Imaging in Forensic Science: Five Years On

Publication date: Available online 9 January 2019

Source: Journal of Forensic Radiology and Imaging

Author(s): Rachael M. Carew, David Errickson

Abstract

The Journal of Forensic Radiology and Imaging was launched in 2013 with the aim to collate the literature and demonstrate high-quality case studies on image-based modalities across the forensic sciences. Largely, the focus of this journal has been on the transmissive aspect of forensic imaging, and therefore a significant number of high-quality case studies have been published focusing on computed tomography and magnetic resonance imaging. As a result, the 'and imaging' aspect is often neglected. Since 2013, technology has fundamentally evolved, and a number of new techniques have become accessible or have been demonstrated as particularly useful within many sub-disciplines of forensic science. These include active and passive surface scanning techniques, and the availability of three-dimensional printing. Therefore, this article discusses non-contact techniques, their applications, advantages, and considerations on the current state of play of imaging in forensic science.

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U.S. Kids Often Get Inappropriate Antibiotics in the ED U.S. Kids Often Get Inappropriate Antibiotics in the ED

In U.S. emergency departments (EDs), especially non-pediatric EDs, children often receive antibiotics inappropriately, a retrospective study suggests.Reuters Health Information (Source: Medscape Allergy Headlines)

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U.S. Kids Often Get Inappropriate Antibiotics in the ED U.S. Kids Often Get Inappropriate Antibiotics in the ED

In U.S. emergency departments (EDs), especially non-pediatric EDs, children often receive antibiotics inappropriately, a retrospective study suggests.Reuters Health Information (Source: Medscape Allergy Headlines)

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Fast isotropic volumetric magnetic resonance imaging of the ankle: acceleration of the three-dimensional fast spin echo sequence using compressed sensing combined with parallel imaging

Publication date: Available online 9 January 2019

Source: European Journal of Radiology

Author(s): Jisook Yi, Young Han Lee, Seok Hahn, Salman S. Albakheet, Ho-Taek Song, Jin-Suck Suh

Abstract

Objectives

To investigate the feasibility of three-dimensional fast spin echo (3D-FSE) imaging with compressed sensing (CS) and parallel imaging (PI) compared to 3D-FSE imaging with only PI in evaluating ankle joint pathologies.

Materials and Methods

Twenty consecutive patients underwent ankle magnetic resonance imaging (MRI), including acquisition of image sets of 2D-FSE sequences, and 3D-FSE sequences without and with CS, between June 2016 and November 2017. Three MR image sets were independently rated by two radiologists for the presence/absence of ankle pathology. Quantitative image similarity and subjective image quality were evaluated using 3D-FSE images without CS and those with CS-PI. Inter-sequence agreement between 3D-FSE sequences without CS and with CS-PI in both readers was evaluated.

Results

Interobserver agreements were nearly perfect for sprain of the anterior talofibular ligament (ATFL, κ=0.77), osteochondral lesion of the talus (OLT, κ=0.76-0.88), osteochondral lesion of the distal tibia (OLTi, κ=0.74) and os subfibulare (OSF, κ=0.62-0.64). The structural similarity index (mean, 0.996; range, 0.990-0.997) between the 3D-FSE sequences without CS and with CS-PI was acceptable. There was no significant difference in subjective image quality between the two imaging sequences (ATFL, p = 0.317; bone marrow, p = 0.083; cartilage, p = 1.000, tendon, p = 1.000). Intersequence agreement between the 3D-FSE sequences with and without CS was nearly perfect (ATFL and OLTi, κ=1.00; OLT, κ=0.87-0.96; OSF, κ=0.62-0.64) in both readers.

Conclusions

Isotropic 3D-FSE ankle MRI with CS provides acceptable diagnostic performance with reduced scan time. Compressed sensing-related artifacts could be minimized with CS reconstruction enhancement, allowing for better image quality for evaluating ankle joint pathologies.

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Fast isotropic volumetric magnetic resonance imaging of the ankle: acceleration of the three-dimensional fast spin echo sequence using compressed sensing combined with parallel imaging

Publication date: Available online 9 January 2019

Source: European Journal of Radiology

Author(s): Jisook Yi, Young Han Lee, Seok Hahn, Salman S. Albakheet, Ho-Taek Song, Jin-Suck Suh

Abstract

Objectives

To investigate the feasibility of three-dimensional fast spin echo (3D-FSE) imaging with compressed sensing (CS) and parallel imaging (PI) compared to 3D-FSE imaging with only PI in evaluating ankle joint pathologies.

