Παρασκευή 16 Νοεμβρίου 2018
Die Erweiterung von Konzepten und Definitionen von Suchtverhalten
Verhaltenstherapie
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Immunization with plasmids encoding M2 acetylcholine muscarinic receptor epitopes impairs cardiac function in mice and induces autophagy in the myocardium.
Authors: Ribeiro KC, Campelo RP, Rodrigues DDRF, Mattos EC, Brandão IT, da Silva CL, Bouskela E, Martinez CG, Kurtenbach E Abstract Autoantibodies against the M2 subtype of muscarinic acetylcholine receptors with functional activities have been found in the sera of patients with dilated cardiomyopathy (DCM), and the second extracellular loop has been established as the predominant epitope. However, it has been shown that the third intracellular loop is recognized by Chagas disease patients with severe cardiac dysfunction. In this work, BALB/c mice were immunized with plasmids encoding these two epitopes, and a control group received the empty plasmid (pcDNA3 vector). Serum from these DNA-immunized animals had elevated and persistent titres of antibodies against respective antigens...
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Genomic and phenotypic diversity of Streptococcus mutans
Publication date: Available online 15 November 2018
Source: Journal of Oral Biosciences
Author(s): Claudia María Bedoya-Correa, Ramiro Javier Rincón Rodríguez, Monica Tatiana Parada-Sanchez
Abstract
Background
Streptococcus mutans (S. mutans) is a commensal microorganism found in the human oral cavity. However, due to environmental changes, selective pressures, and the presence of a variable genome, it adapts and may acquire new physiological and metabolic properties that alter dental biofilm homeostasis, promoting the development of dental caries. Although the plasticity and heterogeneity of S. mutans is widely recognized, very little is known about the mechanisms for the expression of pathogenic properties in specific genotypes.
Highlight
The implementation of molecular biology techniques in the study of S. mutans has provided information on the genomic diversity of this species. This variability is generated by genome rearrangements, natural genetic transformation, and horizontal gene transfer, and continues to grow due to an open pan-genome. The main virulence factors associated with the cariogenic potential of S. mutans include adhesion, acid production (acidogenicity), and acid tolerance (aciduricity), and also show variability. These factors coordinate the modification of the physicochemical properties of the biofilm, which results in the accumulation of S. mutans and other acidogenic and aciduric species in the oral cavity.
Conclusion
We review the current literature on the main processes that generate S. mutans genomic diversity, as well as the phenotypic variability of its main virulence factors. S. mutans achieves its pathogenesis by sensing the intra- and extracellular environments and regulating gene transcription according to perceived environmental modifications. Consequently, this regulation gives rise to differential synthesis of proteins, allowing this species to potentially express virulence factors.
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Endovascular management of multiple intracranial dural arteriovenous fistulas
Publication date: Available online 16 November 2018
Source: Journal of Neuroradiology
Author(s): Ching-Chang Chen, Young Dae Cho, Dong Hyun Yoo, Jusun Moon, Jeongjun Lee, Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho, Moon Hee Han
Abstract
Background and purpose: Multiply occurring intracranial dural arteriovenous fistulas (dAVFs) have been documented but rarely occur, and neither pathogenesis nor prognosis is clearly understood. This study was conducted to analyze angiographic characteristics of multiple dAVFs and to chronicle our treatment experience.
Methods:Between April, 2002 and January, 2018, data prospectively collected from 310 patients with intracranial dAVFs were systematically reviewed, assessing clinical and anatomic outcomes of endovascular treatment in 32 patients with multiple dAVFs (≥2 fistulas each). Lesions were categorized as multifocal or diffuse type, depending on presentation, and further characterized as progressive or non-progressive disease.
Results: Overall, 18 patients (56.3%) experienced aggressive presentations, including intracerebral hemorrhage or venous infarction. Cortical venous reflux (CVR) was observed in 26 patients (81.3%), and sinus thrombosis or occlusion was seen in 24 (75.0%). Clinical outcomes in patients with multifocal fistulas (n = 11) were excellent (100%), marked by a moderately high rate of complete occlusion (54.5%). Those with progressive disease (n = 10) regularly displayed certain angiographic findings, namely diffuse configuration (100%), sinus thrombosis (100%), and CVR (100%). Complete anatomic obliteration was achieved in 12 patients (37.5%), and in 26 patients (81.3%), clinical outcomes were favorable.
Conclusion:Multiple dAVFs are typically aggressive at presentation, given strong associations with CVR and sinus thrombosis. In diffuse-type fistulas, the potential to recur or progress is high. Although definitive treatment poses a challenge, outcomes of endovascular therapeutics may be still optimized in this setting through strategic procedural modifications and careful follow-up monitoring.
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Endovascular management of multiple intracranial dural arteriovenous fistulas
Publication date: Available online 16 November 2018
Source: Journal of Neuroradiology
Author(s): Ching-Chang Chen, Young Dae Cho, Dong Hyun Yoo, Jusun Moon, Jeongjun Lee, Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho, Moon Hee Han
Abstract
Background and purpose: Multiply occurring intracranial dural arteriovenous fistulas (dAVFs) have been documented but rarely occur, and neither pathogenesis nor prognosis is clearly understood. This study was conducted to analyze angiographic characteristics of multiple dAVFs and to chronicle our treatment experience.
Methods:Between April, 2002 and January, 2018, data prospectively collected from 310 patients with intracranial dAVFs were systematically reviewed, assessing clinical and anatomic outcomes of endovascular treatment in 32 patients with multiple dAVFs (≥2 fistulas each). Lesions were categorized as multifocal or diffuse type, depending on presentation, and further characterized as progressive or non-progressive disease.
Results: Overall, 18 patients (56.3%) experienced aggressive presentations, including intracerebral hemorrhage or venous infarction. Cortical venous reflux (CVR) was observed in 26 patients (81.3%), and sinus thrombosis or occlusion was seen in 24 (75.0%). Clinical outcomes in patients with multifocal fistulas (n = 11) were excellent (100%), marked by a moderately high rate of complete occlusion (54.5%). Those with progressive disease (n = 10) regularly displayed certain angiographic findings, namely diffuse configuration (100%), sinus thrombosis (100%), and CVR (100%). Complete anatomic obliteration was achieved in 12 patients (37.5%), and in 26 patients (81.3%), clinical outcomes were favorable.
Conclusion:Multiple dAVFs are typically aggressive at presentation, given strong associations with CVR and sinus thrombosis. In diffuse-type fistulas, the potential to recur or progress is high. Although definitive treatment poses a challenge, outcomes of endovascular therapeutics may be still optimized in this setting through strategic procedural modifications and careful follow-up monitoring.
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Congenital Zika syndrome associated with findings of cerebellar cortical dysplasia - Broadening the spectrum of presentation of the syndrome
Publication date: Available online 15 November 2018
Source: Journal of Neuroradiology
Author(s): Bruno Niemeyer de Freitas Ribeiro, Edson Marchiori
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BRAIN EMBOLIZATION OF A HEALTHY ARTERY FRAGMENT AS A COMPLICATION OF A CARDIAC CATHETERIZATION
Publication date: Available online 15 November 2018
Source: Journal of Neuroradiology
Author(s): L Martín-Aguilar, M Hernández-Pérez, A Planas, J Broto, C Llibre, E Fernández-Nofrerias, C Castaño, S Remollo, JL Subirats, L Dorado, M Millán
Abstract
Ischemic stroke is the most common neurological complication of cardiac catheterization resulting in a high morbidity and mortality. We present a 44-year-old man admitted for vasospastic angina that suffered a right middle cerebral artery (MCA) occlusion after a cardiac catheterization. Mechanical thrombectomy was indicated and complete arterial recanalization was achieved. The material obtained showed a fragment of a healthy artery. Partial radial endarterectomy and cerebral embolization may be a rare complication of cardiac catheterization.
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BRAIN EMBOLIZATION OF A HEALTHY ARTERY FRAGMENT AS A COMPLICATION OF A CARDIAC CATHETERIZATION
Publication date: Available online 15 November 2018
Source: Journal of Neuroradiology
Author(s): L Martín-Aguilar, M Hernández-Pérez, A Planas, J Broto, C Llibre, E Fernández-Nofrerias, C Castaño, S Remollo, JL Subirats, L Dorado, M Millán
Abstract
Ischemic stroke is the most common neurological complication of cardiac catheterization resulting in a high morbidity and mortality. We present a 44-year-old man admitted for vasospastic angina that suffered a right middle cerebral artery (MCA) occlusion after a cardiac catheterization. Mechanical thrombectomy was indicated and complete arterial recanalization was achieved. The material obtained showed a fragment of a healthy artery. Partial radial endarterectomy and cerebral embolization may be a rare complication of cardiac catheterization.
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Chronic Spontaneous Urticaria or Autoinflammatory Disease? The Therapeutic Effect of Omalizumab in a Pediatric Patient.
We describe the clinical case of a 9-year-olf-female with recurrent monthly episodes of fever, arthralgia, abdominal pain, and urticaria-angioedema who did not respond to steroids associated with antihistamines, however showed the complete resolution of the disease with omalizumab. PMID: 30426806 [PubMed - as supplied by publisher] (Source: Journal of Dermatological Treatment)
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Chronic Spontaneous Urticaria or Autoinflammatory Disease? The Therapeutic Effect of Omalizumab in a Pediatric Patient.
We describe the clinical case of a 9-year-olf-female with recurrent monthly episodes of fever, arthralgia, abdominal pain, and urticaria-angioedema who did not respond to steroids associated with antihistamines, however showed the complete resolution of the disease with omalizumab. PMID: 30426806 [PubMed - as supplied by publisher] (Source: Journal of Dermatological Treatment)
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Bilateral Vision Loss with p-ANCA Associated Lymphocytic Vasculitis.
CONCLUSION: It is important to consider ANCA associated vasculitides when temporal artery biopsy does not support GCA. PMID: 30427747 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)
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Bilateral Vision Loss with p-ANCA Associated Lymphocytic Vasculitis.
