A case of minor salivary gland sialolithiasis of the upper lip

Abstract

Background

Sialolithiasis is the most common disease of the salivary glands. Sialolithiasis usually develops in the major salivary glands, and rarely in the minor salivary glands, with only 2% of all cases of sialolithiasis occurring in the minor salivary glands and sublingual glands. Sialoliths in the minor salivary glands result in few or no clinical symptoms and are seldom identified on imaging.

Case presentation

We report herein our experience with a case of minor salivary gland sialolithiasis in a 67-year-old woman. On examination, an elastic soft, mobile, and well-circumscribed mass was palpable within the left upper lip. Ultrasound examination revealed a hypoechoic mass with heterogeneous internal echoes. The mass was excised under local anesthesia. Based on histopathological findings, a diagnosis of minor salivary gland sialolithiasis was established.

Conclusions

Diagnosis of minor salivary gland sialolithiasis is challenging due to the difficulty of detecting sialoliths on imaging. A well-circumscribed mass was detected in the upper lip, and ultrasound examination revealed a round lesion, raising the suspicion of a benign tumor. Other diseases that can develop at the upper lip are calcified lymph node, phlebolith, fibroma, pleomorphic adenoma, myxoma, vascular malformation, salivary gland tumor, non-specific sialadenitis, and malignant tumor. Surgical excision is the favored approach for confirming a diagnosis of intramucosal nodular lesions.

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

A case of minor salivary gland sialolithiasis of the upper lip

Abstract

Background

Sialolithiasis is the most common disease of the salivary glands. Sialolithiasis usually develops in the major salivary glands, and rarely in the minor salivary glands, with only 2% of all cases of sialolithiasis occurring in the minor salivary glands and sublingual glands. Sialoliths in the minor salivary glands result in few or no clinical symptoms and are seldom identified on imaging.

Case presentation

We report herein our experience with a case of minor salivary gland sialolithiasis in a 67-year-old woman. On examination, an elastic soft, mobile, and well-circumscribed mass was palpable within the left upper lip. Ultrasound examination revealed a hypoechoic mass with heterogeneous internal echoes. The mass was excised under local anesthesia. Based on histopathological findings, a diagnosis of minor salivary gland sialolithiasis was established.

Conclusions

Diagnosis of minor salivary gland sialolithiasis is challenging due to the difficulty of detecting sialoliths on imaging. A well-circumscribed mass was detected in the upper lip, and ultrasound examination revealed a round lesion, raising the suspicion of a benign tumor. Other diseases that can develop at the upper lip are calcified lymph node, phlebolith, fibroma, pleomorphic adenoma, myxoma, vascular malformation, salivary gland tumor, non-specific sialadenitis, and malignant tumor. Surgical excision is the favored approach for confirming a diagnosis of intramucosal nodular lesions.

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

The Role of Progesterone in Cellular Apoptosis of Skin and Lung in a Bleomycin-injured Mouse Model

Systemic sclerosis is a female predominant, a fibrotic autoimmune disease in which disturbance in tissue homeostasis and cell turnover including cell apoptosis are central events in pathogenesis. Sex hormones are known as the important players in sexual dimorphism of autoimmune diseases and in tissue homeostasis. Progesterone influences autoimmune disease via its immunomodulatory effect or by its direct action on parenchymal cell function. On the other hand, this hormone impacts tissue homeostasis by acting on cell apoptosis in a different situation. The objective of this study was to examine the effect of progesterone on cellular apoptosis of skin and lung tissues in a mouse model of scleroderma. Four group of mice were involved in this study with 10 mice in each. The fibrotic model was induced by daily subcutaneous injection of bleomycin for 28 days. One week after initiation of fibrosis induction, mice received subcutaneous progesterone alone or with bleomycin for 21 days. Control group received only Phosphate buffered saline PBS. After 28 days, under lethal anesthesia skin and lung tissues were harvested for histological assessment and hydroxyproline measurement. Apoptosis in tissue sections was detected by TUNEL assay technique. Bleomycin administration induced fibrosis in skin and lung tissues. Severe apoptosis was seen in skin and lung tissues of the bleomycin-treated group (p<0.001 in the skin and p<0.05 in the lung). Progesterone injection either in the skin (p>0.05) or in the lung (p>0.05) did not alter apoptosis in bleomycin-treated animals. Our data confirm the role of apoptosis in the pathogenesis of fibrosis in this model; however, progesterone does not affect cellular apoptosis in skin and lung tissues of bleomycin-injured animals.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RCgq0k

The Role of Progesterone in Cellular Apoptosis of Skin and Lung in a Bleomycin-injured Mouse Model

Systemic sclerosis is a female predominant, a fibrotic autoimmune disease in which disturbance in tissue homeostasis and cell turnover including cell apoptosis are central events in pathogenesis. Sex hormones are known as the important players in sexual dimorphism of autoimmune diseases and in tissue homeostasis. Progesterone influences autoimmune disease via its immunomodulatory effect or by its direct action on parenchymal cell function. On the other hand, this hormone impacts tissue homeostasis by acting on cell apoptosis in a different situation. The objective of this study was to examine the effect of progesterone on cellular apoptosis of skin and lung tissues in a mouse model of scleroderma. Four group of mice were involved in this study with 10 mice in each. The fibrotic model was induced by daily subcutaneous injection of bleomycin for 28 days. One week after initiation of fibrosis induction, mice received subcutaneous progesterone alone or with bleomycin for 21 days. Control group received only Phosphate buffered saline PBS. After 28 days, under lethal anesthesia skin and lung tissues were harvested for histological assessment and hydroxyproline measurement. Apoptosis in tissue sections was detected by TUNEL assay technique. Bleomycin administration induced fibrosis in skin and lung tissues. Severe apoptosis was seen in skin and lung tissues of the bleomycin-treated group (p<0.001 in the skin and p<0.05 in the lung). Progesterone injection either in the skin (p>0.05) or in the lung (p>0.05) did not alter apoptosis in bleomycin-treated animals. Our data confirm the role of apoptosis in the pathogenesis of fibrosis in this model; however, progesterone does not affect cellular apoptosis in skin and lung tissues of bleomycin-injured animals.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RCgq0k

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


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

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


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

Creating an Easier Path for Head/Neck Cancer Patients

Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers—understood the process, what to expect and how to prepare for next steps. After deciding to create this process pathway and getting it approved by the hospital cancer board ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GoFm9E

Creating an Easier Path for Head/Neck Cancer Patients

Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers—understood the process, what to expect and how to prepare for next steps. After deciding to create this process pathway and getting it approved by the hospital cancer board ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GoFm9E

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


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

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


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

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S9P8DO

A Practical Approach for the Verification and Determination of Site- and Trimester-Specific Reference Intervals for Thyroid Function Tests in Pregnancy

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S9P8DO

The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière’s disease on MRI

Abstract

Purpose

There is still a clinical-radiologic discrepancy in patients with Menière's disease (MD). Therefore, the purpose of this study was to investigate the reliability of current MRI endolymphatic hydrops (EH) criteria according to Baráth in a larger study population and the clinical utility of new imaging signs such as a supplementary fourth low-grade vestibular EH and the degree of perilymphatic enhancement (PE) in patients with Menière's disease (MD).

Methods

This retrospective study included 148 patients with probable or definite MD according to the 2015 American Academy of Otolaryngology, Head and Neck Surgery criteria who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI between January 2015 and December 2016. Vestibular EH, vestibular PE, cochlear EH, and cochlear PE were reviewed twice by three experienced readers. Cohen's Kappa and multivariate logistic regression were used for analysis.

Results

The intra- and inter-reader reliability for the grading of vestibular-cochlear EH and PE was excellent (0.7 < kappa < 0.9). The two most distinctive characteristics to identify MD are cochlear PE and vestibular EH which combined gave a sensitivity and specificity of 79.5 and 93.6%. By addition of a lower grade vestibular EH, the sensitivity improved to 84.6% without losing specificity (92.3%). Cochlear EH nor vestibular PE showed added-value.

Conclusions

MRI using vestibular-cochlear EH and PE grading system is a reliable technique. A four-stage vestibular EH grading system in combination with cochlear PE assessment gives the best diagnostic accuracy to detect MD.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2StvwK7

The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière’s disease on MRI

Abstract

Purpose

There is still a clinical-radiologic discrepancy in patients with Menière's disease (MD). Therefore, the purpose of this study was to investigate the reliability of current MRI endolymphatic hydrops (EH) criteria according to Baráth in a larger study population and the clinical utility of new imaging signs such as a supplementary fourth low-grade vestibular EH and the degree of perilymphatic enhancement (PE) in patients with Menière's disease (MD).

Methods

This retrospective study included 148 patients with probable or definite MD according to the 2015 American Academy of Otolaryngology, Head and Neck Surgery criteria who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI between January 2015 and December 2016. Vestibular EH, vestibular PE, cochlear EH, and cochlear PE were reviewed twice by three experienced readers. Cohen's Kappa and multivariate logistic regression were used for analysis.

Results

The intra- and inter-reader reliability for the grading of vestibular-cochlear EH and PE was excellent (0.7 < kappa < 0.9). The two most distinctive characteristics to identify MD are cochlear PE and vestibular EH which combined gave a sensitivity and specificity of 79.5 and 93.6%. By addition of a lower grade vestibular EH, the sensitivity improved to 84.6% without losing specificity (92.3%). Cochlear EH nor vestibular PE showed added-value.