Materials and Methods

Twenty consecutive patients underwent ankle magnetic resonance imaging (MRI), including acquisition of image sets of 2D-FSE sequences, and 3D-FSE sequences without and with CS, between June 2016 and November 2017. Three MR image sets were independently rated by two radiologists for the presence/absence of ankle pathology. Quantitative image similarity and subjective image quality were evaluated using 3D-FSE images without CS and those with CS-PI. Inter-sequence agreement between 3D-FSE sequences without CS and with CS-PI in both readers was evaluated.

Results

Interobserver agreements were nearly perfect for sprain of the anterior talofibular ligament (ATFL, κ=0.77), osteochondral lesion of the talus (OLT, κ=0.76-0.88), osteochondral lesion of the distal tibia (OLTi, κ=0.74) and os subfibulare (OSF, κ=0.62-0.64). The structural similarity index (mean, 0.996; range, 0.990-0.997) between the 3D-FSE sequences without CS and with CS-PI was acceptable. There was no significant difference in subjective image quality between the two imaging sequences (ATFL, p = 0.317; bone marrow, p = 0.083; cartilage, p = 1.000, tendon, p = 1.000). Intersequence agreement between the 3D-FSE sequences with and without CS was nearly perfect (ATFL and OLTi, κ=1.00; OLT, κ=0.87-0.96; OSF, κ=0.62-0.64) in both readers.

Conclusions

Isotropic 3D-FSE ankle MRI with CS provides acceptable diagnostic performance with reduced scan time. Compressed sensing-related artifacts could be minimized with CS reconstruction enhancement, allowing for better image quality for evaluating ankle joint pathologies.

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EGFR as a biomarker of smoking status and survival in oropharyngeal squamous cell carcinoma

This study aims to investigate EGFR as a prognostic biomarker in oropharyngeal squamous cell carcinoma (OPSCC).

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EGFR as a biomarker of smoking status and survival in oropharyngeal squamous cell carcinoma

This study aims to investigate EGFR as a prognostic biomarker in oropharyngeal squamous cell carcinoma (OPSCC).

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La chirurgie des sens et de la douleur

Publication date: Available online 9 January 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): B. Devauchelle

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La chirurgie des sens et de la douleur

Publication date: Available online 9 January 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): B. Devauchelle

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A new checkpoint in lupus

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): George C. Tsokos

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Report from the National Institute of Allergy and Infectious Diseases Workshop on “Atopic Dermatitis and the Atopic March: Mechanisms and Interventions”

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Wendy F. Davidson, Donald Y.M. Leung, Lisa A. Beck, Cecilia M. Berin, Mark Boguniewicz, William W. Busse, Talal A. Chatila, Raif S. Geha, James E. Gern, Emma Guttman-Yassky, Alan D. Irvine, Brian S. Kim, Heidi H. Kong, Gideon Lack, Kari C. Nadeau, Julie Schwaninger, Angela Simpson, Eric L. Simpson, Jonathan M. Spergel, Alkis Togias

Abstract

Atopic dermatitis (AD) affects up to 20% of children world-wide and is an increasing public health problem particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized, increased risk of sequential progression from AD to other atopic diseases including food allergy, allergic rhinitis, allergic asthma and allergic rhinoconjunctivitis; a process referred to as the "atopic march". The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly food allergy, are incompletely understood and the subject of intense investigation. Other major research objectives are the development of effective strategies to prevent AD and food allergy as well as therapeutic interventions to inhibit the atopic march. In 2017, the Division of Allergy, Immunology and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop to discuss current understanding and important advances in these research areas and to identify gaps in knowledge and future research directions. International and national experts in the field were joined by representatives from several National Institutes of Health institutes. Summaries of workshop presentations, key conclusions and recommendations are presented herein.

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Genetic diagnosis of primary immunodeficiencies: a survey of the French national registry

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Nizar Mahlaoui, Capucine Picard, Perrine Bach, Laurence Costes, Virginie Courteille, Anja Ranohavimparany, Alexandre Alcaïs, Jean-Philippe Jais, Alain Fischer, CEREDIH French PID study group

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Macrophage polarization: reaching across the aisle?