CONCLUSION: It is important to consider ANCA associated vasculitides when temporal artery biopsy does not support GCA. PMID: 30427747 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)
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Immunization with plasmids encoding M2 acetylcholine muscarinic receptor epitopes impairs cardiac function in mice and induces autophagy in the myocardium.
Authors: Ribeiro KC, Campelo RP, Rodrigues DDRF, Mattos EC, Brandão IT, da Silva CL, Bouskela E, Martinez CG, Kurtenbach E Abstract Autoantibodies against the M2 subtype of muscarinic acetylcholine receptors with functional activities have been found in the sera of patients with dilated cardiomyopathy (DCM), and the second extracellular loop has been established as the predominant epitope. However, it has been shown that the third intracellular loop is recognized by Chagas disease patients with severe cardiac dysfunction. In this work, BALB/c mice were immunized with plasmids encoding these two epitopes, and a control group received the empty plasmid (pcDNA3 vector). Serum from these DNA-immunized animals had elevated and persistent titres of antibodies against respective antigens...
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Species richness, cultural importance, and prioritization of wild spices for conservation in the Sudano-Guinean zone of Benin (West Africa)
Spices have always been used for their flavor-enhancement characteristics and for their medicinal properties. In Benin, scientific research on spices is scarce, despite their importance in the local population...
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Species richness, cultural importance, and prioritization of wild spices for conservation in the Sudano-Guinean zone of Benin (West Africa)
Spices have always been used for their flavor-enhancement characteristics and for their medicinal properties. In Benin, scientific research on spices is scarce, despite their importance in the local population...
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Genomic and phenotypic diversity of Streptococcus mutans
Publication date: Available online 15 November 2018
Source: Journal of Oral Biosciences
Author(s): Claudia María Bedoya-Correa, Ramiro Javier Rincón Rodríguez, Monica Tatiana Parada-Sanchez
Abstract
Background
Streptococcus mutans (S. mutans) is a commensal microorganism found in the human oral cavity. However, due to environmental changes, selective pressures, and the presence of a variable genome, it adapts and may acquire new physiological and metabolic properties that alter dental biofilm homeostasis, promoting the development of dental caries. Although the plasticity and heterogeneity of S. mutans is widely recognized, very little is known about the mechanisms for the expression of pathogenic properties in specific genotypes.
Highlight
The implementation of molecular biology techniques in the study of S. mutans has provided information on the genomic diversity of this species. This variability is generated by genome rearrangements, natural genetic transformation, and horizontal gene transfer, and continues to grow due to an open pan-genome. The main virulence factors associated with the cariogenic potential of S. mutans include adhesion, acid production (acidogenicity), and acid tolerance (aciduricity), and also show variability. These factors coordinate the modification of the physicochemical properties of the biofilm, which results in the accumulation of S. mutans and other acidogenic and aciduric species in the oral cavity.
Conclusion
We review the current literature on the main processes that generate S. mutans genomic diversity, as well as the phenotypic variability of its main virulence factors. S. mutans achieves its pathogenesis by sensing the intra- and extracellular environments and regulating gene transcription according to perceived environmental modifications. Consequently, this regulation gives rise to differential synthesis of proteins, allowing this species to potentially express virulence factors.
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Salvage surgery for a locally persistent or recurrent tumour in maxillary cancer patients who have undergone radiotherapy and concomitant intra-arterial cisplatin: implications for surgical margin assessment
Publication date: Available online 15 November 2018
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): T. ono, K. Sakata, N. Tanaka, S. Hashiguchi, H. Migita, K. Kiyokawa, M. Morioka, T. Kurita, K. Sato, N. Takeshige, H. Umeno
Abstract
Limited information about salvage surgery is available for locally persistent and recurrent maxillary sinus cancers after the completion of chemoradiation therapy. Seventy-six maxillary sinus cancer patients who had undergone chemoradioselection using initial radiotherapy and concomitant intra-arterial cisplatin were screened retrospectively. Twenty-four of these patients who had a locally persistent or recurrent tumour were investigated. The 2-year overall survival rate of patients with maxillary sinus cancer of all types was 39.0% for those who underwent salvage surgery and 10.0% for those who did not. The 2-year overall survival rate of patients with maxillary sinus squamous cell carcinoma was 45.8% for those who underwent salvage surgery and 11.1% for those who did not. Furthermore, the 2-year local control and overall survival rates of patients with positive and negative surgical margins were 14.3% and 83.3% and 14.3% and 66.7%, respectively. There were significant differences in local control (P = 0.004) and overall survival (P = 0.005) regarding surgical margin status. Although salvage surgery for a locally persistent or recurrent maxillary sinus cancer is a feasible treatment, patients with positive surgical margins are more prone to local relapse. Therefore, surgical safety margins should be assessed thoroughly.
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Salvage surgery for a locally persistent or recurrent tumour in maxillary cancer patients who have undergone radiotherapy and concomitant intra-arterial cisplatin: implications for surgical margin assessment
Publication date: Available online 15 November 2018
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): T. ono, K. Sakata, N. Tanaka, S. Hashiguchi, H. Migita, K. Kiyokawa, M. Morioka, T. Kurita, K. Sato, N. Takeshige, H. Umeno
Abstract
Limited information about salvage surgery is available for locally persistent and recurrent maxillary sinus cancers after the completion of chemoradiation therapy. Seventy-six maxillary sinus cancer patients who had undergone chemoradioselection using initial radiotherapy and concomitant intra-arterial cisplatin were screened retrospectively. Twenty-four of these patients who had a locally persistent or recurrent tumour were investigated. The 2-year overall survival rate of patients with maxillary sinus cancer of all types was 39.0% for those who underwent salvage surgery and 10.0% for those who did not. The 2-year overall survival rate of patients with maxillary sinus squamous cell carcinoma was 45.8% for those who underwent salvage surgery and 11.1% for those who did not. Furthermore, the 2-year local control and overall survival rates of patients with positive and negative surgical margins were 14.3% and 83.3% and 14.3% and 66.7%, respectively. There were significant differences in local control (P = 0.004) and overall survival (P = 0.005) regarding surgical margin status. Although salvage surgery for a locally persistent or recurrent maxillary sinus cancer is a feasible treatment, patients with positive surgical margins are more prone to local relapse. Therefore, surgical safety margins should be assessed thoroughly.
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Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study
Global chronic urticaria (CU) disease experience and management is not well documented. This study descriptively compares these aspects among CU patients residing in Europe (EU) and Central and South America (...
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Arterial stiffness and white matter integrity in the elderly: A diffusion tensor and magnetization transfer imaging study
Publication date: Available online 16 November 2018
Source: NeuroImage
Author(s): Atef Badji, Adrián Noriega de la Colina, Agah Karakuzu, Tanguy Duval, Laurence Desjardins-Crépeau, Sven Joubert, Louis Bherer, Maxime Lamarre-cliche, Nikola Stikov, Hélène Girouard, Julien Cohen-Adad
Abstract
Background
and purpose: The stiffness of large arteries and increased pulsatility can have an impact on the brain white matter (WM) microstructure, however those mechanisms are still poorly understood. The aim of this study was to investigate the association between central artery stiffness, axonal and myelin integrity in 54 cognitively unimpaired elderly aged 65–75 years old.
Methods
The neuronal fiber integrity of brain WM was assessed using diffusion tensor metrics and magnetization transfer imaging as measures of axonal organization (Fractional anisotropy, Radial diffusivity) and state of myelination (Myelin volume fraction). Central artery stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Statistical analyses included 4 regions (the corpus callosum, the corona radiata, the internal capsule and the superior longitudinal fasciculus) which have been previously denoted as vulnerable to increased central artery stiffness.
Results
cfPWV was significantly associated with fractional anisotropy and radial diffusivity (p < 0.05, corrected for multiple comparisons) but not with myelin volume fraction. Findings from this study also show that improved executive function performance correlates with Fractional anisotropy positively (p < 0.05 corrected) as well as with myelin volume fraction and radial diffusivity negatively (p < 0.05 corrected).
Conclusions
These findings suggest that arterial stiffness is associated with axon degeneration rather than demyelination. Controlling arterial stiffness may play a role in maintaining the health of WM axons in the aging brain.
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Differences in chronic spontaneous urticaria between Europe and Central/South America: results of the multi-center real world AWARE study
Global chronic urticaria (CU) disease experience and management is not well documented. This study descriptively compares these aspects among CU patients residing in Europe (EU) and Central and South America (...
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Transplantation of human limbus–derived mesenchymal stromal cells via occipital approach improves hearing in animal auditory neuropathy
Publication date: Available online 15 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Hsin-Chien Chen, Chang-Min Liang, Chih-Hung Wang, Ming-Yuan Huang, Yuan-Yung Lin, Cheng-Ping Shih, Chao-Yin Kuo, Yi-Chun Lin, Hang-Kang Chen
Abstract
Objective
To develop a surgical approach for cell transplantation into mouse cochlear nerves via an intracranial route and investigate whether transplantation of human limbus–derived mesenchymal stromal cells (HL-MSCs) can improve hearing in this model of auditory neuropathy.
Methods
We used 8-week-old CBA/CaJ male mice and created ouabain-induced auditory neuropathy. The surgical approach passed through the cerebellum to reveal the superior semicircular canal and brainstem, allowing access to the auditory nerve. Then HL-MSCs were injected around the cochlear nerve trunk using a micropipette driven by a micropump. Hearing thresholds in the mice were determined by auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs).
Results
We produced ouabain-induced neuropathy in mice with an elevated hearing threshold but normal DPOAE. Using immunohistological staining, we detected HL-MSCs were localized in the cochlear nerve trunk 2 days after cell transplantation via this occipital approach. More spiral ganglion neurons were detected in ouabain-treated cochleae 3 months after HL-MSCs transplantation compared to those without HL-MSCs transplantation. The ABR showed significant hearing improvement 3 months after HL-MSCs transplantation.