Conclusions

MRI using vestibular-cochlear EH and PE grading system is a reliable technique. A four-stage vestibular EH grading system in combination with cochlear PE assessment gives the best diagnostic accuracy to detect MD.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2StvwK7

Congenital hypothyroidism as a risk factor for central hearing process disorders

Conclusions: The data obtained show a high frequency of lag symptoms in cognitive functions related to central auditory processing, particularly with regard to auditory attention, figure-background ability and auditory memory in patients with congenital hypothyroidism. (Source: Revista Paulista de Pediatria)

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

A case of minor salivary gland sialolithiasis of the upper lip

Abstract

Background

Sialolithiasis is the most common disease of the salivary glands. Sialolithiasis usually develops in the major salivary glands, and rarely in the minor salivary glands, with only 2% of all cases of sialolithiasis occurring in the minor salivary glands and sublingual glands. Sialoliths in the minor salivary glands result in few or no clinical symptoms and are seldom identified on imaging.

Case presentation

We report herein our experience with a case of minor salivary gland sialolithiasis in a 67-year-old woman. On examination, an elastic soft, mobile, and well-circumscribed mass was palpable within the left upper lip. Ultrasound examination revealed a hypoechoic mass with heterogeneous internal echoes. The mass was excised under local anesthesia. Based on histopathological findings, a diagnosis of minor salivary gland sialolithiasis was established.

Conclusions

Diagnosis of minor salivary gland sialolithiasis is challenging due to the difficulty of detecting sialoliths on imaging. A well-circumscribed mass was detected in the upper lip, and ultrasound examination revealed a round lesion, raising the suspicion of a benign tumor. Other diseases that can develop at the upper lip are calcified lymph node, phlebolith, fibroma, pleomorphic adenoma, myxoma, vascular malformation, salivary gland tumor, non-specific sialadenitis, and malignant tumor. Surgical excision is the favored approach for confirming a diagnosis of intramucosal nodular lesions.

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

Congenital hypothyroidism as a risk factor for central hearing process disorders

Conclusions: The data obtained show a high frequency of lag symptoms in cognitive functions related to central auditory processing, particularly with regard to auditory attention, figure-background ability and auditory memory in patients with congenital hypothyroidism. (Source: Revista Paulista de Pediatria)

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

A case of minor salivary gland sialolithiasis of the upper lip

Abstract

Background

Sialolithiasis is the most common disease of the salivary glands. Sialolithiasis usually develops in the major salivary glands, and rarely in the minor salivary glands, with only 2% of all cases of sialolithiasis occurring in the minor salivary glands and sublingual glands. Sialoliths in the minor salivary glands result in few or no clinical symptoms and are seldom identified on imaging.

Case presentation

We report herein our experience with a case of minor salivary gland sialolithiasis in a 67-year-old woman. On examination, an elastic soft, mobile, and well-circumscribed mass was palpable within the left upper lip. Ultrasound examination revealed a hypoechoic mass with heterogeneous internal echoes. The mass was excised under local anesthesia. Based on histopathological findings, a diagnosis of minor salivary gland sialolithiasis was established.

Conclusions

Diagnosis of minor salivary gland sialolithiasis is challenging due to the difficulty of detecting sialoliths on imaging. A well-circumscribed mass was detected in the upper lip, and ultrasound examination revealed a round lesion, raising the suspicion of a benign tumor. Other diseases that can develop at the upper lip are calcified lymph node, phlebolith, fibroma, pleomorphic adenoma, myxoma, vascular malformation, salivary gland tumor, non-specific sialadenitis, and malignant tumor. Surgical excision is the favored approach for confirming a diagnosis of intramucosal nodular lesions.

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

Creating an Easier Path for Head/Neck Cancer Patients

Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers—understood the process, what to expect and how to prepare for next steps. After deciding to create this process pathway and getting it approved by the hospital cancer board ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GoFm9E

Creating an Easier Path for Head/Neck Cancer Patients

Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers—understood the process, what to expect and how to prepare for next steps. After deciding to create this process pathway and getting it approved by the hospital cancer board ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GoFm9E

Pediatric immune diseases, all genetics?

NIH Director ' s Wednesday Afternoon Lecture Series Dr. Fischer is interested in understanding how genetic errors cause vulnerability to microorganisms, autoimmunity, inflammation and allergy, with the dual goal to decipher in vivo immunity in humans and to correct its defects.Air date: 2/20/2019 3:00:00 PM (Source: Videocast - All Events)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HQ7jcY

Pediatric immune diseases, all genetics?

NIH Director ' s Wednesday Afternoon Lecture Series Dr. Fischer is interested in understanding how genetic errors cause vulnerability to microorganisms, autoimmunity, inflammation and allergy, with the dual goal to decipher in vivo immunity in humans and to correct its defects.Air date: 2/20/2019 3:00:00 PM (Source: Videocast - All Events)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HQ7jcY

Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility

Single-sided deafness (SSD) and asymmetric hearing loss (AHL) have recently been proposed as a new indication for cochlear implantation. There is still no recommended treatment for these hearing deficits, and ... (Source: BMC Ear, Nose and Throat Disorders)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D7jegO

Controlled comparative clinical trial of hearing benefit outcomes for users of the Cochlear ™ Nucleus® 7 Sound Processor with mobile connectivity

. (Source: Cochlear Implants International)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93ihX

Auditory risk of exposure to ballistic N-waves from bullets

Volume 58, Issue sup1, February 2019, Page S58-S64 . (Source: International Journal of Audiology)

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

Validation of the Japanese version of the tinnitus functional index (TFI)

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93fTj

Distorted sound perception and subjective benefit after stapedotomy – a prospective single-centre study

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DdF16j

Envelope frequency following responses are stronger for high-pass than low-pass filtered vowels

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93ayZ

Online evaluation of congenital amusia (tone deafness) in paediatric stuttering individuals

. (Source: Hearing, Balance and Communication)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D4UxkU

Objective auditory brainstem response classification using machine learning

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GfhFS7

Can adults living with dementia complete pure-tone audiometry? A systematic review

. (Source: International Journal of Audiology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D9aK8N

Cochlear implantation as a treatment for single-sided deafness and asymmetric hearing loss: a randomized controlled evaluation of cost-utility

Single-sided deafness (SSD) and asymmetric hearing loss (AHL) have recently been proposed as a new indication for cochlear implantation. There is still no recommended treatment for these hearing deficits, and ... (Source: BMC Ear, Nose and Throat Disorders)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D7jegO

Controlled comparative clinical trial of hearing benefit outcomes for users of the Cochlear ™ Nucleus® 7 Sound Processor with mobile connectivity

. (Source: Cochlear Implants International)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93ihX

Auditory risk of exposure to ballistic N-waves from bullets

Volume 58, Issue sup1, February 2019, Page S58-S64 . (Source: International Journal of Audiology)

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

Validation of the Japanese version of the tinnitus functional index (TFI)

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93fTj

Distorted sound perception and subjective benefit after stapedotomy – a prospective single-centre study

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DdF16j

Envelope frequency following responses are stronger for high-pass than low-pass filtered vowels

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G93ayZ

Online evaluation of congenital amusia (tone deafness) in paediatric stuttering individuals

. (Source: Hearing, Balance and Communication)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D4UxkU

Objective auditory brainstem response classification using machine learning

. (Source: International Journal of Audiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GfhFS7

Can adults living with dementia complete pure-tone audiometry? A systematic review

. (Source: International Journal of Audiology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D9aK8N

Regulation of Ectodomain Shedding of ADAM33 In Vitro and In Vivo

TGF- β signaling regulates ectodomain shedding of ADAM33 mainly via an autocatalytic mechanism and is essential for shedding of catalytically-active ADAM33 in vivo. These mechanisms have implications for the genetic contribution of ADAM33 to asthma and BHR. (Source: Journal of Allergy and Clinical Immunology)

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Cockroach allergens – coping with challenging complexity

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gmr09U

Mining Social Media Data to Assess the Risk of Skin and Soft Tissue Infections from Allergen Immunotherapy

Mining of social media data suggests that skin and soft tissue infection from allergen immunotherapy, prepared with aseptic technique, is as rare as skin and soft tissue infection from Influenza vaccination, a sterile pharmaceutical. (Source: Journal of Allergy and Clinical Immunology)

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

Reaction thresholds in in peanut-allergic adults and the influence of exercise and sleep deprivation: a randomised controlled trial

Peanut allergy is a public health concern causing severe reactions. Food allergen labeling poorly represents risk, with limited data on thresholds of reactivity and the influence of everyday factors. We estimated peanut threshold doses for a UK peanut-allergic population and examined the effect of sleep deprivation and exercise. (Source: Journal of Allergy and Clinical Immunology)

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

Irradiated Almond Flour Meets Established Criteria for use in Oral Immunotherapy

Almond, a popular tree nut, can cause IgE-mediated allergic reactions. Almond flour from various vendors are often contaminated with high levels of microbes. Irradiation is a method that can decrease bioburden, however, irradiated almond flour used in oral immunotherapy (OIT) trials has not been characterized. We aimed to quantify relative amounts of the major almond allergen (Pru du 6) and bioburden levels present in irradiated almond flour used in OIT trials and assess whether these parameters are stable. (Source: Journal of Allergy and Clinical Immunology)

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

Effect of House Dust Mite SLIT-tablet Treatment on Quality of Sleep in Allergic Rhinitis Patients

House dust mite (HDM) SLIT-tablet (12 SQ-HDM, ALK, Denmark) has been shown to be effective in treating HDM allergic rhinitis and asthma in DBPC trials. This post-hoc analysis investigates effect of treatment with SQ-HDM SLIT-tablet on sleep in HDM allergic rhinitis. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gmpuo9