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Maria Carla Bosco

Abstract

Macrophage polarization may influence the pathogenesis of many human diseases; however the transcriptional program regulating this process remains poorly characterized. Gharib et al.¹ highlight the high diversity of M1-to-M2 re-polarization exerted by distinct M2 stimuli via transcriptome-based pathway analysis and provide a new approach to phenotype human macrophages in clinically relevant disease states such as cystic fibrosis and asthma

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A new checkpoint in lupus

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): George C. Tsokos

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Report from the National Institute of Allergy and Infectious Diseases Workshop on “Atopic Dermatitis and the Atopic March: Mechanisms and Interventions”

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Wendy F. Davidson, Donald Y.M. Leung, Lisa A. Beck, Cecilia M. Berin, Mark Boguniewicz, William W. Busse, Talal A. Chatila, Raif S. Geha, James E. Gern, Emma Guttman-Yassky, Alan D. Irvine, Brian S. Kim, Heidi H. Kong, Gideon Lack, Kari C. Nadeau, Julie Schwaninger, Angela Simpson, Eric L. Simpson, Jonathan M. Spergel, Alkis Togias

Abstract

Atopic dermatitis (AD) affects up to 20% of children world-wide and is an increasing public health problem particularly in developed countries. Although AD in infants and young children can resolve, there is a well-recognized, increased risk of sequential progression from AD to other atopic diseases including food allergy, allergic rhinitis, allergic asthma and allergic rhinoconjunctivitis; a process referred to as the "atopic march". The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly food allergy, are incompletely understood and the subject of intense investigation. Other major research objectives are the development of effective strategies to prevent AD and food allergy as well as therapeutic interventions to inhibit the atopic march. In 2017, the Division of Allergy, Immunology and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop to discuss current understanding and important advances in these research areas and to identify gaps in knowledge and future research directions. International and national experts in the field were joined by representatives from several National Institutes of Health institutes. Summaries of workshop presentations, key conclusions and recommendations are presented herein.

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Genetic diagnosis of primary immunodeficiencies: a survey of the French national registry

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Nizar Mahlaoui, Capucine Picard, Perrine Bach, Laurence Costes, Virginie Courteille, Anja Ranohavimparany, Alexandre Alcaïs, Jean-Philippe Jais, Alain Fischer, CEREDIH French PID study group

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Macrophage polarization: reaching across the aisle?

Publication date: Available online 9 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Maria Carla Bosco

Abstract

Macrophage polarization may influence the pathogenesis of many human diseases; however the transcriptional program regulating this process remains poorly characterized. Gharib et al.¹ highlight the high diversity of M1-to-M2 re-polarization exerted by distinct M2 stimuli via transcriptome-based pathway analysis and provide a new approach to phenotype human macrophages in clinically relevant disease states such as cystic fibrosis and asthma

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Normative data for olfactory threshold and odor identification in children and adolescents

Publication date: Available online 9 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Janine Gellrich, Lisa-Marie Sparing-Paschke, Theresa Thieme, Katharina Schwabe, Annika Dworschak, Thomas Hummel, Valentin A. Schriever

Abstract

Objective

Although previous studies have demonstrated the feasibility and validity of olfactory testing in children and adolescents using the "Sniffin' Sticks" odor threshold and "U-Sniff" odor identification test, normative data obtained in a large sample for these tests are missing. Aim of this study was therefore to obtain normative data of healthy children and adolescents for olfactory assessment.

Material and Methods

Olfactory testing was conducted using the "Sniffin' Sticks" olfactory threshold (THR) and the 12-item "U-Sniff" odor identification (ID). The data were collected from 490 children and adolescents (234 girls, 257 boys) between the age of 6 and 17 years (mean age: 11.2±3.4 years). In line with previous studies, participants were divided into subgroups regarding their age: i) 6-8 years, ii) 9-11 years, iii) 12-14 years and iv) 15-17 years.

Results

All participants were able to perform the task. Neither sex nor age significantly influenced THR. Girls outperformed boys in ID. In addition, the youngest age group scored lower than the three other age groups on the "U-Sniff" odor identification test. Using the 10^th percentile to distinguish normosmia from a reduced sense of smell the following values were obtained for the four age groups: i) THR 4.25 points, ID 7 points, ii) THR 5.0 points, ID 9 points, iii) THR 4.75 points, ID 10 points and iv) THR 5.5 points, ID 10 points.