Conclusions
We successfully established a mouse model for cell transplantation into the intracranial cochlear nerve trunk and showed that HL-MSCs potentially can be applied as cell therapy to treat sensorineural hearing loss.
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Radiologic assessment of mandibular third molars: an ex vivo comparative study of panoramic radiography, extraoral bitewing radiography, and cone beam CT
Publication date: Available online 16 November 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Bernardo Barbosa Freire, Eduarda Helena Leandro Nascimento, Karla de Faria Vasconcelos, Deborah Queiroz Freitas, Francisco Haiter-Neto
Objectives
: To compare the performance of panoramic radiography (PAN), extraoral bitewing radiography (EBW), and cone beam computed tomography (CBCT) in the assessment of mandibular third molars.
Study Design
: PAN and EBW were obtained to visualize 34 third molars. The teeth were evaluated according to their position, the presence of radiographic signs of proximity of the roots to the mandibular canal, the relationship of the roots to the canal, and the relationship of second and third molars in PAN and EBW. Third molar position and root relationship with the canal were also assessed with CBCT.
Results
: PAN and EBW showed significantly closer relationships than CBCT between the tooth and the mandibular canal (p≤0.002). For all other parameters, there were no differences between PAN and EBW (p≥0.072), although EBW produced a decreased overlap between proximal surfaces of second and third molars, and a greater trend than PAN towards approximating root apices and the canal.
Conclusions
: In comparison with PAN, EBW showed a tendency to project the roots closer to mandibular canal, but a decrease in the proximal surfaces overlapping the second molar. The relationship between the third molar and the mandibular canal appeared closer in PAN and EBW than in CBCT.
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Twist and E-Cadherin deregulation might predict poor prognosis in lower lip squamous cell carcinoma
Publication date: Available online 16 November 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Everton Freitas de Morais, Hellen Bandeira de Pontes Santos, Israel Leal Cavalcante, Silvia Helena Barem Rabenhorst, Jean Nunes dos Santos, Hébel Cavalcanti Galvão, Roseana de Almeida Freitas
ABSTRACT
Objective
To evaluate the expression of Twist and E-cadherin in Lower Lip Squamous Cell Carcinoma (LLSCC) and their association to clinical-pathological parameters.
Study Design
Fifty-nine LLSCC cases were analyzed applying immunohistochemistry techniques in a semi-quantitative manner. The systems proposed by Bryne et al. (1992), Brandwein-Gensler et al. (2005) and Almangush et al. (2015) were applied for the histopathological malignancy grading system analysis.
Results
Higher E-cadherin expression (general and membrane) was observed in cases presenting disease-free survival after 5 years of follow-up (p < 0 .05). Higher Twist expression was observed in lesions classified as in advanced stages, displaying recurrence and a high degree of malignancy. A significant negative correlation was detected between cytoplasmic Twist expression and membrane E-cadherin expression (p = 0.028). A statistically significant relationship between high total Twist expression in tumors classified as high risk by Brandwein-Gensler et al. (2005) was detected, and no significant difference was observed between total, membrane and cytoplasmic E-cadherin expression in LLSCC cases and the three applied grading systems (p>0.05).
Conclusions
The results of the present study suggest the potential involvement of Twist and E-cadherin in the modulation of events related to worse LLSCC prognoses.
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Craniopharyngiomas and odontogenic tumors mimic normal odontogenesis and share genetic mutations, histopathological features and molecular pathways activation
Publication date: Available online 16 November 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Carolina Cavalieri Gomes, Silvia Ferreira de Sousa, Ricardo Santiago Gomez
Odontogenic tumors bear some histopathological and molecular resemblance to craniopharyngiomas. Specifically, adamantinomatous craniopharyngioma (ACP) shares morphological features and CTNNB1 (the gene encoding β-catenin) mutations with calcifying odontogenic cyst (COC), whereas papillary craniopharyngioma (PCP) and ameloblastoma are driven by BRAF mutations. Recently, important similarities between ACP and the cell signaling pathways involved in tooth formation have been described. Here we expand the interpretation of this data in the context of odontogenic tumors. We discuss some morphological and molecular features that are shared by tumors from these two distinct sites (i.e., craniopharyngiomas and odontogenic tumors). Current conservative surgical treatment is effective for most cases of benign odontogenic tumors, but in the future, the understanding of the molecular pathogenesis could impact the treatment of aggressive and/or malignant cases.
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Hookah Use among Russian adolescents: Prevalence and correlates
Publication date: Available online 16 November 2018
Source: Addictive Behaviors
Author(s): Artur Galimov, Omar El Shahawy, Jennifer B. Unger, Radik Masagutov, Steve Sussman
Abstract
Hookah use among adolescents is increasing globally. No prior studies in the published literature have examined hookah use among youth in the Russian Federation. We assessed demographic, psychological and behavioral factors associated with lifetime and past 30-day hookah use among Russian youth. This cross-sectional study was conducted in three areas of Bashkortostan, Russia. In 2015, we surveyed Russian high school students (n = 716) on socio-demographic characteristics, tobacco (cigarettes, e-cigarettes, hookah) and drug use (alcohol, marijuana, and other illicit drugs), coping strategies, and getting in trouble (self and/or family). We estimated hookah use prevalence and performed bivariate analyses prior to fitting two multilevel models evaluating lifetime and past 30-day hookah use. Within this sample, 34.92% and 9.36% were lifetime and last 30-day hookah users, respectively. Lifetime hookah use was associated with older age (OR = 1.29), higher anger coping (OR = 1.41), school troubles (OR = 2.30), lifetime cigarette (OR = 1.59), e-cigarette (OR = 4.62), alcohol (OR = 5.61), and marijuana use (OR = 8.05). Additionally, past 30-day hookah use was associated with older age (OR = 1.71), lifetime use of alcohol (OR = 5.39), school troubles (OR = 5.82), and anger coping strategies (OR = 1.40). Hookah use is currently high among Russian youth in Bashkortostan and is associated with other risky behaviors. Effective interventions targeting multiple substances and coping strategies are needed. Social media campaigns encouraging cessation and advocating against its use at home may be beneficial in curbing hookah use among youth.
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E-cigarette palatability in smokers as a function of flavorings, nicotine content and propylthiouracil (PROP) taster phenotype
Publication date: Available online 15 November 2018
Source: Addictive Behaviors
Author(s): Erin L. Mead, Valerie Duffy, Cheryl Oncken, Mark D. Litt
Abstract
Background
The popularity of E-cigarettes is due in part to their flavorings. The purpose of this study was to determine the effect on smokers' sensory perceptions and liking of various e-cigarette flavorings, and the degree to which those perceptions are influenced by nicotine level, sex, and PROP bitter taster phenotype.
Methods
We recruited 132 non-treatment-seeking, daily cigarette smokers. In repeated trials in one laboratory session participants vaped the Joyetech eGo-C e-cigarette with each of the following flavorings (in random order): unflavored, tobacco, cherry, chocolate, and menthol. Participants vaped the e-juice first without nicotine and then with high nicotine (18 mg/ml), and provided sensory (bitterness/sourness, irritation, sweetness) and liking ratings. Perceived intensity of 6-n-propylthiouracil (PROP) was used to classify the participants as non-tasters (n = 28), medium-tasters (n = 74), or supertasters (n = 28). Mixed-effects linear models and generalized estimating equations were used to evaluate ratings as a function of flavor interacting with nicotine content, sex and taster phenotype, adjusting for age, race/ethnicity, menthol use, and nicotine dependence.
Results
Regardless of nicotine level, cherry (β = 1.76, p < .001) and chocolate (β = 0.69, p < .001) were rated as sweeter, but were not better liked, than unflavored e-juice. Menthol elicited the highest liking rating, especially for women (β = 12.23, p < .05) and supertasters (β = 20.52, p < .05). Regardless of flavor, high nicotine was rated as more irritating (OR = 1.43, 95% CI = 1.02–2.01) than the no-nicotine e-juice. Irritation (β = −13.65, p < .001), bitterness/sourness (β = −11.38, p < .001), and sweetness (β = 4.79, p < .001) were associated with liking.
Conclusion
Menthol may enhance e-cigarette palatability for some smokers, which may increase e-cigarette utility in smoking cessation.
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Transplantation of human limbus–derived mesenchymal stromal cells via occipital approach improves hearing in animal auditory neuropathy
Publication date: Available online 15 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Hsin-Chien Chen, Chang-Min Liang, Chih-Hung Wang, Ming-Yuan Huang, Yuan-Yung Lin, Cheng-Ping Shih, Chao-Yin Kuo, Yi-Chun Lin, Hang-Kang Chen
Abstract
Objective
To develop a surgical approach for cell transplantation into mouse cochlear nerves via an intracranial route and investigate whether transplantation of human limbus–derived mesenchymal stromal cells (HL-MSCs) can improve hearing in this model of auditory neuropathy.
Methods
We used 8-week-old CBA/CaJ male mice and created ouabain-induced auditory neuropathy. The surgical approach passed through the cerebellum to reveal the superior semicircular canal and brainstem, allowing access to the auditory nerve. Then HL-MSCs were injected around the cochlear nerve trunk using a micropipette driven by a micropump. Hearing thresholds in the mice were determined by auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs).
Results
We produced ouabain-induced neuropathy in mice with an elevated hearing threshold but normal DPOAE. Using immunohistological staining, we detected HL-MSCs were localized in the cochlear nerve trunk 2 days after cell transplantation via this occipital approach. More spiral ganglion neurons were detected in ouabain-treated cochleae 3 months after HL-MSCs transplantation compared to those without HL-MSCs transplantation. The ABR showed significant hearing improvement 3 months after HL-MSCs transplantation.
Conclusions
We successfully established a mouse model for cell transplantation into the intracranial cochlear nerve trunk and showed that HL-MSCs potentially can be applied as cell therapy to treat sensorineural hearing loss.