Sex Differences in Type 2 Innate Lymphoid Cells in Adult Asthmatics

Cellular sex differences remain largely unexplored in asthma. Type 2 innate lymphoid cells (ILC2s), identified as critical modulators of asthmatic inflammation, are less abundant in the lungs of HDM-sensitized and challenged male mice. Specifically, lung ILC2s numbers increase in the absence of androgen signaling, but not estrogen. Therefore, we hypothesize that female asthmatics have increased airway ILC2s compared to males. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SsOD6Z

Risk Factors for Anaphylaxis in Patients with Cutaneous and Systemic Mastocytosis

We examined factors associated with anaphylaxis in these two populations. (Source: Journal of Allergy and Clinical Immunology)

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

Topical Application of the Quaternary Ammonium Compound Didecyldimethylammonium Chloride Activates Type 2 Innate Lymphoid Cells and Initiates a Mixed-type Allergic Response

Didecyldimethylammonium chloride (DDAC) is an antimicrobial dialkyl-quaternary ammonium compound used in numerous products. Clinical data suggest that DDAC exposure elicits multiple types of hypersensitivity reactions; animal data supports a mixed-type response. Skin is a major route of exposure to chemicals; thus, we investigated immune responses in the skin to determine the mechanism behind DDAC-induced sensitization. (Source: Journal of Allergy and Clinical Immunology)

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

Association of Prescription Opioid Use for Chronic Pain Syndromes with Asthma and Allergy

Opioids have, in addition to analgesic properties, immune altering effects including upregulation of Th2 responses. Whether this has clinical expression in altering asthma and allergic responses has not been determined. We hypothesize that in patients with chronic pain conditions, there is an increased prevalence of asthma and allergy when prescribed opioid medications. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GmplB7

TNF Induces the Production of Type 2 Cytokines in Human Group 2 Innate Lymphoid Cells

Group 2 innate lymphoid cells (ILC2s) play an important role in the initiation and amplification of type 2 inflammation by producing type 2 cytokines, including IL-5 and IL-13, and are elevated in type 2 inflammatory diseases. Recently, several studies, including our own, found that members of the TNF superfamily, TL1A and RANKL, induced production of type 2 cytokines in ILC2s. However, whether TNF itself induces type 2 cytokines in ILC2s has not been elucidated. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Snv4x3

Is Emergency Room Care After Home Use Of An Epinephrine Auto Injector Always Needed?

Emergency room evaluation and observation of patients who have used an epinephrine auto injector to treat an allergic food reaction at home is the standard of care. Requiring patients to go to the ER after epinephrine injection often deters families from administering epinephrine. Withholding or delaying treatment with epinephrine increases the risk of death from anaphylaxis. We hypothesized that this standard could be modified to prompt the early and more frequent use of epinephrine during an allergic reaction without decreasing patient safety. (Source: Journal of Allergy and Clinical Immunology)

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

Unconventional ST2- and CD127-negative lung ILC2 populations are induced by Alternaria

The purpose of this study was to determine whether conventionally used ILC2 markers, ST2 and CD127, are sufficient to include all Th2-cytokine producing ILCs. We hypothesized that ST2- and CD127-negative ILC2 populations exist in mouse lung and that these non-traditional populations might be activated by the clinically relevant fungal allergen Alternaria, a known potent inducer of IL-33. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Su3m1E

Eosinophils Display Subtype-specific Metabolic Profiles

Under homeostatic conditions and in disease progression eosinophils have a variety of effector functions regulating Local Immunity And/or Remodeling/Repair (LIAR hypothesis). These activities are manifestations of different eosinophil subtypes, which, in turn, depend on the cytokine milieu of the tissue microenvironment. Eosinophil subtypes are characterized by expression of specific genes and we hypothesize that their functions are supported by a distinct metabolic phenotype. The goal of this study was to examine relationships between Th1 or Th2 cytokine-dependent gene expression and parameters of energy metabolism in mouse eosinophils. (Source: Journal of Allergy and Clinical Immunology)

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

Estrogen receptor alpha signaling increases ILC2-mediated allergic airway inflammation

Sex hormones regulate asthma pathogenesis, providing a potential mechanism for female predominance in adult asthma. Group 2 innate lymphoid cells (ILC2) produce IL-5 and IL-13, enhancing allergic airway inflammation. While testosterone attenuated ILC2-mediated airway inflammation, the role of estrogen receptor (ER) signaling is unknown. We hypothesized that ER α signaling increases ILC2-mediated airway inflammation. (Source: Journal of Allergy and Clinical Immunology)

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

Usability of a Novel Digital Asthma Management Program

Digital asthma management programs can enable closer monitoring and improved asthma management in the home environment. The Tueo program involves non-contact physiologic monitors, personalized analytics, and a smartphone application (app) to deliver targeted educational and clinical feedback that promotes asthma self-management. Whether the caregivers of asthmatic children find the app easy to use and access remains unknown. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GnZo47

Integrative Analysis of the Intestinal Metabolome of Childhood Asthma

The intestinal metabolome reflects biological consequences of diverse exposures and may provide insight into asthma pathophysiology. We performed an untargeted integrative analysis of the intestinal metabolome of childhood asthma in this ancillary study of the Vitamin D Antenatal Asthma Reduction Trial (VDAART). (Source: Journal of Allergy and Clinical Immunology)

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

Prostaglandin I2 signaling promotes Treg function during allergic inflammation

Our laboratory reported that prostaglandin I2 (PGI2) promotes immune tolerance in mice. Thus, we hypothesized that PGI2 promotes the functionality of Tregs in vivo, in an adoptive-transfer model of allergic inflammation. (Source: Journal of Allergy and Clinical Immunology)

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

Characterization of Gut Microbiome in Infants with Severe Respiratory Syncytial Virus Bronchiolitis

The effects of early life exposures, including respiratory syncytial virus (RSV) infection, on the infant gut microbiome may contribute to immune dysregulation and the development of asthma. Here, we describe the gut microbiome in infants during severe RSV bronchiolitis. (Source: Journal of Allergy and Clinical Immunology)

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

Influence of Hydrophobic Cargo Binding on the Structure, Stability, and Allergenicity of the Cockroach Allergen Bla g 1

The rate of endosomal processing of allergens by antigen presenting cells has been suggested to influence sensitization. In addition, allergens often occur in the presence of lipids and other hydrophobic ligands, which also influence allergenicity. Due to its ability to bind a variety of hydrophobic cargoes, the cockroach allergen Bla g 1 was used as a model system to probe for a potential connection between antigen processing and lipid delivery, and the molecular mechanisms underlying this interaction. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gon48l

Regulation of Ectodomain Shedding of ADAM33 In Vitro and In Vivo

TGF- β signaling regulates ectodomain shedding of ADAM33 mainly via an autocatalytic mechanism and is essential for shedding of catalytically-active ADAM33 in vivo. These mechanisms have implications for the genetic contribution of ADAM33 to asthma and BHR. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Sw47Hi

Cockroach allergens – coping with challenging complexity

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gmr09U

Mining Social Media Data to Assess the Risk of Skin and Soft Tissue Infections from Allergen Immunotherapy

Mining of social media data suggests that skin and soft tissue infection from allergen immunotherapy, prepared with aseptic technique, is as rare as skin and soft tissue infection from Influenza vaccination, a sterile pharmaceutical. (Source: Journal of Allergy and Clinical Immunology)

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

Reaction thresholds in in peanut-allergic adults and the influence of exercise and sleep deprivation: a randomised controlled trial

Peanut allergy is a public health concern causing severe reactions. Food allergen labeling poorly represents risk, with limited data on thresholds of reactivity and the influence of everyday factors. We estimated peanut threshold doses for a UK peanut-allergic population and examined the effect of sleep deprivation and exercise. (Source: Journal of Allergy and Clinical Immunology)

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

Irradiated Almond Flour Meets Established Criteria for use in Oral Immunotherapy

Almond, a popular tree nut, can cause IgE-mediated allergic reactions. Almond flour from various vendors are often contaminated with high levels of microbes. Irradiation is a method that can decrease bioburden, however, irradiated almond flour used in oral immunotherapy (OIT) trials has not been characterized. We aimed to quantify relative amounts of the major almond allergen (Pru du 6) and bioburden levels present in irradiated almond flour used in OIT trials and assess whether these parameters are stable. (Source: Journal of Allergy and Clinical Immunology)

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

Effect of House Dust Mite SLIT-tablet Treatment on Quality of Sleep in Allergic Rhinitis Patients

House dust mite (HDM) SLIT-tablet (12 SQ-HDM, ALK, Denmark) has been shown to be effective in treating HDM allergic rhinitis and asthma in DBPC trials. This post-hoc analysis investigates effect of treatment with SQ-HDM SLIT-tablet on sleep in HDM allergic rhinitis. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gmpuo9

Sex Differences in Type 2 Innate Lymphoid Cells in Adult Asthmatics

Cellular sex differences remain largely unexplored in asthma. Type 2 innate lymphoid cells (ILC2s), identified as critical modulators of asthmatic inflammation, are less abundant in the lungs of HDM-sensitized and challenged male mice. Specifically, lung ILC2s numbers increase in the absence of androgen signaling, but not estrogen. Therefore, we hypothesize that female asthmatics have increased airway ILC2s compared to males. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SsOD6Z

Risk Factors for Anaphylaxis in Patients with Cutaneous and Systemic Mastocytosis