Conclusion

The present study provides normative data for olfactory assessment in children and adolescents using both an olfactory threshold and a suprathreshold test to distinguish between normosmia and a reduced sense of smell using the 10^th percentile.

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Effect of Competing Noise on Cortical Auditory Evoked Potentials Elicited by Speech Sounds in 7- to 25-year-old Listeners

Publication date: Available online 9 January 2019

Source: Hearing Research

Author(s): Samantha J. Gustafson, Curtis J. Billings, Benjamin W.Y. Hornsby, Alexandra P. Key

Abstract

Child listeners have particular difficulty with speech perception when competing speech noise is present; this challenge is often attributed to their immature top-down processing abilities. The purpose of this study was to determine if the effects of competing speech noise on speech-sound processing vary with age. Cortical auditory evoked potentials (CAEPs) were measured during an active speech-syllable discrimination task in 58 normal-hearing participants (age 7-25 years). Speech syllables were presented in quiet and embedded in competing speech noise (4-talker babble, +15 dB signal-to-noise ratio; SNR). While noise was expected to similarly reduce amplitude and delay latencies of N1 and P2 peaks in all listeners, it was hypothesized that effects of noise on the P3b peak would be inversely related to age due to the maturation of top-down processing abilities throughout childhood. Consistent with previous work, results showed that a +15 dB SNR reduces amplitudes and delays latencies of CAEPs for listeners of all ages, affecting speech-sound processing, delaying stimulus evaluation, and causing a reduction in behavioral speech-sound discrimination. Contrary to expectations, findings suggest that competing speech noise at a +15 dB SNR may have similar effects on various stages of speech-sound processing for listeners of all ages. Future research directions should examine how more difficult listening conditions (poorer SNRs) might affect results across ages.

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An Improved Method of Obtaining Electrocochleography Recordings from Nucleus Hybrid Cochlear Implant users

Publication date: Available online 9 January 2019

Source: Hearing Research

Author(s): Viral D. Tejani, Paul J. Abbas, Carolyn J. Brown, Jihwan Woo

Abstract

Interest in electrocochleography (ECoG) has recently resurged as a potential tool to assess peripheral auditory function in cochlear implant (CI) users. ECoG recordings can be evoked using acoustic stimulation and recorded from an extra- or intra-cochlear electrode in CI users. Recordings reflect contributions from cochlear hair cells and the auditory nerve. We recently demonstrated the feasibility of using Custom Sound EP (clinically available software) to record ECoG responses in Nucleus Hybrid CI users with preserved acoustic hearing in the implanted ear (Abbas et al, 2017). While successful, the recording procedures were time intensive, limiting clinical applications. The current report describes how we improved data collection efficiency by writing custom software using Python programming language. The software interfaced with Nucleus Implant Communicator (NIC) routines to record responses from an intracochlear electrode. ECoG responses were recorded in eight CI users with preserved acoustic hearing using Custom Sound EP and the Python-based software. Responses were similar across both recording systems, but the recording time decreased significantly using the Python-based software. Seven additional CI users underwent repeated testing using the Python-based software and showed high test-retest reliability. The improved efficiency and high reliability increases the likelihood of translating intracochlear ECoG to clinical practice.

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"Effect of CT localizer radiographs on radiation dose associated with automatic tube current modulation: a multivendor study”

Publication date: Available online 9 January 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Fabio Paolicchi, Luca Bastiani, Jacopo Negri, Davide Caramella

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Normative data for olfactory threshold and odor identification in children and adolescents

Publication date: Available online 9 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Janine Gellrich, Lisa-Marie Sparing-Paschke, Theresa Thieme, Katharina Schwabe, Annika Dworschak, Thomas Hummel, Valentin A. Schriever

Abstract

Objective

Although previous studies have demonstrated the feasibility and validity of olfactory testing in children and adolescents using the "Sniffin' Sticks" odor threshold and "U-Sniff" odor identification test, normative data obtained in a large sample for these tests are missing. Aim of this study was therefore to obtain normative data of healthy children and adolescents for olfactory assessment.

Material and Methods

Olfactory testing was conducted using the "Sniffin' Sticks" olfactory threshold (THR) and the 12-item "U-Sniff" odor identification (ID). The data were collected from 490 children and adolescents (234 girls, 257 boys) between the age of 6 and 17 years (mean age: 11.2±3.4 years). In line with previous studies, participants were divided into subgroups regarding their age: i) 6-8 years, ii) 9-11 years, iii) 12-14 years and iv) 15-17 years.