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Radiologic assessment of mandibular third molars: an ex vivo comparative study of panoramic radiography, extraoral bitewing radiography, and cone beam CT
Publication date: Available online 16 November 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Bernardo Barbosa Freire, Eduarda Helena Leandro Nascimento, Karla de Faria Vasconcelos, Deborah Queiroz Freitas, Francisco Haiter-Neto
Objectives
: To compare the performance of panoramic radiography (PAN), extraoral bitewing radiography (EBW), and cone beam computed tomography (CBCT) in the assessment of mandibular third molars.
Study Design
: PAN and EBW were obtained to visualize 34 third molars. The teeth were evaluated according to their position, the presence of radiographic signs of proximity of the roots to the mandibular canal, the relationship of the roots to the canal, and the relationship of second and third molars in PAN and EBW. Third molar position and root relationship with the canal were also assessed with CBCT.
Results
: PAN and EBW showed significantly closer relationships than CBCT between the tooth and the mandibular canal (p≤0.002). For all other parameters, there were no differences between PAN and EBW (p≥0.072), although EBW produced a decreased overlap between proximal surfaces of second and third molars, and a greater trend than PAN towards approximating root apices and the canal.
Conclusions
: In comparison with PAN, EBW showed a tendency to project the roots closer to mandibular canal, but a decrease in the proximal surfaces overlapping the second molar. The relationship between the third molar and the mandibular canal appeared closer in PAN and EBW than in CBCT.
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Substance use disorder treatment admissions and state-level prenatal substance use policies: Evidence from a national treatment database
Publication date: Available online 16 November 2018
Source: Addictive Behaviors
Author(s): Katy Kozhimannil, William N. Dowd, Mir M. Ali, Priscilla Novak, Jie Chen
Abstract
State policies pertaining to prenatal substance use have important implications for health outcomes of pregnant women and their infants. However, little is known about the impact of the various types of state-level prenatal substance use policies (i.e., treatment and supportive services; criminal justice initiatives; and health care provider reporting requirements) on substance use disorder treatment admissions. Using data from the 2002–2014 Treatment Episode Data Set - Admissions, we exploited state-level variation in the implementation of different types of policies to assess their impact on pregnant women's admission to substance use disorder treatment. The study found that state-level prenatal substance use policies focused only on the criminal justice sector were negatively associated with the proportion of women of reproductive age who were pregnant upon admission to treatment. Additionally, the implementation of policies that engaged all three sectors was positively associated with the proportion of women of reproductive age who were pregnant upon admission to treatment. These results were consistent across age groups and for both non-Hispanic white women and women of other racial/ethnic groups. The findings imply that states with cross-sector policy engagement around prenatal substance use and policies that take a multifaceted, comprehensive approach are more likely to see an increase in admissions to substance use disorder treatment during pregnancy.
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Hookah Use among Russian adolescents: Prevalence and correlates
Publication date: Available online 16 November 2018
Source: Addictive Behaviors
Author(s): Artur Galimov, Omar El Shahawy, Jennifer B. Unger, Radik Masagutov, Steve Sussman
Abstract
Hookah use among adolescents is increasing globally. No prior studies in the published literature have examined hookah use among youth in the Russian Federation. We assessed demographic, psychological and behavioral factors associated with lifetime and past 30-day hookah use among Russian youth. This cross-sectional study was conducted in three areas of Bashkortostan, Russia. In 2015, we surveyed Russian high school students (n = 716) on socio-demographic characteristics, tobacco (cigarettes, e-cigarettes, hookah) and drug use (alcohol, marijuana, and other illicit drugs), coping strategies, and getting in trouble (self and/or family). We estimated hookah use prevalence and performed bivariate analyses prior to fitting two multilevel models evaluating lifetime and past 30-day hookah use. Within this sample, 34.92% and 9.36% were lifetime and last 30-day hookah users, respectively. Lifetime hookah use was associated with older age (OR = 1.29), higher anger coping (OR = 1.41), school troubles (OR = 2.30), lifetime cigarette (OR = 1.59), e-cigarette (OR = 4.62), alcohol (OR = 5.61), and marijuana use (OR = 8.05). Additionally, past 30-day hookah use was associated with older age (OR = 1.71), lifetime use of alcohol (OR = 5.39), school troubles (OR = 5.82), and anger coping strategies (OR = 1.40). Hookah use is currently high among Russian youth in Bashkortostan and is associated with other risky behaviors. Effective interventions targeting multiple substances and coping strategies are needed. Social media campaigns encouraging cessation and advocating against its use at home may be beneficial in curbing hookah use among youth.
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E-cigarette palatability in smokers as a function of flavorings, nicotine content and propylthiouracil (PROP) taster phenotype
Publication date: Available online 15 November 2018
Source: Addictive Behaviors
Author(s): Erin L. Mead, Valerie Duffy, Cheryl Oncken, Mark D. Litt
Abstract
Background
The popularity of E-cigarettes is due in part to their flavorings. The purpose of this study was to determine the effect on smokers' sensory perceptions and liking of various e-cigarette flavorings, and the degree to which those perceptions are influenced by nicotine level, sex, and PROP bitter taster phenotype.
Methods
We recruited 132 non-treatment-seeking, daily cigarette smokers. In repeated trials in one laboratory session participants vaped the Joyetech eGo-C e-cigarette with each of the following flavorings (in random order): unflavored, tobacco, cherry, chocolate, and menthol. Participants vaped the e-juice first without nicotine and then with high nicotine (18 mg/ml), and provided sensory (bitterness/sourness, irritation, sweetness) and liking ratings. Perceived intensity of 6-n-propylthiouracil (PROP) was used to classify the participants as non-tasters (n = 28), medium-tasters (n = 74), or supertasters (n = 28). Mixed-effects linear models and generalized estimating equations were used to evaluate ratings as a function of flavor interacting with nicotine content, sex and taster phenotype, adjusting for age, race/ethnicity, menthol use, and nicotine dependence.
Results
Regardless of nicotine level, cherry (β = 1.76, p < .001) and chocolate (β = 0.69, p < .001) were rated as sweeter, but were not better liked, than unflavored e-juice. Menthol elicited the highest liking rating, especially for women (β = 12.23, p < .05) and supertasters (β = 20.52, p < .05). Regardless of flavor, high nicotine was rated as more irritating (OR = 1.43, 95% CI = 1.02–2.01) than the no-nicotine e-juice. Irritation (β = −13.65, p < .001), bitterness/sourness (β = −11.38, p < .001), and sweetness (β = 4.79, p < .001) were associated with liking.
Conclusion
Menthol may enhance e-cigarette palatability for some smokers, which may increase e-cigarette utility in smoking cessation.
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Hypersensitivity Pneumonitis: A Fibrosing Alveolitis Produced by Inhalation of Diverse Antigens
Publication date: Available online 15 November 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Paul A. Greenberger
Abstract
Hypersensitivity pneumonitis (HP) is a TH1 lymphocyte biased fibrosing alveolitis that is caused by antigens ranging from avian excreta, fungi, thermophilic bacteria, and protozoa to reactive chemicals found in the workplace. Mimicking a viral syndrome, acute exposures to inciting antigens cause abrupt onset of non-productive cough, dyspnea, chills, with arthralgias or malaise usually from 4-8 hours later so that the temporal relationship between antigen exposure and symptoms may be unsuspected. The histology of HP reveals prominent lymphocyte infiltrates that thicken the alveolar septa with poorly formed granulomas or giant cells. Broncholalveolar lavage demonstrates > 20% lymphocytes in nearly all patients. Abnormalities on high resolution computerized tomography examinations range from nodular, centrilobular opacities in acute/subacute disease to increased reticular markings and honeycombing fibrosis, which typically are predominant in the upper lobes, in advanced disease. Descriptors include "mosaic attenuation" and "ground-glass" opacities. Repeated episodes can result in nodular pulmonary infiltrates and suspected nonspecific interstitial pneumonia or idiopathic pulmonary fibrosis. Clinicians require a high level of suspicion to make an early diagnosis of HP before extensive pulmonary fibrosis or restrictive lung disease has occurred.
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Radiologic evaluation of pulmonary injury following carmustine- and cyclophosphamide-based preparative regimen for autologous peripheral blood stem cell transplantation in children
Abstract
Background
Toxicity of carmustine and cyclophosphamide can cause pulmonary injury after hematopoietic stem cell transplantation.
Objective
To evaluate the radiologic findings of pulmonary injuries following carmustine- and cyclophosphamide-based preparative regimens in children.
Materials and methods
From 2010 to 2014, 35 children received carmustine- and cyclophosphamide-based preparative regimens. Fourteen of 35 children presented with symptoms and radiologic abnormalities. Eight of 14 children had no evidence of infection, cardiogenic edema, or other explainable causes. We retrospectively analyzed their chest radiographs and CT scans for ground-glass opacity, consolidation, septal thickening and pleural effusion.
Results
Major chest radiographic findings were bilateral diffuse ground-glass opacity (n=8) and septal thickening (n=7). CT findings were multifocal patchy (n=4) or inhomogeneously diffuse (n=4) ground-glass opacity, multifocal consolidations (n=7) and septal thickening (n=7). All of these lesions at CT were bilateral, but showed lower lobe predominance in 88, 100, and 63%, respectively. There was no central/peripheral or anterior/posterior predilection. Six children had small pleural effusions, which were bilateral in five children.
Conclusion
Bilateral ground-glass opacity with or without consolidation, septal thickening and pleural effusion were common radiologic findings in pulmonary injury following carmustine- and cyclophosphamide-based preparative regimens.
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Correction to: Comparative safety and efficacy of balloon use in air enema reduction for pediatric intussusception
The original version on this paper contained an error. The names of M. John Hicks and R. Paul Guillerman, though correctly appeared in the published version, are incorrectly displayed in indexing sites.
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Radiologic evaluation of pulmonary injury following carmustine- and cyclophosphamide-based preparative regimen for autologous peripheral blood stem cell transplantation in children
Abstract
Background
Toxicity of carmustine and cyclophosphamide can cause pulmonary injury after hematopoietic stem cell transplantation.