We examined factors associated with anaphylaxis in these two populations. (Source: Journal of Allergy and Clinical Immunology)

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

Topical Application of the Quaternary Ammonium Compound Didecyldimethylammonium Chloride Activates Type 2 Innate Lymphoid Cells and Initiates a Mixed-type Allergic Response

Didecyldimethylammonium chloride (DDAC) is an antimicrobial dialkyl-quaternary ammonium compound used in numerous products. Clinical data suggest that DDAC exposure elicits multiple types of hypersensitivity reactions; animal data supports a mixed-type response. Skin is a major route of exposure to chemicals; thus, we investigated immune responses in the skin to determine the mechanism behind DDAC-induced sensitization. (Source: Journal of Allergy and Clinical Immunology)

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

Association of Prescription Opioid Use for Chronic Pain Syndromes with Asthma and Allergy

Opioids have, in addition to analgesic properties, immune altering effects including upregulation of Th2 responses. Whether this has clinical expression in altering asthma and allergic responses has not been determined. We hypothesize that in patients with chronic pain conditions, there is an increased prevalence of asthma and allergy when prescribed opioid medications. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GmplB7

TNF Induces the Production of Type 2 Cytokines in Human Group 2 Innate Lymphoid Cells

Group 2 innate lymphoid cells (ILC2s) play an important role in the initiation and amplification of type 2 inflammation by producing type 2 cytokines, including IL-5 and IL-13, and are elevated in type 2 inflammatory diseases. Recently, several studies, including our own, found that members of the TNF superfamily, TL1A and RANKL, induced production of type 2 cytokines in ILC2s. However, whether TNF itself induces type 2 cytokines in ILC2s has not been elucidated. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Snv4x3

Is Emergency Room Care After Home Use Of An Epinephrine Auto Injector Always Needed?

Emergency room evaluation and observation of patients who have used an epinephrine auto injector to treat an allergic food reaction at home is the standard of care. Requiring patients to go to the ER after epinephrine injection often deters families from administering epinephrine. Withholding or delaying treatment with epinephrine increases the risk of death from anaphylaxis. We hypothesized that this standard could be modified to prompt the early and more frequent use of epinephrine during an allergic reaction without decreasing patient safety. (Source: Journal of Allergy and Clinical Immunology)

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

Unconventional ST2- and CD127-negative lung ILC2 populations are induced by Alternaria

The purpose of this study was to determine whether conventionally used ILC2 markers, ST2 and CD127, are sufficient to include all Th2-cytokine producing ILCs. We hypothesized that ST2- and CD127-negative ILC2 populations exist in mouse lung and that these non-traditional populations might be activated by the clinically relevant fungal allergen Alternaria, a known potent inducer of IL-33. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Su3m1E

Eosinophils Display Subtype-specific Metabolic Profiles

Under homeostatic conditions and in disease progression eosinophils have a variety of effector functions regulating Local Immunity And/or Remodeling/Repair (LIAR hypothesis). These activities are manifestations of different eosinophil subtypes, which, in turn, depend on the cytokine milieu of the tissue microenvironment. Eosinophil subtypes are characterized by expression of specific genes and we hypothesize that their functions are supported by a distinct metabolic phenotype. The goal of this study was to examine relationships between Th1 or Th2 cytokine-dependent gene expression and parameters of energy metabolism in mouse eosinophils. (Source: Journal of Allergy and Clinical Immunology)

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

Estrogen receptor alpha signaling increases ILC2-mediated allergic airway inflammation

Sex hormones regulate asthma pathogenesis, providing a potential mechanism for female predominance in adult asthma. Group 2 innate lymphoid cells (ILC2) produce IL-5 and IL-13, enhancing allergic airway inflammation. While testosterone attenuated ILC2-mediated airway inflammation, the role of estrogen receptor (ER) signaling is unknown. We hypothesized that ER α signaling increases ILC2-mediated airway inflammation. (Source: Journal of Allergy and Clinical Immunology)

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

Usability of a Novel Digital Asthma Management Program

Digital asthma management programs can enable closer monitoring and improved asthma management in the home environment. The Tueo program involves non-contact physiologic monitors, personalized analytics, and a smartphone application (app) to deliver targeted educational and clinical feedback that promotes asthma self-management. Whether the caregivers of asthmatic children find the app easy to use and access remains unknown. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GnZo47

Integrative Analysis of the Intestinal Metabolome of Childhood Asthma

The intestinal metabolome reflects biological consequences of diverse exposures and may provide insight into asthma pathophysiology. We performed an untargeted integrative analysis of the intestinal metabolome of childhood asthma in this ancillary study of the Vitamin D Antenatal Asthma Reduction Trial (VDAART). (Source: Journal of Allergy and Clinical Immunology)

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

Prostaglandin I2 signaling promotes Treg function during allergic inflammation

Our laboratory reported that prostaglandin I2 (PGI2) promotes immune tolerance in mice. Thus, we hypothesized that PGI2 promotes the functionality of Tregs in vivo, in an adoptive-transfer model of allergic inflammation. (Source: Journal of Allergy and Clinical Immunology)

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

Characterization of Gut Microbiome in Infants with Severe Respiratory Syncytial Virus Bronchiolitis

The effects of early life exposures, including respiratory syncytial virus (RSV) infection, on the infant gut microbiome may contribute to immune dysregulation and the development of asthma. Here, we describe the gut microbiome in infants during severe RSV bronchiolitis. (Source: Journal of Allergy and Clinical Immunology)

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

Influence of Hydrophobic Cargo Binding on the Structure, Stability, and Allergenicity of the Cockroach Allergen Bla g 1

The rate of endosomal processing of allergens by antigen presenting cells has been suggested to influence sensitization. In addition, allergens often occur in the presence of lipids and other hydrophobic ligands, which also influence allergenicity. Due to its ability to bind a variety of hydrophobic cargoes, the cockroach allergen Bla g 1 was used as a model system to probe for a potential connection between antigen processing and lipid delivery, and the molecular mechanisms underlying this interaction. (Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gon48l

Genome structure of malaria parasites linked to virulence

(University of California - Riverside) An international research team led by scientists at the University of California, Riverside, and the La Jolla Institute for Immunology has found that malaria parasite genomes are shaped by parasite-specific gene families, and that this genome organization strongly correlates with the parasite's virulence. The findings highlight the importance of spatial genome organization in gene regulation and the control of virulence in malaria parasites. (Source: EurekAlert! - Infectious and Emerging Diseases)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UEmR4T

Teva's Generic EpiPen Launch Stalls Months After Approval Teva's Generic EpiPen Launch Stalls Months After Approval

Many of the largest U.S. pharmacies and drug distributors do not have Teva Pharmaceutical Industries Ltd's generic version of the life-saving EpiPen allergy treatment five months after it was approved for sale in the United States, pharmacy chains and a group that tracks drug shortages told Reuters.Reuters Health Information (Source: Medscape Medical News Headlines)

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

Genome structure of malaria parasites linked to virulence

(University of California - Riverside) An international research team led by scientists at the University of California, Riverside, and the La Jolla Institute for Immunology has found that malaria parasite genomes are shaped by parasite-specific gene families, and that this genome organization strongly correlates with the parasite's virulence. The findings highlight the importance of spatial genome organization in gene regulation and the control of virulence in malaria parasites. (Source: EurekAlert! - Infectious and Emerging Diseases)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UEmR4T

Teva's Generic EpiPen Launch Stalls Months After Approval Teva's Generic EpiPen Launch Stalls Months After Approval

Many of the largest U.S. pharmacies and drug distributors do not have Teva Pharmaceutical Industries Ltd's generic version of the life-saving EpiPen allergy treatment five months after it was approved for sale in the United States, pharmacy chains and a group that tracks drug shortages told Reuters.Reuters Health Information (Source: Medscape Medical News Headlines)

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

Google unveils two new apps support communication for deaf and hard of hearing people

One app will help transcribe speech to text and the other will help amplify certain sounds and minimize others.   (Source: mobihealthnews)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SbRj9S

40 Cases of Measles Confirmed Amid Concerns the Pacific Northwest Outbreak May Spread

(VANCOUVER, Wash.) — A measles outbreak in the Pacific Northwest became more worrisome Wednesday with word that people infected with the extremely contagious viral illness traveled to Hawaii and central Oregon after being exposed. The revelation prompted public health officials in Oregon's Deschutes County and in Hawaii to issue alerts, although no cases were confirmed in either location. "It raises concerns that this can go on for a long time, become geographically larger than it is and more cases over weeks and months," said Dr. Alan Melnick, public health director for Clark County, in southern Washington, which is at the epicenter of the outbreak and has a lower-than-normal vaccination rate. There are 40 confirmed cases in the Northwest, including 38 clustered i...

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

Google unveils two new apps support communication for deaf and hard of hearing people

One app will help transcribe speech to text and the other will help amplify certain sounds and minimize others.   (Source: mobihealthnews)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SbRj9S

40 Cases of Measles Confirmed Amid Concerns the Pacific Northwest Outbreak May Spread

(VANCOUVER, Wash.) — A measles outbreak in the Pacific Northwest became more worrisome Wednesday with word that people infected with the extremely contagious viral illness traveled to Hawaii and central Oregon after being exposed. The revelation prompted public health officials in Oregon's Deschutes County and in Hawaii to issue alerts, although no cases were confirmed in either location. "It raises concerns that this can go on for a long time, become geographically larger than it is and more cases over weeks and months," said Dr. Alan Melnick, public health director for Clark County, in southern Washington, which is at the epicenter of the outbreak and has a lower-than-normal vaccination rate. There are 40 confirmed cases in the Northwest, including 38 clustered i...