Results

All participants were able to perform the task. Neither sex nor age significantly influenced THR. Girls outperformed boys in ID. In addition, the youngest age group scored lower than the three other age groups on the "U-Sniff" odor identification test. Using the 10^th percentile to distinguish normosmia from a reduced sense of smell the following values were obtained for the four age groups: i) THR 4.25 points, ID 7 points, ii) THR 5.0 points, ID 9 points, iii) THR 4.75 points, ID 10 points and iv) THR 5.5 points, ID 10 points.

Conclusion

The present study provides normative data for olfactory assessment in children and adolescents using both an olfactory threshold and a suprathreshold test to distinguish between normosmia and a reduced sense of smell using the 10^th percentile.

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Effect of Competing Noise on Cortical Auditory Evoked Potentials Elicited by Speech Sounds in 7- to 25-year-old Listeners

Publication date: Available online 9 January 2019

Source: Hearing Research

Author(s): Samantha J. Gustafson, Curtis J. Billings, Benjamin W.Y. Hornsby, Alexandra P. Key

Abstract

Child listeners have particular difficulty with speech perception when competing speech noise is present; this challenge is often attributed to their immature top-down processing abilities. The purpose of this study was to determine if the effects of competing speech noise on speech-sound processing vary with age. Cortical auditory evoked potentials (CAEPs) were measured during an active speech-syllable discrimination task in 58 normal-hearing participants (age 7-25 years). Speech syllables were presented in quiet and embedded in competing speech noise (4-talker babble, +15 dB signal-to-noise ratio; SNR). While noise was expected to similarly reduce amplitude and delay latencies of N1 and P2 peaks in all listeners, it was hypothesized that effects of noise on the P3b peak would be inversely related to age due to the maturation of top-down processing abilities throughout childhood. Consistent with previous work, results showed that a +15 dB SNR reduces amplitudes and delays latencies of CAEPs for listeners of all ages, affecting speech-sound processing, delaying stimulus evaluation, and causing a reduction in behavioral speech-sound discrimination. Contrary to expectations, findings suggest that competing speech noise at a +15 dB SNR may have similar effects on various stages of speech-sound processing for listeners of all ages. Future research directions should examine how more difficult listening conditions (poorer SNRs) might affect results across ages.

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An Improved Method of Obtaining Electrocochleography Recordings from Nucleus Hybrid Cochlear Implant users

Publication date: Available online 9 January 2019

Source: Hearing Research

Author(s): Viral D. Tejani, Paul J. Abbas, Carolyn J. Brown, Jihwan Woo

Abstract

Interest in electrocochleography (ECoG) has recently resurged as a potential tool to assess peripheral auditory function in cochlear implant (CI) users. ECoG recordings can be evoked using acoustic stimulation and recorded from an extra- or intra-cochlear electrode in CI users. Recordings reflect contributions from cochlear hair cells and the auditory nerve. We recently demonstrated the feasibility of using Custom Sound EP (clinically available software) to record ECoG responses in Nucleus Hybrid CI users with preserved acoustic hearing in the implanted ear (Abbas et al, 2017). While successful, the recording procedures were time intensive, limiting clinical applications. The current report describes how we improved data collection efficiency by writing custom software using Python programming language. The software interfaced with Nucleus Implant Communicator (NIC) routines to record responses from an intracochlear electrode. ECoG responses were recorded in eight CI users with preserved acoustic hearing using Custom Sound EP and the Python-based software. Responses were similar across both recording systems, but the recording time decreased significantly using the Python-based software. Seven additional CI users underwent repeated testing using the Python-based software and showed high test-retest reliability. The improved efficiency and high reliability increases the likelihood of translating intracochlear ECoG to clinical practice.

