presently having a rash. Ninety‐four per cent of participants reported that using the tool took < 2 minutes, 99% indicated the tool was easy to use and 86% reported workplace screening to be very important. Workplace and dermatologist photo screening showed fair agreement.

Conclusions

The prevalence of hand dermatitis and identified risk factors were consistent with the literature. These findings, along with positive feasibility results, support further testing of the tool despite only fair agreement between workplace and dermatologist screening.

This article is protected by copyright. All rights reserved.

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Differentiation between intraspinal schwannoma and meningioma by MR characteristics and clinic features

Abstract

Objectives

To retrospectively review the MRI characteristics and clinic features and evaluate the effectiveness of MR imaging in differentiating intraspinal schwannomas and meningiomas, with the excised histopathologic findings as the reference standard.

Materials and methods

One hundred and four schwannomas (M/F, 57:47) and 53 meningiomas (M/F, 13:40) underwent MR examinations before surgical treatment. Simple clinic data and imaging findings were considered:(a) location (craniocaudal and axial), (b) size, (c) morphology, (d) dural contact, (e) signal characteristics, (f) enhancement degree and patterns. The usefulness of the algorithm for differential diagnosis was examined between the two tumors.

Results

Interobserver agreement was good (κ = 0.7–0.9). Ten cases meningiomas demonstrated multiple lesions. There was a female predominance in the meningiomas (P < 0.001). Meningiomas predominantly were located in the ventral or anterolateral areas of thoracic regions, while schwannomas in the posterolateral areas of the thoracic and the lumbar regions (P < 0.001). Mean size of the lesions was 1.47 ± 0.36 cm for meningioma, and 2.02 ± 1.13 cm for schwannoma (P < 0.001). A dumbbell shape with intervertebral foramen widening could detect schwannomas, while the "dural tail sign" did meningiomas (P < 0.001). Hypointense and miscellaneous signal implied meningioma on T₁WIs (P < 0.001). Isointense was more frequently observed in the meningiomas, while the fluid signal intensity and miscellaneous signal in the schwannomas on T₂WIs (P < 0.001). Schwannomas usually manifested rim enhancement, while meningiomas diffuse enhancement (P = 0.005). There were six variables including the logistic equation (age, size, dural tail sign, morphology, T₂WI, and axial location). The accuracy of the algorithm in diagnosis of schwannomas was 87.1%.

Conclusions

Combination of clinic data and MRI performs significantly for differentiating between intraspinal meningiomas and schwannomas.

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Contact dermatitis to homemade “slime”: Report of two cases with chemical analysis

Homemade slime is a new growing toy trend among children. We report 2 cases of hand dermatitis due to slime with analytical detection of isothiazolinones in slime and glue.

This article is protected by copyright. All rights reserved.

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Using health insurance administrative data to explore patching testing utilization in Ontario, Canada – An untapped resource

Background

Patch testing is the key diagnostic test for diagnosing allergic contact dermatitis, but there is limited information about the use of patch testing at the population level.

Objectives

To utilize Ontario Health Insurance Plan (OHIP) data to analyse trends in the rate of patch testing in Ontario.

Methods

Patch test billing data submitted to the OHIP between 1992 and 2014 was analysed. Two patch test billing codes were investigated, one for work‐related testing (G198) and one for non‐work‐related testing (G206). Rates of patch testing overall were calculated and trends over time were described.

Results

There were 51576 patch test billings, 48416 non‐work‐related and 3160 work‐related. The annual rate of non‐work‐related PT (G206) ranged from 11.9 per 100000 people to 25.9 per 100000 people, increasing over time. The rate for work‐related PT (G198) ranged from 0.17 to 2.32 per 1000000 people and was relatively stable. The overall distribution of billing by specialty was 70% dermatology, 19% other medical subspecialties, 10% paediatrics and family medicine.

Conclusions

Administrative health data can contribute to a more complete understanding of patch test utilization at the population level and, over time, can be used to track patch testing practices.

This article is protected by copyright. All rights reserved.

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Screening for hand dermatitis in healthcare workers: Comparing workplace screening with dermatologist photo screening

Background

Healthcare workers are at an increased risk for occupational contact dermatitis due to wet work exposure. Early detection and management improves outcomes. While several diagnostic tools are available, none are appropriate for rapid screening.

Objectives

To assess the validity and feasibility of the Hand Dermatitis Screening Tool in the acute healthcare sector.