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

Buccal nerve dissection via an intraoral approach: correcting an error regarding buccal nerve blockade

The buccal nerve (BN) supplies sensation to the skin over the anterior part of the buccinator and the buccal mucosa, as well as the buccal gingivae corresponding to the second and third molar teeth. Some dental anatomy books show the main trunk of the BN coursing over the buccal shelf of the mandible, which leads to a significant misunderstanding of this anatomy. Therefore, this study aims to reveal the course of the BN on the retromolar area and establish new evidence based anatomy for appropriate buccal nerve blockade.

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

Physical Simulation Models in Oral and Maxillofacial Surgery: A New Concept in 3-Dimensional Modeling for Removal of Impacted Third Molars

A medical grade computed tomographic (CT) scan of a mandible was obtained. A DICOM series was exported in 1mm slices and digitally 3D reconstructed to create a stereolithography file (STL). The mandible STL was digitally manipulated to create sites for simulated placement of third molar teeth, then 3D printed in a plastic material. Third molar tooth models were coated in red box wax, simulating a ligament space, then submerged into the mandible site using lab stone. A layer of GI mask was placed over the impacted third molar site for soft tissue simulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bj2naS

Autogenous Mandibular Bone Graft for Maxillary LeFort I Osteotomy Inter-positional Gap in Orthognathic Surgery: A Technique Case Series

Correction of maxillofacial skeletal dental deformities often includes surgical interventions in the maxilla and mandible. LeFort I maxillary osteotomies are performed to correct maxillary horizontal, vertical and transverse discrepancies. Repositioning of the maxilla creates an inter-positional gap in bone which may lead to psuedoarthrosis, instability, mobility, infection and eventual relapse. Grafting the inter-positional gap with bone creates mechanical stops to prevent relapse, provides a matrix for secondary ossification, accelerates bony union and inhibits soft tissue herniation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tw5zGZ

Buccal nerve dissection via an intraoral approach: correcting an error regarding buccal nerve blockade

The buccal nerve (BN) supplies sensation to the skin over the anterior part of the buccinator and the buccal mucosa, as well as the buccal gingivae corresponding to the second and third molar teeth. Some dental anatomy books show the main trunk of the BN coursing over the buccal shelf of the mandible, which leads to a significant misunderstanding of this anatomy. Therefore, this study aims to reveal the course of the BN on the retromolar area and establish new evidence based anatomy for appropriate buccal nerve blockade.

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

Physical Simulation Models in Oral and Maxillofacial Surgery: A New Concept in 3-Dimensional Modeling for Removal of Impacted Third Molars

A medical grade computed tomographic (CT) scan of a mandible was obtained. A DICOM series was exported in 1mm slices and digitally 3D reconstructed to create a stereolithography file (STL). The mandible STL was digitally manipulated to create sites for simulated placement of third molar teeth, then 3D printed in a plastic material. Third molar tooth models were coated in red box wax, simulating a ligament space, then submerged into the mandible site using lab stone. A layer of GI mask was placed over the impacted third molar site for soft tissue simulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bj2naS

Autogenous Mandibular Bone Graft for Maxillary LeFort I Osteotomy Inter-positional Gap in Orthognathic Surgery: A Technique Case Series

Correction of maxillofacial skeletal dental deformities often includes surgical interventions in the maxilla and mandible. LeFort I maxillary osteotomies are performed to correct maxillary horizontal, vertical and transverse discrepancies. Repositioning of the maxilla creates an inter-positional gap in bone which may lead to psuedoarthrosis, instability, mobility, infection and eventual relapse. Grafting the inter-positional gap with bone creates mechanical stops to prevent relapse, provides a matrix for secondary ossification, accelerates bony union and inhibits soft tissue herniation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tw5zGZ

Physical Simulation Models in Oral and Maxillofacial Surgery: A New Concept in 3-Dimensional Modeling for Removal of Impacted Third Molars

A medical grade computed tomographic (CT) scan of a mandible was obtained. A DICOM series was exported in 1mm slices and digitally 3D reconstructed to create a stereolithography file (STL). The mandible STL was digitally manipulated to create sites for simulated placement of third molar teeth, then 3D printed in a plastic material. Third molar tooth models were coated in red box wax, simulating a ligament space, then submerged into the mandible site using lab stone. A layer of GI mask was placed over the impacted third molar site for soft tissue simulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bj2naS

Autogenous Mandibular Bone Graft for Maxillary LeFort I Osteotomy Inter-positional Gap in Orthognathic Surgery: A Technique Case Series

Correction of maxillofacial skeletal dental deformities often includes surgical interventions in the maxilla and mandible. LeFort I maxillary osteotomies are performed to correct maxillary horizontal, vertical and transverse discrepancies. Repositioning of the maxilla creates an inter-positional gap in bone which may lead to psuedoarthrosis, instability, mobility, infection and eventual relapse. Grafting the inter-positional gap with bone creates mechanical stops to prevent relapse, provides a matrix for secondary ossification, accelerates bony union and inhibits soft tissue herniation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tw5zGZ

Buccal nerve dissection via an intraoral approach: correcting an error regarding buccal nerve blockade

The buccal nerve (BN) supplies sensation to the skin over the anterior part of the buccinator and the buccal mucosa, as well as the buccal gingivae corresponding to the second and third molar teeth. Some dental anatomy books show the main trunk of the BN coursing over the buccal shelf of the mandible, which leads to a significant misunderstanding of this anatomy. Therefore, this study aims to reveal the course of the BN on the retromolar area and establish new evidence based anatomy for appropriate buccal nerve blockade.

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

Physical Simulation Models in Oral and Maxillofacial Surgery: A New Concept in 3-Dimensional Modeling for Removal of Impacted Third Molars

A medical grade computed tomographic (CT) scan of a mandible was obtained. A DICOM series was exported in 1mm slices and digitally 3D reconstructed to create a stereolithography file (STL). The mandible STL was digitally manipulated to create sites for simulated placement of third molar teeth, then 3D printed in a plastic material. Third molar tooth models were coated in red box wax, simulating a ligament space, then submerged into the mandible site using lab stone. A layer of GI mask was placed over the impacted third molar site for soft tissue simulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bj2naS

Autogenous Mandibular Bone Graft for Maxillary LeFort I Osteotomy Inter-positional Gap in Orthognathic Surgery: A Technique Case Series

Correction of maxillofacial skeletal dental deformities often includes surgical interventions in the maxilla and mandible. LeFort I maxillary osteotomies are performed to correct maxillary horizontal, vertical and transverse discrepancies. Repositioning of the maxilla creates an inter-positional gap in bone which may lead to psuedoarthrosis, instability, mobility, infection and eventual relapse. Grafting the inter-positional gap with bone creates mechanical stops to prevent relapse, provides a matrix for secondary ossification, accelerates bony union and inhibits soft tissue herniation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tw5zGZ

Buccal nerve dissection via an intraoral approach: correcting an error regarding buccal nerve blockade

The buccal nerve (BN) supplies sensation to the skin over the anterior part of the buccinator and the buccal mucosa, as well as the buccal gingivae corresponding to the second and third molar teeth. Some dental anatomy books show the main trunk of the BN coursing over the buccal shelf of the mandible, which leads to a significant misunderstanding of this anatomy. Therefore, this study aims to reveal the course of the BN on the retromolar area and establish new evidence based anatomy for appropriate buccal nerve blockade.

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

Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy. An NIAID/AHRQ Workshop

Study designs are presented that could be used to address basic questions in immunotherapy: efficacy of SLIT vs. SCIT, appropriate number of allergens for immunotherapy, dose and duration of SCIT, and SCIT as preventive therapy.

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

Mast cells within cellular networks

Mast cells are highly versatile in terms of their mode of activation by a host of stimuli and their ability to flexibly release a plethora of biologically highly active mediators. Within the immune system, mast cells can best be designated as an active nexus interlinking innate and adaptive immunity. Herein, we try to draw an arc from the initiation of acute inflammatory reactions to microbial pathogens to the development of adaptive immunity and allergies. This multifaceted nature of mast cells is made possible by the interaction with multiple cell types of immunological and non-immunological origin.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D8FtmE

New graft manipulation strategies improved outcome of mismatched stem cell transplantation in children with primary immunodeficiencies

Mismatched stem cell transplantation is associated with high risk of graft loss, graft versus host disease (GvHD) and transplant related mortality (TRM). Alternative graft manipulation strategies have been employed over the last 11 years to reduce these risks.

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

Activation of Group 2 innate lymphoid cells after allergen challenge in asthmatics

This study is first to show ILC2 recruitment from the circulation to the lung in response to an allergic airway inflammation in humans, where they become locally activated to further promote type 2 inflammation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D6uutO

Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy. An NIAID/AHRQ Workshop

Study designs are presented that could be used to address basic questions in immunotherapy: efficacy of SLIT vs. SCIT, appropriate number of allergens for immunotherapy, dose and duration of SCIT, and SCIT as preventive therapy.

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Mast cells within cellular networks

Mast cells are highly versatile in terms of their mode of activation by a host of stimuli and their ability to flexibly release a plethora of biologically highly active mediators. Within the immune system, mast cells can best be designated as an active nexus interlinking innate and adaptive immunity. Herein, we try to draw an arc from the initiation of acute inflammatory reactions to microbial pathogens to the development of adaptive immunity and allergies. This multifaceted nature of mast cells is made possible by the interaction with multiple cell types of immunological and non-immunological origin.