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"Effect of CT localizer radiographs on radiation dose associated with automatic tube current modulation: a multivendor study”

Publication date: Available online 9 January 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Fabio Paolicchi, Luca Bastiani, Jacopo Negri, Davide Caramella

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Reliability and validity of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: A systematic replication in a crowdsourced sample

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Ethan M. Campbell, Justin C. Strickland

Abstract

Effectively and efficiently identifying alcohol use disorder (AUD) is an essential goal for researchers and clinicians alike. To date, there are a limited number of self-reported tools specifically designed for evaluating DSM-5 criteria for AUD. The Brief DSM-5 AUD Diagnostic Assessment is a recently created participant self-reported measure with demonstrated reliability and validity in college student populations. The purpose of this study was to replicate and extend these findings by evaluating the psychometric properties of the Brief DSM-5 AUD Diagnostic Assessment in a geographically diverse adult sample with varying alcohol use history. Participants (N = 1986) were sampled from the crowdsourcing website Amazon Mechanical Turk (mTurk). The Brief DSM-5 AUD Diagnostic Assessment was completed to evaluate scale reliability and validity. A subset of individuals with answers indicative of AUD (N = 448) also completed a battery of standardized alcohol use questionnaires for additional validity assessments. High internal consistency reliability was observed (α = 0.92) along with strong item-total correlations. Convergent validity was supported by significant positive relationships between diagnostic category and measures of alcohol use consumption and severity. Modest relationships that were generally not statistically significant were observed with soda use measures supporting discriminant validity. AUD severity remained a significant predictor of alcohol use measures after accounting for AUDIT scores, thereby establishing incremental validity. These findings collectively support the Brief DSM-5 AUD Diagnostic Assessment as a reliable, valid, and rapid self-report tool for evaluating DSM-5 AUD in diverse research and clinical settings.

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Which behavior change techniques help young adults reduce binge drinking? A pilot randomized clinical trial of 5 text message interventions

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Brian Suffoletto, Levent Kirisci, Duncan B. Clark, Tammy Chung

Abstract

Text message (SMS) interventions can reduce binge drinking in young adults, but optimal behavior change techniques (BCTs) remain unknown. The present study tests the acceptability and preliminary efficacy of different combinations of SMS-delivered BCTs. 149 young adults who screened positive for hazardous drinking completed a baseline survey in the Emergency Department. For the following 2-weeks, on days they typically drank (1 to 3 days per week), participants received ecological momentary assessments (EMA) of drinking plans and desire to get drunk; the next day they were prompted to report recall of number of drinks consumed the prior day. Participants who responded to at least 50% these EMA (N = 127) were randomized to one of five 12-week interventions: Cued Self-Monitoring (TRACK); Drinking Intentions Feedback (PLAN); Drinking Performance Feedback (USE); Adaptive Goal Support (GOAL); and a combination of BCTs (COMBO). 79% of all EMA were completed over 12 weeks, which decreased from around 93% on week 1 to 65% by week 12. Using EMA data, relative to TRACK, only COMBO showed significant reductions in binge drinking and max drinks per drinking episode over time. Using TLFB data, there were no significant differences between groups from baseline to 14- and 28-weeks follow-up. Results lay the groundwork for a larger trial testing the effects of BCTs on binge drinking for young adults.

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Discrimination from family and substance use for multiracial individuals

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Marisa Franco, Sierra Carter

Abstract

Whereas Multiracial people exhibit heightened rates of substance use, existing research has yet to account for why. The current study examines whether Multiracial people's experiences of discrimination from family may explain their substance use behaviors, and furthermore, whether compromised mental health indirectly explains relationships between familial discrimination and substance use. Online cross-sectional survey data was collected from (N = 466) Multiracial participants. Negative binomial regression analysis indicated that discrimination from family predicted drug use above and beyond general discrimination. Results of bootstrapping analysis revealed that the pathway from discrimination from family to drug use is partially explained by anxiety and depressive symptoms. The implications of these findings for addressing heightened rates of substance abuse among the Multiracial population are discussed.

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Reliability and validity of the Brief DSM-5 Alcohol Use Disorder Diagnostic Assessment: A systematic replication in a crowdsourced sample

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Ethan M. Campbell, Justin C. Strickland

Abstract

Effectively and efficiently identifying alcohol use disorder (AUD) is an essential goal for researchers and clinicians alike. To date, there are a limited number of self-reported tools specifically designed for evaluating DSM-5 criteria for AUD. The Brief DSM-5 AUD Diagnostic Assessment is a recently created participant self-reported measure with demonstrated reliability and validity in college student populations. The purpose of this study was to replicate and extend these findings by evaluating the psychometric properties of the Brief DSM-5 AUD Diagnostic Assessment in a geographically diverse adult sample with varying alcohol use history. Participants (N = 1986) were sampled from the crowdsourcing website Amazon Mechanical Turk (mTurk). The Brief DSM-5 AUD Diagnostic Assessment was completed to evaluate scale reliability and validity. A subset of individuals with answers indicative of AUD (N = 448) also completed a battery of standardized alcohol use questionnaires for additional validity assessments. High internal consistency reliability was observed (α = 0.92) along with strong item-total correlations. Convergent validity was supported by significant positive relationships between diagnostic category and measures of alcohol use consumption and severity. Modest relationships that were generally not statistically significant were observed with soda use measures supporting discriminant validity. AUD severity remained a significant predictor of alcohol use measures after accounting for AUDIT scores, thereby establishing incremental validity. These findings collectively support the Brief DSM-5 AUD Diagnostic Assessment as a reliable, valid, and rapid self-report tool for evaluating DSM-5 AUD in diverse research and clinical settings.