Objective
To evaluate the radiologic findings of pulmonary injuries following carmustine- and cyclophosphamide-based preparative regimens in children.
Materials and methods
From 2010 to 2014, 35 children received carmustine- and cyclophosphamide-based preparative regimens. Fourteen of 35 children presented with symptoms and radiologic abnormalities. Eight of 14 children had no evidence of infection, cardiogenic edema, or other explainable causes. We retrospectively analyzed their chest radiographs and CT scans for ground-glass opacity, consolidation, septal thickening and pleural effusion.
Results
Major chest radiographic findings were bilateral diffuse ground-glass opacity (n=8) and septal thickening (n=7). CT findings were multifocal patchy (n=4) or inhomogeneously diffuse (n=4) ground-glass opacity, multifocal consolidations (n=7) and septal thickening (n=7). All of these lesions at CT were bilateral, but showed lower lobe predominance in 88, 100, and 63%, respectively. There was no central/peripheral or anterior/posterior predilection. Six children had small pleural effusions, which were bilateral in five children.
Conclusion
Bilateral ground-glass opacity with or without consolidation, septal thickening and pleural effusion were common radiologic findings in pulmonary injury following carmustine- and cyclophosphamide-based preparative regimens.
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A retrospective segmentation analysis of placental volume by magnetic resonance imaging from first trimester to term gestation
Abstract
Background
Abnormalities of the placenta affect 5–7% of pregnancies. Because disturbances in fetal growth are often preceded by dysfunction of the placenta or attenuation of its normal expansion, placental health warrants careful surveillance. There are limited normative data available for placental volume by MRI.
Objective
To determine normative ranges of placental volume by MRI throughout gestation.
Materials and methods
In this cross-sectional retrospective analysis, we reviewed MRI examinations of pregnant females obtained between 2002 and 2017 at a single institution. We performed semi-automated segmentation of the placenta in images obtained in patients with no radiologic evidence of maternal or fetal pathology, using the Philips Intellispace Tumor Tracking Tool.
Results
Placental segmentation was performed in 112 women and had a high degree of interrater reliability (single-measure intraclass correlation coefficient =0.978 with 95% confidence interval [CI] 0.956, 0.989; P<0.001). Normative data on placental volume by MRI increased nonlinearly from 6 weeks to 39 weeks of gestation, with wider variability of placental volume at higher gestational age (GA). We fit placental volumetric data to a polynomial curve of third order described as placental volume = –0.02*GA3 + 1.6*GA2 – 13.3*GA + 8.3. Placental volume showed positive correlation with estimated fetal weight (P=0.03) and birth weight (P=0.05).
Conclusion
This study provides normative placental volume by MRI from early first trimester to term gestation. Deviations in placental volume from normal might prove to be an imaging biomarker of adverse fetal health and neonatal outcome, and further studies are needed to more fully understand this metric. Assessment of placental volume should be considered in all routine fetal MRI examinations.
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Gauging potential risk for patients in pediatric radiology by review of over 2,000 incident reports
Abstract
Background
Incident reporting can be used to inform imaging departments about adverse events and near misses.
Objective
To study incident reports submitted during a 5-year period at a large pediatric imaging system to evaluate which imaging modalities and other factors were associated with a greater rate of filed incident reports.
Materials and methods
All incident reports filed between 2013 and 2017 were reviewed and categorized by modality, patient type (inpatient, outpatient or emergency center) and use of sedation/anesthesia. The number of incident reports was compared to the number of imaging studies performed during that time period to calculate an incident report rate for each factor. Statistical analysis of whether there were differences in these rates between factors was performed.
Results
During the study period, there were 2,009 incident reports filed and 1,071,809 imaging studies performed for an incident report rate of 0.19%. The differences in rates by modality were statistically significant (P=0.0001). There was a greater rate of incident reports in interventional radiology (1.54%) (P=0.0001) and in magnetic resonance imaging (MRI) (0.62%) (P=0.001) as compared to other imaging modalities. There was a higher incident report rate for inpatients (0.34%) as compared to outpatient (0.1%) or emergency center (0.14%) (P=0.0001). There was a higher rate of incident reports for patients under sedation (1.27%) as compared to non-sedated (0.12%) (P=0.0001).
Conclusion
Using incident report rates as a proxy for potential patient harm, the areas of our pediatric radiology service that are associated with the greatest potential for issues are interventional radiology, sedated patients, and inpatients. The areas associated with the least risk are ultrasound (US) and radiography. Safety improvement efforts should be focused on the high-risk areas.
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Iterative algorithms for metal artifact reduction in children with orthopedic prostheses: preliminary results
Abstract
Background
Increased computational power allows computed tomography (CT) software to process very advanced mathematical algorithms to generate better quality images at lower doses. One such algorithm, iterative metal artifact reduction (iMAR) has proven to decrease metal artifacts seen in CT images of adults with orthopedic implants.
Objectives
To evaluate artifact reduction capability of the algorithm in lower-dose pediatric CT compared to our routine third-generation advanced modeled iterative reconstruction (ADMIRE) algorithm.
Materials and methods
Thirteen children (11–17 years old) with metal implants underwent routine clinically indicated CT. Data sets were reconstructed with an iMAR algorithm. Hounsfield units and image noise were measured in bone, muscle and fat in the streak artifact (near the implant) and at the greatest distance from the artifact (far from the implant). A regression model compared the effects of the algorithm (standard ADMIRE vs. iMAR) near and far from the implant.
Results
Near the implant, Hounsfield units with iMAR were significantly different in our standard ADMIRE vs. iMAR for bone, muscle and fat (P<0.001). Noise was significantly different in standard ADMIRE vs. iMAR in bone (P<0.003). Far from the implant, Hounsfield units and noise were not significantly different for ADMIRE vs. iMAR, for the three tissue types.
Conclusion
These preliminary results demonstrate that iMAR algorithms improves Hounsfield units near the implant and decreases image noise in bone in low-dose pediatric CT. It does this without changing baseline tissue density or noise far from the implant.
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Patchy increased echogenicity: a sonographic sign of femoral head necrosis following reduction and casting for developmental dysplasia of the hip
Abstract
A developmental dysplasia of the hip (DDH) case treated by closed reduction and casting and subsequently confirmed to have avascular necrosis (AVN) was retrospectively noted to have an abnormal pattern of echogenicity in the femoral head on sonograms obtained within 1.5 months of surgery. Patchy increased echogenicity in parts of the unossified cartilage replaced the normal pattern of central coalescence of vessels described with development of the ossification center. An additional case with similar findings confirms this should be considered a sign of evolving AVN following closed reduction.
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Active reviewers (from October 1, 2017 through September 30, 2018)
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Correction to: Comparative safety and efficacy of balloon use in air enema reduction for pediatric intussusception
The original version on this paper contained an error. The names of M. John Hicks and R. Paul Guillerman, though correctly appeared in the published version, are incorrectly displayed in indexing sites.
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A retrospective segmentation analysis of placental volume by magnetic resonance imaging from first trimester to term gestation
Abstract
Background
Abnormalities of the placenta affect 5–7% of pregnancies. Because disturbances in fetal growth are often preceded by dysfunction of the placenta or attenuation of its normal expansion, placental health warrants careful surveillance. There are limited normative data available for placental volume by MRI.
Objective
To determine normative ranges of placental volume by MRI throughout gestation.
Materials and methods
In this cross-sectional retrospective analysis, we reviewed MRI examinations of pregnant females obtained between 2002 and 2017 at a single institution. We performed semi-automated segmentation of the placenta in images obtained in patients with no radiologic evidence of maternal or fetal pathology, using the Philips Intellispace Tumor Tracking Tool.
Results
Placental segmentation was performed in 112 women and had a high degree of interrater reliability (single-measure intraclass correlation coefficient =0.978 with 95% confidence interval [CI] 0.956, 0.989; P<0.001). Normative data on placental volume by MRI increased nonlinearly from 6 weeks to 39 weeks of gestation, with wider variability of placental volume at higher gestational age (GA). We fit placental volumetric data to a polynomial curve of third order described as placental volume = –0.02*GA3 + 1.6*GA2 – 13.3*GA + 8.3. Placental volume showed positive correlation with estimated fetal weight (P=0.03) and birth weight (P=0.05).
Conclusion
This study provides normative placental volume by MRI from early first trimester to term gestation. Deviations in placental volume from normal might prove to be an imaging biomarker of adverse fetal health and neonatal outcome, and further studies are needed to more fully understand this metric. Assessment of placental volume should be considered in all routine fetal MRI examinations.
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Iterative algorithms for metal artifact reduction in children with orthopedic prostheses: preliminary results
Abstract
Background
Increased computational power allows computed tomography (CT) software to process very advanced mathematical algorithms to generate better quality images at lower doses. One such algorithm, iterative metal artifact reduction (iMAR) has proven to decrease metal artifacts seen in CT images of adults with orthopedic implants.
Objectives
To evaluate artifact reduction capability of the algorithm in lower-dose pediatric CT compared to our routine third-generation advanced modeled iterative reconstruction (ADMIRE) algorithm.
Materials and methods
Thirteen children (11–17 years old) with metal implants underwent routine clinically indicated CT. Data sets were reconstructed with an iMAR algorithm. Hounsfield units and image noise were measured in bone, muscle and fat in the streak artifact (near the implant) and at the greatest distance from the artifact (far from the implant). A regression model compared the effects of the algorithm (standard ADMIRE vs. iMAR) near and far from the implant.
Results
Near the implant, Hounsfield units with iMAR were significantly different in our standard ADMIRE vs. iMAR for bone, muscle and fat (P<0.001). Noise was significantly different in standard ADMIRE vs. iMAR in bone (P<0.003). Far from the implant, Hounsfield units and noise were not significantly different for ADMIRE vs. iMAR, for the three tissue types.
Conclusion
These preliminary results demonstrate that iMAR algorithms improves Hounsfield units near the implant and decreases image noise in bone in low-dose pediatric CT. It does this without changing baseline tissue density or noise far from the implant.