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New graft manipulation strategies improved outcome of mismatched stem cell transplantation in children with primary immunodeficiencies

Mismatched stem cell transplantation is associated with high risk of graft loss, graft versus host disease (GvHD) and transplant related mortality (TRM). Alternative graft manipulation strategies have been employed over the last 11 years to reduce these risks.

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Activation of Group 2 innate lymphoid cells after allergen challenge in asthmatics

This study is first to show ILC2 recruitment from the circulation to the lung in response to an allergic airway inflammation in humans, where they become locally activated to further promote type 2 inflammation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D6uutO

CT perfusion hypervolemia: brain ischemia or stroke mimic?

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CT perfusion hypervolemia: brain ischemia or stroke mimic?

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The efficacy and limitations of USI for diagnosing TMJ internal derangements

Abstract

Introduction

This study was conducted to determine the effectiveness of ultrasonographic imaging for diagnosing temporomandibular joint internal derangements.

Materials and methods

Ultrasonographic and magnetic resonance imaging scans of temporomandibular joints were obtained bilaterally in 55 patients who had temporomandibular joint disorders and who were diagnosed with temporomandibular joint internal derangements following a clinical examination. Diagnostic accuracy of ultrasonographic imaging was assessed considering magnetic resonance imaging as the gold standard method.

Results

When the results of ultrasonographic imaging and magnetic resonance imaging were compared, the diagnostic accuracy of ultrasonographic imaging was 0.81 for detecting TMJ disc displacement. The diagnostic accuracy of ultrasonographic imaging in detecting TMJ disc position was 0.81 in the closed-mouth position and 0.93 in the open-mouth position.

Conclusion

As a noninvasive and reproducible imaging method acquiring dynamic images, ultrasonographic imaging is a successful method in the evaluation of temporomandibular joint disc displacement.

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

The efficacy and limitations of USI for diagnosing TMJ internal derangements

Abstract

Introduction

This study was conducted to determine the effectiveness of ultrasonographic imaging for diagnosing temporomandibular joint internal derangements.

Materials and methods

Ultrasonographic and magnetic resonance imaging scans of temporomandibular joints were obtained bilaterally in 55 patients who had temporomandibular joint disorders and who were diagnosed with temporomandibular joint internal derangements following a clinical examination. Diagnostic accuracy of ultrasonographic imaging was assessed considering magnetic resonance imaging as the gold standard method.

Results

When the results of ultrasonographic imaging and magnetic resonance imaging were compared, the diagnostic accuracy of ultrasonographic imaging was 0.81 for detecting TMJ disc displacement. The diagnostic accuracy of ultrasonographic imaging in detecting TMJ disc position was 0.81 in the closed-mouth position and 0.93 in the open-mouth position.

Conclusion

As a noninvasive and reproducible imaging method acquiring dynamic images, ultrasonographic imaging is a successful method in the evaluation of temporomandibular joint disc displacement.

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

Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment

. (Source: International Journal of Speech-Language Pathology)

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Detecting Bulbar Motor Involvement in ALS: Comparing speech and chewing tasks

. (Source: International Journal of Speech-Language Pathology)

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Quality of life in primary progressive aphasia: What do we know and what can we do next?

. (Source: Aphasiology)

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Cognitive predictors of sentence comprehension in children with and without developmental language disorder: Implications for assessment and treatment

. (Source: International Journal of Speech-Language Pathology)

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Detecting Bulbar Motor Involvement in ALS: Comparing speech and chewing tasks

. (Source: International Journal of Speech-Language Pathology)

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Quality of life in primary progressive aphasia: What do we know and what can we do next?

. (Source: Aphasiology)

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Levels of horse allergen Equ C 4 in dander and saliva from ten horse breeds

Abstract

Background

Horses are an important source of allergens, but the distribution of horse allergens is poorly understood. Five horse allergens have been identified, Equ c 1‐4 and 6. Equ c 4 seems to be an important allergen, with an IgE‐binding frequency of 77% in horse‐sensitized individuals.

Objectives

The aim of this study was to investigate levels of horse allergen Equ c 4 in dander, saliva and urine from ten horse breeds.

Method: The study population included 170 horses (87 mares, 27 stallions, 56 geldings) from ten breeds. Horse dander, saliva and urine samples were collected. Levels of horse allergen Equ c 4 were quantified using a two‐site sandwich ELISA (mAb 103 and 14G4) and were expressed as Equ c 4 U/μg protein.

Results

The horse allergen Equ c 4 was present in all dander and saliva samples from ten horse breeds, with high within‐breed and inter‐breed variations; GM values were 639 Equ c 4 U /μg protein (range 5 – 15264) for dander and 39.5 (4 – 263) for saliva. Equ c 4 was found in 19/21 urine samples. Adjusted for age, sex and changes over time, no differences between breeds could be seen in dander, while in saliva the North Swedish horse showed lower levels of Equ c 4 than any other breed. The levels of Equ c 4 protein in dander and saliva were significantly higher in samples from stallions compared to mares and geldings, independent of breed.

Conclusions & Clinical Relevance

The results show a high variability in allergen levels of Equ c 4 in dander and saliva both within and between breeds. Significantly higher levels were found in stallions compared to mares and geldings, independent of breed. Results suggest that none of the horse breeds studied can be recommended for individuals allergic to Equ c 4.

This article is protected by copyright. All rights reserved.

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

Levels of horse allergen Equ C 4 in dander and saliva from ten horse breeds

Abstract

Background

Horses are an important source of allergens, but the distribution of horse allergens is poorly understood. Five horse allergens have been identified, Equ c 1‐4 and 6. Equ c 4 seems to be an important allergen, with an IgE‐binding frequency of 77% in horse‐sensitized individuals.

Objectives

The aim of this study was to investigate levels of horse allergen Equ c 4 in dander, saliva and urine from ten horse breeds.

Method: The study population included 170 horses (87 mares, 27 stallions, 56 geldings) from ten breeds. Horse dander, saliva and urine samples were collected. Levels of horse allergen Equ c 4 were quantified using a two‐site sandwich ELISA (mAb 103 and 14G4) and were expressed as Equ c 4 U/μg protein.

Results

The horse allergen Equ c 4 was present in all dander and saliva samples from ten horse breeds, with high within‐breed and inter‐breed variations; GM values were 639 Equ c 4 U /μg protein (range 5 – 15264) for dander and 39.5 (4 – 263) for saliva. Equ c 4 was found in 19/21 urine samples. Adjusted for age, sex and changes over time, no differences between breeds could be seen in dander, while in saliva the North Swedish horse showed lower levels of Equ c 4 than any other breed. The levels of Equ c 4 protein in dander and saliva were significantly higher in samples from stallions compared to mares and geldings, independent of breed.

Conclusions & Clinical Relevance

The results show a high variability in allergen levels of Equ c 4 in dander and saliva both within and between breeds. Significantly higher levels were found in stallions compared to mares and geldings, independent of breed. Results suggest that none of the horse breeds studied can be recommended for individuals allergic to Equ c 4.

This article is protected by copyright. All rights reserved.

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

Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 1 – A Strategic Framework

Colin Konschak Dave Levin  By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. In this article, we propose a strategic framework for evaluating and pursuing technical solutions. Future articles will explore specific areas and solutions within this framework. A Full-Blown Crisis One of the authors recently had the opportunity to participate in a multi-stakeholder workshop in Cleveland, OH dedicated to finding new, collaborative approaches to addressing the nation's opioid abuse epidemic. While Ohio might be considered ground zero for this epidemic, the evidence is clear that...

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Junk Science Exposed: New Study Purports to Show that E-Cigarettes Increase Heart Attack Risk

According to the headline of aUPInews story from last week, vaping has been linked to an increased risk of having a heart attack. This research finding was reported worldwide, including a scary headline in London'sSunday Express reading: " New research claimsvaping raises risk of deadly heart attacks and strokes. "This finding is profoundly important because if e-cigarette use does indeed increase heart attack risk, then the role of vaping in harm reduction comes into serious question.The news headline stems from a paper that is being presented this week at the American Stroke Association 'sInternational Stroke Conference in Hawaii.According to the news coverage, the researchers used cross-sectional data from the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) and found that ever...

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

Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 1 – A Strategic Framework

Colin Konschak Dave Levin  By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. In this article, we propose a strategic framework for evaluating and pursuing technical solutions. Future articles will explore specific areas and solutions within this framework. A Full-Blown Crisis One of the authors recently had the opportunity to participate in a multi-stakeholder workshop in Cleveland, OH dedicated to finding new, collaborative approaches to addressing the nation's opioid abuse epidemic. While Ohio might be considered ground zero for this epidemic, the evidence is clear that...

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

Junk Science Exposed: New Study Purports to Show that E-Cigarettes Increase Heart Attack Risk

According to the headline of aUPInews story from last week, vaping has been linked to an increased risk of having a heart attack. This research finding was reported worldwide, including a scary headline in London'sSunday Express reading: " New research claimsvaping raises risk of deadly heart attacks and strokes. "This finding is profoundly important because if e-cigarette use does indeed increase heart attack risk, then the role of vaping in harm reduction comes into serious question.The news headline stems from a paper that is being presented this week at the American Stroke Association 'sInternational Stroke Conference in Hawaii.According to the news coverage, the researchers used cross-sectional data from the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) and found that ever...