Methods

Screening of 508 employees at three hospitals in Ontario, Canada was done using the Hand Dermatitis Screening Tool either by an occupational health nurse (OHN, N=225) or by self‐administration (N=283). Two occupational dermatologists rated photos of participants' hands.

Results

30.5% of participants screened positive for hand dermatitis. A positive screen was associated with wet work, history of eczema, dermatitis, or other rash, and presently having a rash. Ninety‐four per cent of participants reported that using the tool took < 2 minutes, 99% indicated the tool was easy to use and 86% reported workplace screening to be very important. Workplace and dermatologist photo screening showed fair agreement.

Conclusions

The prevalence of hand dermatitis and identified risk factors were consistent with the literature. These findings, along with positive feasibility results, support further testing of the tool despite only fair agreement between workplace and dermatologist screening.

This article is protected by copyright. All rights reserved.

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Editorial Board

Publication date: February 2019

Source: Auris Nasus Larynx, Volume 46, Issue 1

Author(s):

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Editorial Board

Publication date: February 2019

Source: Auris Nasus Larynx, Volume 46, Issue 1

Author(s):

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Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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What is the Incidence of an Immune Disorder in Children With Invasive Pneumococcal Disease (IPD)?

Conditions:   Invasive Pneumococcal Disease, Recurrent Isolated, 1;   Invasive Pneumococcal Disease, Recurrent Isolated, 2;   Invasive Pneumococcal Disease, Protection Against;   Primary Immunodeficiency Intervention:   Other: Referral to Immunology Sponsor:   Murdoch Childrens Research Institute Recruiting (Source: ClinicalTrials.gov)

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Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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What is the Incidence of an Immune Disorder in Children With Invasive Pneumococcal Disease (IPD)?

Conditions:   Invasive Pneumococcal Disease, Recurrent Isolated, 1;   Invasive Pneumococcal Disease, Recurrent Isolated, 2;   Invasive Pneumococcal Disease, Protection Against;   Primary Immunodeficiency Intervention:   Other: Referral to Immunology Sponsor:   Murdoch Childrens Research Institute Recruiting (Source: ClinicalTrials.gov)

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A new analysis workflow for discrimination of nuclear grade graphite using laser-induced breakdown spectroscopy

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): John P.O. Horsfall, Divyesh Trivedi, Nick T. Smith, Philip A. Martin, Paul Coffey, Stella Tournier, Anthony Banford, Lin Li, David Whitehead, Adam Lang, Gareth T.W. Law

Abstract

Stand-off, in-situ, laser induced breakdown spectroscopy (LIBS) offers a rapid, safe, and cost-effective method for discrimination of radioactive waste materials arising during the operation of nuclear plants and from decommissioning activities. Characterisation of waste materials is a critical activity in understanding the nature of the waste, ensuring hazardous material is managed safely and that waste can be segregated for reuse, recycle or sentenced for appropriate disposal. Characterisation of materials, often in hostile environments, requires the ability to remotely differentiate between materials in terms of their chemical composition and radioactivity.

This proposition was tested using a case study on nuclear grade graphite. Graphite has been used extensively as a moderator material in many nuclear reactors. Internationally, over 250,000 tons of various nuclear-grade graphite, and graphite-bearing, materials exist. These are a major issue for nuclear decommissioning and radioactive waste management, due to the long half-lives of the associated ¹⁴C and ³⁶Cl isotopes. LIBS offers a method for discrimination of nuclear grade graphites and other carbon and non-carbon-bearing wastes. This paper describes the development of a workflow method, including LIBS measurement analysis, for the discrimination of pre-irradiated nuclear 'Pile Grade A' (PGA) graphite moderator rod and domestic lumpwood charcoal, which act as surrogates for nuclear grade graphite and other carbon-bearing wastes. A new analysis workflow comprising the examination of spectral characteristics, multivariate analysis and molecular isotopic spectroscopy is proposed to enable rapid segregation of graphite from a heterogeneous waste stream. Enhanced characterisation techniques have the potential to significantly reduce the cost of decommissioning large parts of legacy nuclear generation plants.