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Active reviewers (from October 1, 2017 through September 30, 2018)
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A stratified reconstructive approach for the post burn axillary adduction contractures based on the anatomical study of thoracodorsal vessel perforator system
Abstract
Background
Post-burn axillary adduction contractures (PBAAC) are commonly seen burn sequelae. They occur in various forms. By imposing colossal restriction on the range of mobility of the shoulder, they completely intervene with the upper limb over head functions.
Methods
In 15 fresh frozen cadavers, 30 specimens of thoracodorsal vessel axes were studied after dye injection. Cadaveric study was conducted to standardise and stratify the clinical approach for harvesting perforator propeller flaps based on the thoracodorsal vessel axis (TDVA) by clear demonstration of various types of perforators arising from them. Three types of perforators (musculocutaneous, septocutaneous and direct cutaneous perforators were demonstrated), their dimensions, distribution and surface anatomy were defined. This knowledge paved the way for a stratified approach in harvesting the TDAPs (thoracodorsal artery perforator propeller flaps) for the reconstruction of PBAACs. The documents containing the data of 36 patients who underwent PBAAC reconstruction from 2010 to 2016 using perforators from TDVA (thoraco dorsal vessels axis) were collected for the retrospective study. Twelve patients underwent TDVA septofasciocutaneous perforator-based flap reconstruction for type 2 PBAACs. In 14 patients, post-burn axillary contractures were reconstructed with musculocutaneous perforator of TDVA (for type 3 PBAACs). Ten patients with type 1 PBAACs were reconstructed with direct cutaneous perforators of the TDVA. The average follow-up period was 18 months.
Results
All the flaps survived completely with no major complications. Average pre-operative range of abduction was 45.5°. The average post-operative pain free abduction obtained in 36 cases was 146.38° at an average of 18 months.
Conclusion
The challenging reconstruction of PBAACs can be simplified by the stratified approach using TDVA perforator-based propeller flaps. Perforator propeller flap based on the direct cutaneous perforator from the TDVA is most suitable for type 1 PBAAC reconstruction, whereas type 2 and type 3 PBAACs can be best served by septofasciocutaneous and musculocutaneous based perforator propeller flaps, respectively.
Level of Evidence: Level IV, therapeutic study.
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Ear lobe rotation flap for the reconstruction of full-thickness defects of the middle third of the auricle
Abstract
The authors propose a novel surgical technique for reconstruction of full-thickness defects of the middle portion of the auricle including the helix and the antihelix up to the neighboring portion of the concha and sparing the whole of the ear lobe. It is a single-stage procedure that is indicated when a large, redundant, and pendulous earlobe exists as typically occurs in the elderly patient. The earlobe is rotated into the full-thickness ear defect and fits as an inlay between two cartilaginous stumps. The ear lobe presents two anatomical patterns: the pendulous or free one, with the ear lobe lying free from the cheek, and the non-pendulous or attached one, where the ear lobe is attached to the cheek. Donor site deformity is therefore limited to the conversion of a pendulous ear lobe pattern into an attached one. Surgery may be scheduled in an outpatient basis as the procedure is easy to plan, is fast to perform, and is carried out under local anesthesia.
Level of Evidence: Level IV, therapeutic study.
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Tonotopy in calcium homeostasis and vulnerability of cochlear hair cells
Publication date: Available online 16 November 2018
Source: Hearing Research
Author(s): Robert Fettiplace, Jong-Hoon Nam
Abstract
Ototoxicity, noise overstimulation, or aging, can all produce hearing loss with similar properties, in which outer hair cells (OHCs), principally those at the high-frequency base of the cochlea, are preferentially affected. We suggest that the differential vulnerability may partly arise from differences in Ca2+ balance among cochlear locations. Homeostasis is determined by three factors: Ca2+ influx mainly via mechanotransducer (MET) channels; buffering by calcium-binding proteins and organelles like mitochondria; and extrusion by the plasma membrane CaATPase pump. We review quantification of these parameters and use our experimentally-determined values to model changes in cytoplasmic and mitochondrial Ca2+ during Ca2+ influx through the MET channels. We suggest that, in OHCs, there are two distinct micro-compartments for Ca2+ handling, one in the hair bundle and the other in the cell soma. One conclusion of the modeling is that there is a tonotopic gradient in the ability of OHCs to handle the Ca2+ load, which correlates with their vulnerability to environmental challenges. High-frequency basal OHCs are the most susceptible because they have much larger MET currents and have smaller dimensions than low-frequency apical OHCs.
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Association between impacted third molars and position of the mandibular canal: a morphological analysis using cone-beam computed tomography
Publication date: Available online 16 November 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): R. Quirino de Almeida Barros, N. Bezerra de Melo, Í. de Macedo Bernardino, M.J. Arêa Leão Lopes Araújo Arruda, P. Meira Bento
Abstract
Our aim was to assess the association between the angle of impaction of the third molar and the position of the mandibular canal on cone-beam computed tomography (CT). We designed a retrospective study of 100 cone-beam CT images of 173 mandibular third molars that were obtained between January 2012 and December 2015, and recorded the angle of impaction of the third molar, the position of the mandibular canal in relation to the impacted tooth, and the potential contact between the roots of the tooth and the mandibular canal. Most third molars tilted mesially (n = 33), while the mandibular canal was positioned below the roots of the third molar in most cases (n = 73). Contact between the two was most likely when the mandibular canal was between (RR = 1.49; 95% CI 1.27 to 1.75, p < 0.001), or to the lingual side (RR = 1.49; 95% CI 1.27 to 1.75, p < 0.001) of the roots of the tooth. These outcomes indicate a greater likelihood of contact between the canal and the roots when the canal is between, and to the lingual side, of the roots. We found no association between the angle of impaction and the position of the canal. These findings illustrate the importance of surgical planning using complementary imaging tests such as cone-beam CT.
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Citation for the 2017 Down Surgical Prize – Paul Johnson
Publication date: Available online 15 November 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): Carrie Newlands
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An unusual case of giant rhinophyma
Abstract
Rosacea is a rather common and frequently diagnosed condition of the skin and may in some cases progress to rhinophyma. This is a case report of a patient with a giant rhinophyma of 358 g. He claimed his first symptoms 5 years prior to our first clinical assessment. We performed an excision of the tumor mass by scalpel and a CO2 laser treatment of the remaining skin surface. Post-surgical therapy only included topical treatment with an ointment containing bacitracin zinc and neomycin sulphate to prevent infections. After stable wound closure, we had the chance to examine the patient after a period of 7.5 years with remarkable aesthetical results.
Level of Evidence: Level V, therapeutic study.
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A stratified reconstructive approach for the post burn axillary adduction contractures based on the anatomical study of thoracodorsal vessel perforator system
Abstract
Background
Post-burn axillary adduction contractures (PBAAC) are commonly seen burn sequelae. They occur in various forms. By imposing colossal restriction on the range of mobility of the shoulder, they completely intervene with the upper limb over head functions.
Methods
In 15 fresh frozen cadavers, 30 specimens of thoracodorsal vessel axes were studied after dye injection. Cadaveric study was conducted to standardise and stratify the clinical approach for harvesting perforator propeller flaps based on the thoracodorsal vessel axis (TDVA) by clear demonstration of various types of perforators arising from them. Three types of perforators (musculocutaneous, septocutaneous and direct cutaneous perforators were demonstrated), their dimensions, distribution and surface anatomy were defined. This knowledge paved the way for a stratified approach in harvesting the TDAPs (thoracodorsal artery perforator propeller flaps) for the reconstruction of PBAACs. The documents containing the data of 36 patients who underwent PBAAC reconstruction from 2010 to 2016 using perforators from TDVA (thoraco dorsal vessels axis) were collected for the retrospective study. Twelve patients underwent TDVA septofasciocutaneous perforator-based flap reconstruction for type 2 PBAACs. In 14 patients, post-burn axillary contractures were reconstructed with musculocutaneous perforator of TDVA (for type 3 PBAACs). Ten patients with type 1 PBAACs were reconstructed with direct cutaneous perforators of the TDVA. The average follow-up period was 18 months.
Results
All the flaps survived completely with no major complications. Average pre-operative range of abduction was 45.5°. The average post-operative pain free abduction obtained in 36 cases was 146.38° at an average of 18 months.
Conclusion
The challenging reconstruction of PBAACs can be simplified by the stratified approach using TDVA perforator-based propeller flaps. Perforator propeller flap based on the direct cutaneous perforator from the TDVA is most suitable for type 1 PBAAC reconstruction, whereas type 2 and type 3 PBAACs can be best served by septofasciocutaneous and musculocutaneous based perforator propeller flaps, respectively.
Level of Evidence: Level IV, therapeutic study.
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Ear lobe rotation flap for the reconstruction of full-thickness defects of the middle third of the auricle
Abstract
The authors propose a novel surgical technique for reconstruction of full-thickness defects of the middle portion of the auricle including the helix and the antihelix up to the neighboring portion of the concha and sparing the whole of the ear lobe. It is a single-stage procedure that is indicated when a large, redundant, and pendulous earlobe exists as typically occurs in the elderly patient. The earlobe is rotated into the full-thickness ear defect and fits as an inlay between two cartilaginous stumps. The ear lobe presents two anatomical patterns: the pendulous or free one, with the ear lobe lying free from the cheek, and the non-pendulous or attached one, where the ear lobe is attached to the cheek. Donor site deformity is therefore limited to the conversion of a pendulous ear lobe pattern into an attached one. Surgery may be scheduled in an outpatient basis as the procedure is easy to plan, is fast to perform, and is carried out under local anesthesia.
Level of Evidence: Level IV, therapeutic study.