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

Automatic Nasopharyngeal Carcinoma Segmentation Using Fully Convolutional Networks with Auxiliary Paths on Dual-Modality PET-CT Images

Abstract

Nasopharyngeal carcinoma (NPC) is prevalent in certain areas, such as South China, Southeast Asia, and the Middle East. Radiation therapy is the most efficient means to treat this malignant tumor. Positron emission tomography–computed tomography (PET-CT) is a suitable imaging technique to assess this disease. However, the large amount of data produced by numerous patients causes traditional manual delineation of tumor contour, a basic step for radiotherapy, to become time-consuming and labor-intensive. Thus, the demand for automatic and credible segmentation methods to alleviate the workload of radiologists is increasing. This paper presents a method that uses fully convolutional networks with auxiliary paths to achieve automatic segmentation of NPC on PET-CT images. This work is the first to segment NPC using dual-modality PET-CT images. This technique is identical to what is used in clinical practice and offers considerable convenience for subsequent radiotherapy. The deep supervision introduced by auxiliary paths can explicitly guide the training of lower layers, thus enabling these layers to learn more representative features and improve the discriminative capability of the model. Results of threefold cross-validation with a mean dice score of 87.47% demonstrate the efficiency and robustness of the proposed method. The method remarkably outperforms state-of-the-art methods in NPC segmentation. We also validated by experiments that the registration process among different subjects and the auxiliary paths strategy are considerably useful techniques for learning discriminative features and improving segmentation performance.

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Computer-Assisted Nuclear Atypia Scoring of Breast Cancer: a Preliminary Study

Abstract

Inter-pathologist agreement for nuclear atypia scoring of breast cancer is poor. To address this problem, previous studies suggested some criteria for describing the variations appearance of tumor cells relative to normal cells. However, these criteria were still assessed subjectively by pathologists. Previous studies used quantitative computer-extracted features for scoring. However, application of these tools is limited as further improvement in their accuracy is required. This study proposes COMPASS (COMputer-assisted analysis combined with Pathologist's ASSessment) for reproducible nuclear atypia scoring. COMPASS relies on both cytological criteria assessed subjectively by pathologists as well as computer-extracted textural features. Using machine learning, COMPASS combines these two sets of features and output nuclear atypia score. COMPASS's performance was evaluated using 300 images for which expert-consensus derived reference nuclear pleomorphism scores were available, and they were scanned by two scanners from different vendors. A personalized model was built for three pathologists who gave scores to six atypia-related criteria for each image. Leave-one-out cross validation (LOOCV) was used. COMPASS was trained and tested for each pathologist separately. Percentage agreement between COMPASS and the reference nuclear scores was 93.8%, 92.9%, and 93.1% for three pathologists. COMPASS's performance in nuclear grading was almost identical for both scanners, with Cohen's kappa ranging from 0.80 to 0.86 for different pathologists and different scanners. Independently, the images were also assessed by two experienced senior pathologists. Cohen's kappa of COMPASS was comparable to the Cohen's kappa for two senior pathologists (0.79 and 0.68).

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Automatic Nasopharyngeal Carcinoma Segmentation Using Fully Convolutional Networks with Auxiliary Paths on Dual-Modality PET-CT Images

Abstract

Nasopharyngeal carcinoma (NPC) is prevalent in certain areas, such as South China, Southeast Asia, and the Middle East. Radiation therapy is the most efficient means to treat this malignant tumor. Positron emission tomography–computed tomography (PET-CT) is a suitable imaging technique to assess this disease. However, the large amount of data produced by numerous patients causes traditional manual delineation of tumor contour, a basic step for radiotherapy, to become time-consuming and labor-intensive. Thus, the demand for automatic and credible segmentation methods to alleviate the workload of radiologists is increasing. This paper presents a method that uses fully convolutional networks with auxiliary paths to achieve automatic segmentation of NPC on PET-CT images. This work is the first to segment NPC using dual-modality PET-CT images. This technique is identical to what is used in clinical practice and offers considerable convenience for subsequent radiotherapy. The deep supervision introduced by auxiliary paths can explicitly guide the training of lower layers, thus enabling these layers to learn more representative features and improve the discriminative capability of the model. Results of threefold cross-validation with a mean dice score of 87.47% demonstrate the efficiency and robustness of the proposed method. The method remarkably outperforms state-of-the-art methods in NPC segmentation. We also validated by experiments that the registration process among different subjects and the auxiliary paths strategy are considerably useful techniques for learning discriminative features and improving segmentation performance.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D9XSzq

Computer-Assisted Nuclear Atypia Scoring of Breast Cancer: a Preliminary Study

Abstract

Inter-pathologist agreement for nuclear atypia scoring of breast cancer is poor. To address this problem, previous studies suggested some criteria for describing the variations appearance of tumor cells relative to normal cells. However, these criteria were still assessed subjectively by pathologists. Previous studies used quantitative computer-extracted features for scoring. However, application of these tools is limited as further improvement in their accuracy is required. This study proposes COMPASS (COMputer-assisted analysis combined with Pathologist's ASSessment) for reproducible nuclear atypia scoring. COMPASS relies on both cytological criteria assessed subjectively by pathologists as well as computer-extracted textural features. Using machine learning, COMPASS combines these two sets of features and output nuclear atypia score. COMPASS's performance was evaluated using 300 images for which expert-consensus derived reference nuclear pleomorphism scores were available, and they were scanned by two scanners from different vendors. A personalized model was built for three pathologists who gave scores to six atypia-related criteria for each image. Leave-one-out cross validation (LOOCV) was used. COMPASS was trained and tested for each pathologist separately. Percentage agreement between COMPASS and the reference nuclear scores was 93.8%, 92.9%, and 93.1% for three pathologists. COMPASS's performance in nuclear grading was almost identical for both scanners, with Cohen's kappa ranging from 0.80 to 0.86 for different pathologists and different scanners. Independently, the images were also assessed by two experienced senior pathologists. Cohen's kappa of COMPASS was comparable to the Cohen's kappa for two senior pathologists (0.79 and 0.68).

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GbilI5

Longitudinal study of hearing loss and subjective cognitive function decline in men.

We examined the relation between self-reported hearing loss, hearing aid use, and risk of subjective cognitive function (SCF) decline. METHODS: We conducted an 8-year (2008-2016) longitudinal study of 10,107 men aged ≥62 years who reported their hearing status in 2006 and had no subjective cognitive concerns in 2008. Change in SCF scores was assessed by a 6-item questionnaire, and subjective decline was defined as new report of at least one SCF concern during follow-up. RESULTS: Hearing loss was associated with higher risk of SCF decline. Compared with no hearing loss, the multivariable-adjusted relative risk (95% CI) of incident SCF decline was 1.30 (1.18, 1.42), 1.42 (1.26, 1.61), and 1.54 (1.22, 1.96) among men with mild, moderate, and severe hearing loss (no hearing aids), ...

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

Longitudinal study of hearing loss and subjective cognitive function decline in men.

We examined the relation between self-reported hearing loss, hearing aid use, and risk of subjective cognitive function (SCF) decline. METHODS: We conducted an 8-year (2008-2016) longitudinal study of 10,107 men aged ≥62 years who reported their hearing status in 2006 and had no subjective cognitive concerns in 2008. Change in SCF scores was assessed by a 6-item questionnaire, and subjective decline was defined as new report of at least one SCF concern during follow-up. RESULTS: Hearing loss was associated with higher risk of SCF decline. Compared with no hearing loss, the multivariable-adjusted relative risk (95% CI) of incident SCF decline was 1.30 (1.18, 1.42), 1.42 (1.26, 1.61), and 1.54 (1.22, 1.96) among men with mild, moderate, and severe hearing loss (no hearing aids), ...

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A deep convolutional neural network for the diagnosis of thyroid nodules on ultrasound

Abstract

Background

We designed a deep convolutional neural network (CNN) to diagnose thyroid malignancy on ultrasound (US) and compared the diagnostic performance of CNN with that of experienced radiologists.

Methods

Between May 2012 and February 2015, 589 thyroid nodules in 519 patients were diagnosed as benign or malignant by surgical excision. Experienced radiologists retrospectively reviewed the US of the thyroid nodules in a test set. CNNs were trained and tested using retrospective data of 439 and 150 US images, respectively. Diagnostic performances were compared between the two groups.

Results

Of the 589 thyroid nodules, 396 were malignant and 193 were benign. The area under the curve (AUC) for diagnosing thyroid malignancy was 0.805‐0.860 for radiologists. The AUCs for diagnosing thyroid malignancy for the three CNNs were 0.845, 0.835, and 0.850. There was no significant difference in AUC between radiologists and CNNs.

Conclusions

CNNs showed comparable diagnostic performance compared to experienced radiologists in differentiating thyroid malignancy on US.

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A deep convolutional neural network for the diagnosis of thyroid nodules on ultrasound

Abstract

Background

We designed a deep convolutional neural network (CNN) to diagnose thyroid malignancy on ultrasound (US) and compared the diagnostic performance of CNN with that of experienced radiologists.

Methods

Between May 2012 and February 2015, 589 thyroid nodules in 519 patients were diagnosed as benign or malignant by surgical excision. Experienced radiologists retrospectively reviewed the US of the thyroid nodules in a test set. CNNs were trained and tested using retrospective data of 439 and 150 US images, respectively. Diagnostic performances were compared between the two groups.

Results

Of the 589 thyroid nodules, 396 were malignant and 193 were benign. The area under the curve (AUC) for diagnosing thyroid malignancy was 0.805‐0.860 for radiologists. The AUCs for diagnosing thyroid malignancy for the three CNNs were 0.845, 0.835, and 0.850. There was no significant difference in AUC between radiologists and CNNs.