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Radon removal trap design and coefficient testing for the development of an effective radioxenon sampling, separation and measurement system

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): Chongyang Zhou, Guoqing Zhou, Shujuan Feng, Xinhua Zhao, Dingwei Huang, Zining Tian, Xiaolong Yu, Ziwei Cheng

Abstract

To monitor low-level radioxenon isotopes activity concentrations in the bulk gases, a radioxenon sampling, separation and measurement system has been developed. The xenon enrichment factor of this system is more than 10⁵ after the separation of impurities, including N₂, O₂, CO₂and H₂O, as well as radon and its progenies, such as ²¹⁴Pb and ²¹⁴Bi. Since radon and its progenies interfere with radioxenon measurement, they have to be removed before radioxenon counting. To separate radon from xenon, different dynamic adsorption coefficients of xenon and radon are used to design small radon removal trap to retain radon after eluting xenon, and the ratio between radon and xenon dynamic adsorption coefficient gives the adsorbent weight relationship between the xenon adsorption trap and its related radon removal trap. To test the effectiveness of radon removal, the relative measuring method is used by measuring γ-rays energies of radon progenies in canister filling with either the measuring sample prepared by the system or the original gas. The results show that the radon removal coefficient and the stable xenon recovery, which are two important parameters in the radioxenon system, are at the order of 10⁻⁶ and >70% respectively. These meet the specifications proposed by the Comprehensive Nuclear-Test-Ban Treaty Organization.

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A new analysis workflow for discrimination of nuclear grade graphite using laser-induced breakdown spectroscopy

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): John P.O. Horsfall, Divyesh Trivedi, Nick T. Smith, Philip A. Martin, Paul Coffey, Stella Tournier, Anthony Banford, Lin Li, David Whitehead, Adam Lang, Gareth T.W. Law

Abstract

Stand-off, in-situ, laser induced breakdown spectroscopy (LIBS) offers a rapid, safe, and cost-effective method for discrimination of radioactive waste materials arising during the operation of nuclear plants and from decommissioning activities. Characterisation of waste materials is a critical activity in understanding the nature of the waste, ensuring hazardous material is managed safely and that waste can be segregated for reuse, recycle or sentenced for appropriate disposal. Characterisation of materials, often in hostile environments, requires the ability to remotely differentiate between materials in terms of their chemical composition and radioactivity.

This proposition was tested using a case study on nuclear grade graphite. Graphite has been used extensively as a moderator material in many nuclear reactors. Internationally, over 250,000 tons of various nuclear-grade graphite, and graphite-bearing, materials exist. These are a major issue for nuclear decommissioning and radioactive waste management, due to the long half-lives of the associated ¹⁴C and ³⁶Cl isotopes. LIBS offers a method for discrimination of nuclear grade graphites and other carbon and non-carbon-bearing wastes. This paper describes the development of a workflow method, including LIBS measurement analysis, for the discrimination of pre-irradiated nuclear 'Pile Grade A' (PGA) graphite moderator rod and domestic lumpwood charcoal, which act as surrogates for nuclear grade graphite and other carbon-bearing wastes. A new analysis workflow comprising the examination of spectral characteristics, multivariate analysis and molecular isotopic spectroscopy is proposed to enable rapid segregation of graphite from a heterogeneous waste stream. Enhanced characterisation techniques have the potential to significantly reduce the cost of decommissioning large parts of legacy nuclear generation plants.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B336g2

Radon removal trap design and coefficient testing for the development of an effective radioxenon sampling, separation and measurement system

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): Chongyang Zhou, Guoqing Zhou, Shujuan Feng, Xinhua Zhao, Dingwei Huang, Zining Tian, Xiaolong Yu, Ziwei Cheng

Abstract

To monitor low-level radioxenon isotopes activity concentrations in the bulk gases, a radioxenon sampling, separation and measurement system has been developed. The xenon enrichment factor of this system is more than 10⁵ after the separation of impurities, including N₂, O₂, CO₂and H₂O, as well as radon and its progenies, such as ²¹⁴Pb and ²¹⁴Bi. Since radon and its progenies interfere with radioxenon measurement, they have to be removed before radioxenon counting. To separate radon from xenon, different dynamic adsorption coefficients of xenon and radon are used to design small radon removal trap to retain radon after eluting xenon, and the ratio between radon and xenon dynamic adsorption coefficient gives the adsorbent weight relationship between the xenon adsorption trap and its related radon removal trap. To test the effectiveness of radon removal, the relative measuring method is used by measuring γ-rays energies of radon progenies in canister filling with either the measuring sample prepared by the system or the original gas. The results show that the radon removal coefficient and the stable xenon recovery, which are two important parameters in the radioxenon system, are at the order of 10⁻⁶ and >70% respectively. These meet the specifications proposed by the Comprehensive Nuclear-Test-Ban Treaty Organization.