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Tonotopy in calcium homeostasis and vulnerability of cochlear hair cells
Publication date: Available online 16 November 2018
Source: Hearing Research
Author(s): Robert Fettiplace, Jong-Hoon Nam
Abstract
Ototoxicity, noise overstimulation, or aging, can all produce hearing loss with similar properties, in which outer hair cells (OHCs), principally those at the high-frequency base of the cochlea, are preferentially affected. We suggest that the differential vulnerability may partly arise from differences in Ca2+ balance among cochlear locations. Homeostasis is determined by three factors: Ca2+ influx mainly via mechanotransducer (MET) channels; buffering by calcium-binding proteins and organelles like mitochondria; and extrusion by the plasma membrane CaATPase pump. We review quantification of these parameters and use our experimentally-determined values to model changes in cytoplasmic and mitochondrial Ca2+ during Ca2+ influx through the MET channels. We suggest that, in OHCs, there are two distinct micro-compartments for Ca2+ handling, one in the hair bundle and the other in the cell soma. One conclusion of the modeling is that there is a tonotopic gradient in the ability of OHCs to handle the Ca2+ load, which correlates with their vulnerability to environmental challenges. High-frequency basal OHCs are the most susceptible because they have much larger MET currents and have smaller dimensions than low-frequency apical OHCs.
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Association between impacted third molars and position of the mandibular canal: a morphological analysis using cone-beam computed tomography
Publication date: Available online 16 November 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): R. Quirino de Almeida Barros, N. Bezerra de Melo, Í. de Macedo Bernardino, M.J. Arêa Leão Lopes Araújo Arruda, P. Meira Bento
Abstract
Our aim was to assess the association between the angle of impaction of the third molar and the position of the mandibular canal on cone-beam computed tomography (CT). We designed a retrospective study of 100 cone-beam CT images of 173 mandibular third molars that were obtained between January 2012 and December 2015, and recorded the angle of impaction of the third molar, the position of the mandibular canal in relation to the impacted tooth, and the potential contact between the roots of the tooth and the mandibular canal. Most third molars tilted mesially (n = 33), while the mandibular canal was positioned below the roots of the third molar in most cases (n = 73). Contact between the two was most likely when the mandibular canal was between (RR = 1.49; 95% CI 1.27 to 1.75, p < 0.001), or to the lingual side (RR = 1.49; 95% CI 1.27 to 1.75, p < 0.001) of the roots of the tooth. These outcomes indicate a greater likelihood of contact between the canal and the roots when the canal is between, and to the lingual side, of the roots. We found no association between the angle of impaction and the position of the canal. These findings illustrate the importance of surgical planning using complementary imaging tests such as cone-beam CT.
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Citation for the 2017 Down Surgical Prize – Paul Johnson
Publication date: Available online 15 November 2018
Source: British Journal of Oral and Maxillofacial Surgery
Author(s): Carrie Newlands
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A stratified reconstructive approach for the post burn axillary adduction contractures based on the anatomical study of thoracodorsal vessel perforator system
Abstract
Background
Post-burn axillary adduction contractures (PBAAC) are commonly seen burn sequelae. They occur in various forms. By imposing colossal restriction on the range of mobility of the shoulder, they completely intervene with the upper limb over head functions.
Methods
In 15 fresh frozen cadavers, 30 specimens of thoracodorsal vessel axes were studied after dye injection. Cadaveric study was conducted to standardise and stratify the clinical approach for harvesting perforator propeller flaps based on the thoracodorsal vessel axis (TDVA) by clear demonstration of various types of perforators arising from them. Three types of perforators (musculocutaneous, septocutaneous and direct cutaneous perforators were demonstrated), their dimensions, distribution and surface anatomy were defined. This knowledge paved the way for a stratified approach in harvesting the TDAPs (thoracodorsal artery perforator propeller flaps) for the reconstruction of PBAACs. The documents containing the data of 36 patients who underwent PBAAC reconstruction from 2010 to 2016 using perforators from TDVA (thoraco dorsal vessels axis) were collected for the retrospective study. Twelve patients underwent TDVA septofasciocutaneous perforator-based flap reconstruction for type 2 PBAACs. In 14 patients, post-burn axillary contractures were reconstructed with musculocutaneous perforator of TDVA (for type 3 PBAACs). Ten patients with type 1 PBAACs were reconstructed with direct cutaneous perforators of the TDVA. The average follow-up period was 18 months.
Results
All the flaps survived completely with no major complications. Average pre-operative range of abduction was 45.5°. The average post-operative pain free abduction obtained in 36 cases was 146.38° at an average of 18 months.
Conclusion
The challenging reconstruction of PBAACs can be simplified by the stratified approach using TDVA perforator-based propeller flaps. Perforator propeller flap based on the direct cutaneous perforator from the TDVA is most suitable for type 1 PBAAC reconstruction, whereas type 2 and type 3 PBAACs can be best served by septofasciocutaneous and musculocutaneous based perforator propeller flaps, respectively.
Level of Evidence: Level IV, therapeutic study.
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A stratified reconstructive approach for the post burn axillary adduction contractures based on the anatomical study of thoracodorsal vessel perforator system
Abstract
Background
Post-burn axillary adduction contractures (PBAAC) are commonly seen burn sequelae. They occur in various forms. By imposing colossal restriction on the range of mobility of the shoulder, they completely intervene with the upper limb over head functions.
Methods
In 15 fresh frozen cadavers, 30 specimens of thoracodorsal vessel axes were studied after dye injection. Cadaveric study was conducted to standardise and stratify the clinical approach for harvesting perforator propeller flaps based on the thoracodorsal vessel axis (TDVA) by clear demonstration of various types of perforators arising from them. Three types of perforators (musculocutaneous, septocutaneous and direct cutaneous perforators were demonstrated), their dimensions, distribution and surface anatomy were defined. This knowledge paved the way for a stratified approach in harvesting the TDAPs (thoracodorsal artery perforator propeller flaps) for the reconstruction of PBAACs. The documents containing the data of 36 patients who underwent PBAAC reconstruction from 2010 to 2016 using perforators from TDVA (thoraco dorsal vessels axis) were collected for the retrospective study. Twelve patients underwent TDVA septofasciocutaneous perforator-based flap reconstruction for type 2 PBAACs. In 14 patients, post-burn axillary contractures were reconstructed with musculocutaneous perforator of TDVA (for type 3 PBAACs). Ten patients with type 1 PBAACs were reconstructed with direct cutaneous perforators of the TDVA. The average follow-up period was 18 months.
Results
All the flaps survived completely with no major complications. Average pre-operative range of abduction was 45.5°. The average post-operative pain free abduction obtained in 36 cases was 146.38° at an average of 18 months.
Conclusion
The challenging reconstruction of PBAACs can be simplified by the stratified approach using TDVA perforator-based propeller flaps. Perforator propeller flap based on the direct cutaneous perforator from the TDVA is most suitable for type 1 PBAAC reconstruction, whereas type 2 and type 3 PBAACs can be best served by septofasciocutaneous and musculocutaneous based perforator propeller flaps, respectively.
Level of Evidence: Level IV, therapeutic study.
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PREVAIL VIII: A CoHOrt Clinical, Viral, and ImmuNOlogic Monitoring Study of People Living With Retroviral Infection in Liberia (HONOR)
Condition: HIV Intervention: Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis
Abstract
Objective
To describe and evaluate the outcome following shoulder manipulation under rotator interval block for the treatment of adhesive capsulitis.
Materials and methods
Patients with adhesive capsulitis referred by our local orthopaedic shoulder surgeons consented to targeted ultrasound-guided injection of the glenohumeral joint via the rotator interval. Inclusion criteria included a failure to respond to conservative treatment and the absence of a full-thickness rotator cuff tear. Twelve millilitres of a mixture of local anaesthetic and steroid was injected into the rotator interval using a 21-gauge needle, with a small volume of the same solution instilled into the subacromial bursa. Following injection, under local anaesthetic block, patients were gently manipulated into abduction, external rotation and internal rotation as far as they could comfortably tolerate. Patients were assessed pre-injection with documented pain scores from 0 to 10 on a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) questionnaire. Initial follow-up comprised a VAS pain score at 1 h, 24 h and 2 weeks. Clinical review by the referring orthopaedic surgeon was performed at 2 months post-injection. Long-term follow-up involved a VAS pain score and the OSS questionnaire at 5 months.
Results
Forty patients were suitable for inclusion in the study. Twenty-three were female (57.5%) and 17 were male. The mean age was 52 years (range, 31–73 years). Twelve patients were post-operative. The duration of symptoms ranged from 3 months to 18 months. Mean pre-procedure OSS was recorded as 23.3 (range, 4–36). The mean VAS pain score was 7.7 before the procedure (range, 4 – 10), 3.4 at 1 h (range, 0–8), 2.9 at 24 h (range, 0–8), and 1.8 at 2 weeks (range 1–4). Orthopaedic follow-up at an average of 66 days post-injection was recorded in 18 patients. All patients reported initial improvement of their shoulder pain and return to near full range of movement; however, recurrence of adhesive capsulitis symptoms was recorded in 5 patients. One case of rupture of the long head of the biceps tendon was reported, but the patient remained asymptomatic. Long-term follow-up at 5 months was obtained in 31 patients, with a mean OSS of 42 (range, 21–60) and VAS of 2.3 (range, 0–7).
Conclusion
Manipulation under general anaesthesia is a well-recognised treatment for adhesive capsulitis. We report that targeted ultrasound-guided injection of the rotator interval and manipulation of the shoulder under local anaesthetic blockade result in good outcomes in reducing shoulder pain and symptoms of adhesive capsulitis with low recurrence and complication rates.