Conclusions

CNNs showed comparable diagnostic performance compared to experienced radiologists in differentiating thyroid malignancy on US.

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Crossed cerebellar diaschisis

Clinical presentation: Frequent seizures, altered sensorium. 

MRI brain shows marked left hemi Atrophy, ex vacuo dilatation of left lateral ventricle owing to volume loss. Left cerebral hemisphere show multifocal patchy areas of cortical T2 hyper intensities without diffusion restriction. Associated Atrophy of left deep grey nuclei, changes of distal Wallerian degeneration involving left cerebral peduncle of mid brain, Pons.

Imaging diagnosis: Sequel of encephalitis / rasmussen encephalitis.

Right cerebellar hemisphere show marked atrophy can attributed to associated contralateral cerebellar diaschisis. 

Crossed cerebellar diaschisis

Refers to supra tentorial lesion leading to depressed function, metabolism and perfusion of contra lateral cerebellar hemisphere which is connected via white matter tracts.
Interruption of this cortico-ponto-cerebellar white matter tracts which then results in deafferentation and hypometabolism of the contralateral cerebellar hemisphere.

Classically seen following cerebral infarction, although it can be a sequel of any significant supratentorial lesion like bleed, encephalitis as in our case. The same phenomenon can also occur in thalamus called ipsilateral thalamic diaschisis, occurring after an ipsilateral middle cerebral artery territory infarction.

CT or MRI perfusion performed during an acute stroke may show a contralateral cerebellar hypo perfusion. In chronic stages volume loss involving contralateral cerebellar hemisphere.

Clinically other than the neurological deficits associated with the contra lateral supra tentorial lesion, the condition is generally asymptomatic. No treatment apart from management of the supratentorial insult.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G8s7KR

Crossed cerebellar diaschisis

Clinical presentation: Frequent seizures, altered sensorium. 

MRI brain shows marked left hemi Atrophy, ex vacuo dilatation of left lateral ventricle owing to volume loss. Left cerebral hemisphere show multifocal patchy areas of cortical T2 hyper intensities without diffusion restriction. Associated Atrophy of left deep grey nuclei, changes of distal Wallerian degeneration involving left cerebral peduncle of mid brain, Pons.

Imaging diagnosis: Sequel of encephalitis / rasmussen encephalitis.

Right cerebellar hemisphere show marked atrophy can attributed to associated contralateral cerebellar diaschisis. 

Crossed cerebellar diaschisis

Refers to supra tentorial lesion leading to depressed function, metabolism and perfusion of contra lateral cerebellar hemisphere which is connected via white matter tracts.
Interruption of this cortico-ponto-cerebellar white matter tracts which then results in deafferentation and hypometabolism of the contralateral cerebellar hemisphere.

Classically seen following cerebral infarction, although it can be a sequel of any significant supratentorial lesion like bleed, encephalitis as in our case. The same phenomenon can also occur in thalamus called ipsilateral thalamic diaschisis, occurring after an ipsilateral middle cerebral artery territory infarction.

CT or MRI perfusion performed during an acute stroke may show a contralateral cerebellar hypo perfusion. In chronic stages volume loss involving contralateral cerebellar hemisphere.

Clinically other than the neurological deficits associated with the contra lateral supra tentorial lesion, the condition is generally asymptomatic. No treatment apart from management of the supratentorial insult.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G8s7KR

Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients in daily practice in Belgium: a BelSACI-Abeforcal-EUFOREA statement

Allergic rhinitis (AR) affects 23–30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontr...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Sur9hO

Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients in daily practice in Belgium: a BelSACI-Abeforcal-EUFOREA statement

Allergic rhinitis (AR) affects 23–30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontr...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Sur9hO

Cone beam computed tomography evaluation of staged lateral ridge augmentation using platelet rich fibrin or resorbable collagen membranes in a randomized controlled clinical trial

Abstract

Objectives

To evaluate the volumetric changes following lateral alveolar ridge augmentation using autogenous bone graft covered by either a platelet rich fibrin membrane (test group) or an inorganic bovine bone substitute and a resorbable collagen barrier membrane (control group).

Material and methods

A total of 27 partially edentulous patients (test n=14, control n=13) with the indication for lateral bone block augmentation were included in this randomized, controlled clinical trial. Cone beam computed tomography (CBCT) examination was performed prior to grafting and 2 weeks and 6 months after grafting. The volumetric changes between the various examinations times were evaluated by planimetric measurements on two‐dimensional CBCT images of the grafted regions.

Results

The mean bone volumetric loss in the test group was 14.7%, SD± 8.9%, while the mean bone volume loss in the control group was 17.8%, SD± 13.3%. This difference was not significant (P=0.48). A total of ten patients were operated in the incisor and canine region with a mean bone volume loss of 23.41% SD, ±10.87%, while 17 patients were operated in the premolar region with at mean bone volume loss of 11.89% SD ±9.05%. This difference was significant (P=0.01).

Conclusion

The test and control group demonstrated no overall difference in volumetric bone changes of the augmented bone at the 6‐month follow‐up. The second major finding revealed a significantly larger amount of bone resorption in the incisor and canine region than in the premolar region of the maxilla, particularly in the control group.

This article is protected by copyright. All rights reserved.

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Cone beam computed tomography evaluation of staged lateral ridge augmentation using platelet rich fibrin or resorbable collagen membranes in a randomized controlled clinical trial

Abstract

Objectives

To evaluate the volumetric changes following lateral alveolar ridge augmentation using autogenous bone graft covered by either a platelet rich fibrin membrane (test group) or an inorganic bovine bone substitute and a resorbable collagen barrier membrane (control group).

Material and methods

A total of 27 partially edentulous patients (test n=14, control n=13) with the indication for lateral bone block augmentation were included in this randomized, controlled clinical trial. Cone beam computed tomography (CBCT) examination was performed prior to grafting and 2 weeks and 6 months after grafting. The volumetric changes between the various examinations times were evaluated by planimetric measurements on two‐dimensional CBCT images of the grafted regions.

Results

The mean bone volumetric loss in the test group was 14.7%, SD± 8.9%, while the mean bone volume loss in the control group was 17.8%, SD± 13.3%. This difference was not significant (P=0.48). A total of ten patients were operated in the incisor and canine region with a mean bone volume loss of 23.41% SD, ±10.87%, while 17 patients were operated in the premolar region with at mean bone volume loss of 11.89% SD ±9.05%. This difference was significant (P=0.01).

Conclusion

The test and control group demonstrated no overall difference in volumetric bone changes of the augmented bone at the 6‐month follow‐up. The second major finding revealed a significantly larger amount of bone resorption in the incisor and canine region than in the premolar region of the maxilla, particularly in the control group.

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Health-related quality of life assessment for patients with advanced or metastatic renal cell carcinoma treated with a tyrosine kinase inhibitor using electronic patient-reported outcomes in daily clinical practice (QUANARIE trial): study protocol

Two main therapies, pazopanib and sunitinib, are used in the first-line setting for metastatic renal cell carcinoma (mRCC). These two tyrosine kinase inhibitors (TKI) are equally effective in terms of survival...

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

Health-related quality of life assessment for patients with advanced or metastatic renal cell carcinoma treated with a tyrosine kinase inhibitor using electronic patient-reported outcomes in daily clinical practice (QUANARIE trial): study protocol

Two main therapies, pazopanib and sunitinib, are used in the first-line setting for metastatic renal cell carcinoma (mRCC). These two tyrosine kinase inhibitors (TKI) are equally effective in terms of survival...

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

Treatment of oral cancers during pregnancy: a case-based discussion

Malignancies occur in approximately 1:1000 pregnancies; the most common being breast (46%) and hematological (18%) malignancies. Oral cancers account for only 2% of all cancers in pregnant women, and there are...

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Pressure induced tissue resection in the larynx: A preliminary canine study

Objectives

The application of laser (light amplification by stimulated emission of radiation) energy in the larynx relies on thermal injury. The impact of this injury on adjacent tissue can be undesirable. Attempts have been made to limit the extent and range of injury to adjacent tissue. The O‐Pel Surgical System (Precise Light Surgical, Inc., Campbell, CA), a new technology, utilizes kinetic energy through Pressure Induced Tissue Resection (PITR) (Precise Light Surgical, Inc.) to cut tissue, theoretically eliminating injury to adjacent tissue. The purpose of this study was to evaluate the PSL in canine vocal folds.

Methods

Four dogs underwent PITR incisions (4 mJ pulses at 200 Hz) on their vocal folds, through mucosa into the muscle. The animals were sacrificed at days 0, 3, 7, and 21 days postsurgery. The larynges were harvested and histology was performed with hematoxylin and eosin, Masson trichrome, and Verhoeff‐van Gieson.

Results

At day 0, focal denudation of the epithelium and coagulation necrosis in the lamina propria and adjacent connective tissue are noted. On days 3 and 7, an inflammatory infiltrate of neutrophils is seen within the lamina propria and surrounding connective tissue with minimal edema and early deposition of collagen. At day 21, the mucosa is completely regenerated with the area of previous PITR into the muscle replaced with thick bundles of collagen.

Conclusion

The unique PITR characteristics offer a potentially unique cutting technology for laryngeal microsurgery. The current canine study suggests appropriate and rapid healing. With refinements of the tip size of the probe and adjustment of energy, PITR will likely be an appropriate alternate to traditional lasers in laryngeal surgery.

Level of Evidence

NA. Laryngoscope, 2019

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