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Dual-energy CT angiography-derived virtual non-contrast images for follow-up of patients with surgically clipped aneurysms: a retrospective study

Abstract

Purpose

To evaluate the diagnostic performance, image quality, artifacts, and radiation doses of virtual non-contrast (VNC) images, relative to true non-contrast (TNC) images, in patients with surgically clipped aneurysms.

Methods

Seventy-six patients who underwent unenhanced computed tomography (CT) and dual-energy (DE)-CT angiography after surgical clipping of 85 intracranial aneurysms were included in the study. Diagnostic performances of VNC and TNC images were compared with respect to sensitivity, specificity, and positive and negative predictive values. The results of quantitative and qualitative analyses were compared between VNC and TNC images. Radiation doses were also compared between VNC and TNC images.

Results

Diagnostic performance of VNC images was lower than that of TNC images; however, addition of contrast-enhanced images improved diagnostic performance. Image noise and mean attenuation of VNC images were significantly higher than those of TNC images in the centrum semiovale, cerebellum, and pons. The quality of VNC images was excellent or sufficient (85.5% for observer 1, 85.5% for observer 2), and complete acceptance of VNC images was achieved in 64.5% for observer 1 and in 71.0% for observer 2; however, the addition of contrast-enhanced images increased the level of acceptance (92.0% for observer 1, 90.9% for observer 2). Clip artifacts were significantly lower in VNC images than in TNC images. CT dose index, dose-length product, and effective dose were significantly lower without TNC images.

Conclusion

VNC images showed lower diagnostic performance and image quality, and higher image noise than TNC images; however, VNC images could reduce clip artifacts and radiation doses.

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Maternal allergen-specific IgG may protect the child against allergic sensitization

Publication date: Available online 25 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Christian Lupinek, Heidrun Hochwallner, Catharina Johansson, Axel Mie, Eva Rigler, Annika Scheynius, Johan Alm, Rudolf Valenta

Abstract

Background

The analysis of allergen-specific IgE responses in birth cohorts with micro-arrayed allergens has provided detailed information regarding the evolution of specific IgE responses in children. High resolution data regarding early development of allergen-specific IgG are needed.

Objective

To analyze IgG reactivity to micro-arrayed allergens in mothers during pregnancy, in cord blood samples, breast milk and in infants in the first years of life with the aim to investigate if maternal allergen-specific IgG may protect against IgE sensitization in the offspring.

Methods

Plasma samples from mothers during third trimester, cord blood, breast milk collected at 2 months after delivery, and plasma samples from children at 6, 12 and 60 months of age were analyzed for IgG reactivity to 164 micro-arrayed allergens (ImmunoCAP ISAC technology) in 99 families in the Swedish birth cohort ALADDIN. IgE sensitizations to micro-arrayed allergens were determined at 5 years of age in the children.

Results

Allergen-specific IgG reactivity profiles in mothers, cord blood and breast milk were highly correlated. Maternal allergen-specific IgG persisted in some children at 6 months. Children´s allergen-specific IgG production occurred at 6 months and reflected allergen exposure. Children who were IgE-sensitized against an allergen at 5 years of age had significantly higher allergen-specific IgG levels than non-sensitized children. For all 164 tested allergens, children from mothers with elevated (>30 ISU) specific plasma IgG against an allergen had no IgE sensitizations against that allergen at 5 years of age.

Conclusion

This is the first detailed analysis of the molecular IgG recognition profile in mothers and their children in early life. High allergen-specific IgG reactivity in mother´s plasma and breast milk and in cord blood seemed to protect against allergic sensitization at 5 years of age.

Clinical implication

High levels of allergen-specific IgG in mothers during third trimester and in cord blood seem to protect against allergic sensitization in the offsprings. This finding has implications for the prevention of allergy.