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Pay-it-forward RCT for Gonorrhea and Chlamydia Testing
Conditions: Gonorrhea Male; Chlamydia;M Interventions: Other: Pay-it-forward testing; Other: Pay as you want Sponsors: University of North Carolina, Chapel Hill; National Institute of Allergy and Infectious Diseases (NIAID); National Institute on Aging (NIA) Recruiting (Source: ClinicalTrials.gov)
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Effects of Exercise and Yogurt on Bone Mineral Density and Immunological Factors in Human Milk: The MEEMA Study
Conditions: Lactational Amenorrhea; Body Weight Changes; Bone Loss Intervention: Other: Exercise and dietary Sponsor: North Carolina Agriculture& Technical State University Not yet recruiting (Source: ClinicalTrials.gov)
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Pay-it-forward RCT for Gonorrhea and Chlamydia Testing
Conditions: Gonorrhea Male; Chlamydia;M Interventions: Other: Pay-it-forward testing; Other: Pay as you want Sponsors: University of North Carolina, Chapel Hill; National Institute of Allergy and Infectious Diseases (NIAID); National Institute on Aging (NIA) Recruiting (Source: ClinicalTrials.gov)
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Seal, Stopping Atopic Dermatitis and Allergy Study
Conditions: Eczema, Infantile; Eczema; Atopic Dermatitis Eczema; Atopic Dermatitis Interventions: Combination Product: Tri-lipid skin barrier cream (Epiceram); Combination Product: Fluticasone propionate Cream 0.05% Sponsors: Stanford University; King's College London; National Jewish Health Not yet recruiting (Source: ClinicalTrials.gov)
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Evaluating the Safety and Pharmacokinetics of VRC-HIVMAB075-00-AB (VRC07-523LS) in the Sera and Mucosae of Healthy, HIV-Uninfected Adult Participants
Condition: HIV Infections Intervention: Biological: VRC07-523LS Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)
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Eczema Reminder and Accountability Program
Conditions: Atopic Dermatitis; Eczema Intervention: Behavioral: Patient reminders and accountability questionnaires Sponsors: McMaster University; Hamilton Allergy Recruiting (Source: ClinicalTrials.gov)
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HOPE in Action Trial of HIV+ Deceased Donor Liver Transplants for HIV+ Recipients
Condition: Hiv Intervention: Other: HIVD+/R+ Sponsors: Johns Hopkins University; National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)
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Pragmatic Assessment Study Influenza Vaccine Effectiveness in DoD
Conditions: Influenza; Influenza-like Illness Interventions: Biological: Egg based influenza vaccines; Biological: Recombinant influenza vaccines; Biological: Cell-culture based influenza vaccines Sponsors: Henry M. Jackson Foundation for the Advancement of Military Medicine; National Institute of Allergy and Infectious Diseases (NIAID); Food and Drug Administration (FDA); Defense Health Agency Immunization Healthcare Branch; Armed Forces Health Surveillance Branch; Naval He alth Research Center; United States Air Force School of Aerospace Medicine; Uniformed Services University of the Health Sciences Not yet recruiting (Source: ClinicalTrials.gov)
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PREVAIL VIII: A CoHOrt Clinical, Viral, and ImmuNOlogic Monitoring Study of People Living With Retroviral Infection in Liberia (HONOR)
Condition: HIV Intervention: Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Safety and Efficacy of Abatacept for Treating Chronic Cytopenia in Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Haploinsufficiency
Conditions: CTLA4 Haplonisufficiency; Chronic Cytopernia Interventions: Drug: Orencia (abatacept); Other: Placebo Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Safety and Efficacy of Abatacept for Treating Chronic Cytopenia in Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Haploinsufficiency
Conditions: CTLA4 Haplonisufficiency; Chronic Cytopernia Interventions: Drug: Orencia (abatacept); Other: Placebo Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)
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Quality of Life in Systemic Nickel Allergy Syndrome
Conditions: Systemic Nickel Allergy Syndrome; Quality of Life Intervention: Biological: Nickel oral hyposensitization treatment Sponsor: Catholic University of the Sacred Heart Recruiting (Source: ClinicalTrials.gov)
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Quality of Life in Systemic Nickel Allergy Syndrome
Conditions: Systemic Nickel Allergy Syndrome; Quality of Life Intervention: Biological: Nickel oral hyposensitization treatment Sponsor: Catholic University of the Sacred Heart Recruiting (Source: ClinicalTrials.gov)
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Effects of Exercise and Yogurt on Bone Mineral Density and Immunological Factors in Human Milk: The MEEMA Study
Conditions: Lactational Amenorrhea; Body Weight Changes; Bone Loss Intervention: Other: Exercise and dietary Sponsor: North Carolina Agriculture& Technical State University Not yet recruiting (Source: ClinicalTrials.gov)
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Shoulder manipulation under targeted ultrasound-guided rotator interval block for adhesive capsulitis
Abstract
Objective
To describe and evaluate the outcome following shoulder manipulation under rotator interval block for the treatment of adhesive capsulitis.
Materials and methods
Patients with adhesive capsulitis referred by our local orthopaedic shoulder surgeons consented to targeted ultrasound-guided injection of the glenohumeral joint via the rotator interval. Inclusion criteria included a failure to respond to conservative treatment and the absence of a full-thickness rotator cuff tear. Twelve millilitres of a mixture of local anaesthetic and steroid was injected into the rotator interval using a 21-gauge needle, with a small volume of the same solution instilled into the subacromial bursa. Following injection, under local anaesthetic block, patients were gently manipulated into abduction, external rotation and internal rotation as far as they could comfortably tolerate. Patients were assessed pre-injection with documented pain scores from 0 to 10 on a visual analogue scale (VAS) and the Oxford Shoulder Score (OSS) questionnaire. Initial follow-up comprised a VAS pain score at 1 h, 24 h and 2 weeks. Clinical review by the referring orthopaedic surgeon was performed at 2 months post-injection. Long-term follow-up involved a VAS pain score and the OSS questionnaire at 5 months.
Results
Forty patients were suitable for inclusion in the study. Twenty-three were female (57.5%) and 17 were male. The mean age was 52 years (range, 31–73 years). Twelve patients were post-operative. The duration of symptoms ranged from 3 months to 18 months. Mean pre-procedure OSS was recorded as 23.3 (range, 4–36). The mean VAS pain score was 7.7 before the procedure (range, 4 – 10), 3.4 at 1 h (range, 0–8), 2.9 at 24 h (range, 0–8), and 1.8 at 2 weeks (range 1–4). Orthopaedic follow-up at an average of 66 days post-injection was recorded in 18 patients. All patients reported initial improvement of their shoulder pain and return to near full range of movement; however, recurrence of adhesive capsulitis symptoms was recorded in 5 patients. One case of rupture of the long head of the biceps tendon was reported, but the patient remained asymptomatic. Long-term follow-up at 5 months was obtained in 31 patients, with a mean OSS of 42 (range, 21–60) and VAS of 2.3 (range, 0–7).
Conclusion
Manipulation under general anaesthesia is a well-recognised treatment for adhesive capsulitis. We report that targeted ultrasound-guided injection of the rotator interval and manipulation of the shoulder under local anaesthetic blockade result in good outcomes in reducing shoulder pain and symptoms of adhesive capsulitis with low recurrence and complication rates.
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Patients with rare, incurable digestive tract cancers respond to new drug combination
| Patients with rare, incurable digestive tract cancers respond to new drug combination Medical XpressFull coverage |
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Patients with rare, incurable digestive tract cancers respond to new drug combination
| Patients with rare, incurable digestive tract cancers respond to new drug combination Medical XpressFull coverage |
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Head and neck cancer patients helped with their care and cooking by future chefs
| Head and neck cancer patients helped with their care and cooking by future chefs Hospitality & Catering NewsFull coverage |
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Head and neck cancer patients helped with their care and cooking by future chefs
| Head and neck cancer patients helped with their care and cooking by future chefs Hospitality & Catering NewsFull coverage |
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Upregulation of proteins of the NLRP3 inflammasome in patients with periodontitis and uncontrolled type 2 diabetes
Abstract
Objectives
To evaluate the expression of proteins related to activation of the NLRP3 inflammasome in patients with chronic periodontitis (CP) and type 2 diabetes mellitus (T2D), and to determine whether the exacerbated periodontal pathological process observed in diabetic patients is related to its upregulation.
Materials and Methods
We performed an observational, analytical, cross‐sectional study in three study groups: individuals systemically and orally healthy, and patients with CP with and without T2D. Gingival biopsies were taken from the three study groups. The expression of mRNAs for CASP1, NLRP3, and ASC was detected using real‐time PCR, the expression of NLRP3 and ASC proteins was determined by immunohistochemistry. The quantification of IL‐18 and IL‐1β was determined in the gingival crevicular fluid using ELISA. The results were analyzed by ANOVA followed by Tukey's test to compare differences between individual groups.
Results
Patients with CP and uncontrolled T2D presented severe periodontal disease and inflammation (PPD, p= 0.0072; CAL, p = 0.0480; bone loss, p = 0.0088), higher levels of CASP1 mRNA expression (p = 0.0026), a stronger pattern of staining for NLRP3 and ASC proteins in the epithelium and connective tissues, and significantly higher production of IL‐18 (p = 0.0063) and IL‐1β (p = 0.0018) in comparison with healthy or CP subjects.
Conclusion
The upregulation of genes and proteins involved in the activation of the NLRP3 inflammasome components in patients with periodontitis and uncontrolled T2D suggests a possible role in the more severe pathological processes leading to destruction of periodontal tissues observed in these patients.
This article is protected by copyright. All rights reserved.
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Πέμπτη 15 Νοεμβρίου 2018
Rising Production Scale Motivates Laryngeal Papillomatosis Treatment Market Growth in the Coming Years
| Rising Production Scale Motivates Laryngeal Papillomatosis Treatment Market Growth in the Coming Years Latest Market Reports By Abhishek Budholiya (press release) (blog)Full coverage |
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Introduction to the Special Issue: Learning to Listen from Sounds to Words.
Authors: Shea C Abstract The eight articles in this special issue 'Learning to listen from sounds to words' were presented at the conference Sound to Word in Bilingual and Second Language Speech Perception held at the University of Iowa in spring 2016. The selected contributions focus on how second language speech perception interacts with orthography, how phonology interacts with speech perception and how listeners use the cues in the input to segment and create the word forms for lexical processing. This collection of papers expands the field of speech perception and production by granting a central role to the lexicon and exploring how listeners and speakers activate representations, from sounds to words. PMID: 30426865 [PubMed - in process] (Source: Language and Speech)
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