Graphical abstract

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Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis

Publication date: Available online 24 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Lisa Zhou, Alexandra Leonard, Ana B. Pavel, Kunal Malik, Aishwarya Raja, Jacob Glickman, Yeriel D. Estrada, Xiangyu Peng, Ester del Duca, Juan Sanz-Cabanillas, Juan Ruano, Hui Xu, Ning Zhang, Huei-Chi Wen, Juana Gonzalez, Sandra Garcet, James G. Krueger, Emma Guttman-Yassky

Abstract

Background

Atopic dermatitis/AD shows differential clinical presentation in older compared to younger patients. Nevertheless, changes in the AD molecular profile with age are unknown.

Objective

To characterize age-related changes in the AD profile.

Methods

We evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) using immunohistochemistry, qRT-PCR, and Singulex in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and 61+ years old).

Results

While disease severity/SCORAD was similar across AD age-groups (mean:∼60; P=0.873), dendritic cell infiltrates (CD1b⁺, FcεRI⁺; P<0.05) decreased with age. T_H2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls. Consistent with T_H2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD (r=-0.24, r=-0.23, P<0.05). T_H22-secreted IL-22 also decreased with age uniquely in AD (P<0.05). T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P<0.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P<0.05 for IL-20) increased with age in both AD and controls. Terminal differentiation measures significantly increased in older AD patients (LOR, FLG; P<0.05), while S100As (S100A8; P<0.01) and hyperplasia markers (epidermal thickness/ET, K16, Ki67; P<0.05 for K16) decreased. Serum trends in AD mimicked skin findings, with T_H2 downregulation (CCL26; r=-0.32, P<0.1) and T_H1 upregulation (IFN-γ; r=0.48, P<0.01) with age.

Conclusion

The adult AD profile varies with age. While T_H1/T_H17-skewing decreases in both AD and controls, AD shows unique decreases in T_H2/T_H22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD.

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Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Conclusions The majority of patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI achieve open set speech perception, with 75% of these patients meeting criteria for being intermediate to high performers. Additional benefits include improved subjective hearing measures, decreased tinnitus, and improved sound localization. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Dual-energy CT angiography-derived virtual non-contrast images for follow-up of patients with surgically clipped aneurysms: a retrospective study

Abstract

Purpose

To evaluate the diagnostic performance, image quality, artifacts, and radiation doses of virtual non-contrast (VNC) images, relative to true non-contrast (TNC) images, in patients with surgically clipped aneurysms.

Methods

Seventy-six patients who underwent unenhanced computed tomography (CT) and dual-energy (DE)-CT angiography after surgical clipping of 85 intracranial aneurysms were included in the study. Diagnostic performances of VNC and TNC images were compared with respect to sensitivity, specificity, and positive and negative predictive values. The results of quantitative and qualitative analyses were compared between VNC and TNC images. Radiation doses were also compared between VNC and TNC images.

Results

Diagnostic performance of VNC images was lower than that of TNC images; however, addition of contrast-enhanced images improved diagnostic performance. Image noise and mean attenuation of VNC images were significantly higher than those of TNC images in the centrum semiovale, cerebellum, and pons. The quality of VNC images was excellent or sufficient (85.5% for observer 1, 85.5% for observer 2), and complete acceptance of VNC images was achieved in 64.5% for observer 1 and in 71.0% for observer 2; however, the addition of contrast-enhanced images increased the level of acceptance (92.0% for observer 1, 90.9% for observer 2). Clip artifacts were significantly lower in VNC images than in TNC images. CT dose index, dose-length product, and effective dose were significantly lower without TNC images.

Conclusion

VNC images showed lower diagnostic performance and image quality, and higher image noise than TNC images; however, VNC images could reduce clip artifacts and radiation doses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B5b1JU

Maternal allergen-specific IgG may protect the child against allergic sensitization

Publication date: Available online 25 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Christian Lupinek, Heidrun Hochwallner, Catharina Johansson, Axel Mie, Eva Rigler, Annika Scheynius, Johan Alm, Rudolf Valenta

Abstract

Background

The analysis of allergen-specific IgE responses in birth cohorts with micro-arrayed allergens has provided detailed information regarding the evolution of specific IgE responses in children. High resolution data regarding early development of allergen-specific IgG are needed.

Objective

To analyze IgG reactivity to micro-arrayed allergens in mothers during pregnancy, in cord blood samples, breast milk and in infants in the first years of life with the aim to investigate if maternal allergen-specific IgG may protect against IgE sensitization in the offspring.

Methods

Plasma samples from mothers during third trimester, cord blood, breast milk collected at 2 months after delivery, and plasma samples from children at 6, 12 and 60 months of age were analyzed for IgG reactivity to 164 micro-arrayed allergens (ImmunoCAP ISAC technology) in 99 families in the Swedish birth cohort ALADDIN. IgE sensitizations to micro-arrayed allergens were determined at 5 years of age in the children.

Results

Allergen-specific IgG reactivity profiles in mothers, cord blood and breast milk were highly correlated. Maternal allergen-specific IgG persisted in some children at 6 months. Children´s allergen-specific IgG production occurred at 6 months and reflected allergen exposure. Children who were IgE-sensitized against an allergen at 5 years of age had significantly higher allergen-specific IgG levels than non-sensitized children. For all 164 tested allergens, children from mothers with elevated (>30 ISU) specific plasma IgG against an allergen had no IgE sensitizations against that allergen at 5 years of age.

Conclusion

This is the first detailed analysis of the molecular IgG recognition profile in mothers and their children in early life. High allergen-specific IgG reactivity in mother´s plasma and breast milk and in cord blood seemed to protect against allergic sensitization at 5 years of age.

Clinical implication

High levels of allergen-specific IgG in mothers during third trimester and in cord blood seem to protect against allergic sensitization in the offsprings. This finding has implications for the prevention of allergy.

Graphical abstract

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tf87Jo

Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis

Publication date: Available online 24 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Lisa Zhou, Alexandra Leonard, Ana B. Pavel, Kunal Malik, Aishwarya Raja, Jacob Glickman, Yeriel D. Estrada, Xiangyu Peng, Ester del Duca, Juan Sanz-Cabanillas, Juan Ruano, Hui Xu, Ning Zhang, Huei-Chi Wen, Juana Gonzalez, Sandra Garcet, James G. Krueger, Emma Guttman-Yassky

Abstract

Background

Atopic dermatitis/AD shows differential clinical presentation in older compared to younger patients. Nevertheless, changes in the AD molecular profile with age are unknown.

Objective

To characterize age-related changes in the AD profile.

Methods

We evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) using immunohistochemistry, qRT-PCR, and Singulex in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and 61+ years old).

Results

While disease severity/SCORAD was similar across AD age-groups (mean:∼60; P=0.873), dendritic cell infiltrates (CD1b⁺, FcεRI⁺; P<0.05) decreased with age. T_H2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls. Consistent with T_H2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD (r=-0.24, r=-0.23, P<0.05). T_H22-secreted IL-22 also decreased with age uniquely in AD (P<0.05). T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P<0.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P<0.05 for IL-20) increased with age in both AD and controls. Terminal differentiation measures significantly increased in older AD patients (LOR, FLG; P<0.05), while S100As (S100A8; P<0.01) and hyperplasia markers (epidermal thickness/ET, K16, Ki67; P<0.05 for K16) decreased. Serum trends in AD mimicked skin findings, with T_H2 downregulation (CCL26; r=-0.32, P<0.1) and T_H1 upregulation (IFN-γ; r=0.48, P<0.01) with age.

Conclusion

The adult AD profile varies with age. While T_H1/T_H17-skewing decreases in both AD and controls, AD shows unique decreases in T_H2/T_H22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B2Z9YK

Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Conclusions The majority of patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI achieve open set speech perception, with 75% of these patients meeting criteria for being intermediate to high performers. Additional benefits include improved subjective hearing measures, decreased tinnitus, and improved sound localization. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity

Publication date: Available online 24 January 2019

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Z.-H. Ren, K. Wu, Y. Wang, Z.-W. Tian, J.-Z. Hu

Abstract

Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n = 89) or control (n = 151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate. Only two patients developed transoral salivary fistulas in the experimental group, while in the control group there were 14 (9%). The incidence of fistulas in the experimental group was significantly lower than that in the control group (p = 0.035). Regression analysis showed that there was a significant correlation between the groups and the incidence of salivary fistulas (p = 0.032). The two-step suture technique is safe, effective, and easy to learn, and could reduce the incidence of postoperative salivary fistulas.

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Automated CT Quantification Methods for the Assessment of Interstitial Lung Disease in Collagen Vascular Diseases: A Systematic Review

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Florien S. van Royen, Sofia A. Moll, Jacob M. van Laar, Joris M. van Montfrans, Pim A. de Jong, Firdaus A.A. Mohamed Hoesein

Abstract

Interstitial lung disease (ILD) is highly prevalent in collagen vascular diseases and reduction of ILD is an important therapeutic target. To that end, reliable quantification of pulmonary disease severity is of great significance. This study systematically reviewed the literature on automated computed tomography (CT) quantification methods for assessing ILD in collagen vascular diseases. PRISMA-DTA guidelines for systematic reviews were used and 19 original research articles up to January 2018 were included based on a MEDLINE/Pubmed and Embase search. Quantitative CT methods were categorized as histogram assessment (12 studies) or pattern/texture recognition (7 studies). R² for correlation with visual ILD scoring ranged from 0.143 (p < 0.01) to 0.687 (p < 0.0001), for FVC from 0.048 (p < 0.0001) to 0.504 (p < 0.0001) and for DLCO from 0.015 (p = 0.61) to 0.449 (p < 0.0001). Automated CT methods are independent of reader's expertise and are a promising tool in the quantification of ILD in collagen vascular disease patients.

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Automated CT Quantification Methods for the Assessment of Interstitial Lung Disease in Collagen Vascular Diseases: A Systematic Review

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Florien S. van Royen, Sofia A. Moll, Jacob M. van Laar, Joris M. van Montfrans, Pim A. de Jong, Firdaus A.A. Mohamed Hoesein

Abstract

Interstitial lung disease (ILD) is highly prevalent in collagen vascular diseases and reduction of ILD is an important therapeutic target. To that end, reliable quantification of pulmonary disease severity is of great significance. This study systematically reviewed the literature on automated computed tomography (CT) quantification methods for assessing ILD in collagen vascular diseases. PRISMA-DTA guidelines for systematic reviews were used and 19 original research articles up to January 2018 were included based on a MEDLINE/Pubmed and Embase search. Quantitative CT methods were categorized as histogram assessment (12 studies) or pattern/texture recognition (7 studies). R² for correlation with visual ILD scoring ranged from 0.143 (p < 0.01) to 0.687 (p < 0.0001), for FVC from 0.048 (p < 0.0001) to 0.504 (p < 0.0001) and for DLCO from 0.015 (p = 0.61) to 0.449 (p < 0.0001). Automated CT methods are independent of reader's expertise and are a promising tool in the quantification of ILD in collagen vascular disease patients.

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MRI Texture Analysis based on 3D tumor measurement Reflects the IDH1 Mutations in Gliomas - A Preliminary Study

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Liang Han, Siyu Wang, Yanwei Miao, Huicong Shen, Yan Guo, Lizhi Xie, Yuqing Shang, Junyi Dong, Xiaoxin Li, Weiwei Wang, Qingwei Song

Abstract

Objective

To evaluate the differentiation efficiency of texture analysis of T1WI, T2WI and contrasted-enhanced T1WI MRI sequences in gliomas with and without IDH1 mutation based on entire tumor region.

Materials and methods

A total of 42 patients with histopathologically confirmed gliomas, including 21 patients carrying IDH1 mutation (IDH1^mutation group) and 21 with wild-type IDH1 (IDH1^wt group) were included in this study. The preoperative MRI and clinical data were collected. The regions of interest (ROIs) covering the entire tumor and edema were manually delineated on axial slices using O.K. (Omni Kinetics, GE Healthcare, China) software; and the histogram and GLCM features based on T1WI, T2WI and contrasted-enhanced T1WI sequences were automatically generated.

Results

Based on contrasted-enhanced T1WI features, the inertia resulted as the best feature for diagnosis, with the AUC of 0.844. Furthermore, the AUC for gliomas prediction with IDH1^mutation was 0.800 for cluster prominence. IDH1-mutation was differentiated on T2WI with the highest AUC of 0.848, which corresponded to GLCM Entropy. After modeling, the accuracy of the contrasted-enhanced T1WI, T1WI, and T2WI features model was 0.952, 0.857, and 0.738, respectively. The AUC of Joint Variable_T1WI+C for predicting IDH1^mutation was 0.984, while the AUC of Joint Variable_T1WI for predicting the same mutation was 0.927. The diagnostic efficiency of Joint Variable_T2WI was also desirable.

Conclusion

MRI texture analysis could be used as a new noninvasive method for identification of gliomas with IDH1 mutation. The present results show that the Joint Variable derived from conventional MR imaging histogram and GLCM features is suitable for precise detection of IDH1-mutated gliomas.

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