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Which behavior change techniques help young adults reduce binge drinking? A pilot randomized clinical trial of 5 text message interventions

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Brian Suffoletto, Levent Kirisci, Duncan B. Clark, Tammy Chung

Abstract

Text message (SMS) interventions can reduce binge drinking in young adults, but optimal behavior change techniques (BCTs) remain unknown. The present study tests the acceptability and preliminary efficacy of different combinations of SMS-delivered BCTs. 149 young adults who screened positive for hazardous drinking completed a baseline survey in the Emergency Department. For the following 2-weeks, on days they typically drank (1 to 3 days per week), participants received ecological momentary assessments (EMA) of drinking plans and desire to get drunk; the next day they were prompted to report recall of number of drinks consumed the prior day. Participants who responded to at least 50% these EMA (N = 127) were randomized to one of five 12-week interventions: Cued Self-Monitoring (TRACK); Drinking Intentions Feedback (PLAN); Drinking Performance Feedback (USE); Adaptive Goal Support (GOAL); and a combination of BCTs (COMBO). 79% of all EMA were completed over 12 weeks, which decreased from around 93% on week 1 to 65% by week 12. Using EMA data, relative to TRACK, only COMBO showed significant reductions in binge drinking and max drinks per drinking episode over time. Using TLFB data, there were no significant differences between groups from baseline to 14- and 28-weeks follow-up. Results lay the groundwork for a larger trial testing the effects of BCTs on binge drinking for young adults.

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Discrimination from family and substance use for multiracial individuals

Publication date: Available online 9 January 2019

Source: Addictive Behaviors

Author(s): Marisa Franco, Sierra Carter

Abstract

Whereas Multiracial people exhibit heightened rates of substance use, existing research has yet to account for why. The current study examines whether Multiracial people's experiences of discrimination from family may explain their substance use behaviors, and furthermore, whether compromised mental health indirectly explains relationships between familial discrimination and substance use. Online cross-sectional survey data was collected from (N = 466) Multiracial participants. Negative binomial regression analysis indicated that discrimination from family predicted drug use above and beyond general discrimination. Results of bootstrapping analysis revealed that the pathway from discrimination from family to drug use is partially explained by anxiety and depressive symptoms. The implications of these findings for addressing heightened rates of substance abuse among the Multiracial population are discussed.

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U.S. Kids Often Get Inappropriate Antibiotics in the ED U.S. Kids Often Get Inappropriate Antibiotics in the ED

In U.S. emergency departments (EDs), especially non-pediatric EDs, children often receive antibiotics inappropriately, a retrospective study suggests.Reuters Health Information (Source: Medscape Allergy Headlines)

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U.S. Kids Often Get Inappropriate Antibiotics in the ED U.S. Kids Often Get Inappropriate Antibiotics in the ED

In U.S. emergency departments (EDs), especially non-pediatric EDs, children often receive antibiotics inappropriately, a retrospective study suggests.Reuters Health Information (Source: Medscape Allergy Headlines)

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Perioperative magnesium levels in total thyroidectomy and relationship to hypocalcemia

Abstract

Background

We have previously shown an association between hypomagnesemia and hypocalcemia after thyroidectomy. However, little is known regarding the trend in magnesium levels in the days after thyroidectomy. Our objective was to study this trend in magnesium levels after thyroidectomy.

Methods

Retrospective review of 173 thyroidectomies with analysis of calcium and magnesium levels on postoperative day 1 (POD1) and POD2.

Results

Across the whole group, there was a highly significant decline in magnesium levels between preoperative (0.87 ± 0.06 mmol/L), POD1 (0.80 ± 0.07 mmol/L), and POD2 (0.78 ± 0.08 mmol/L) (P < .0001). The magnitudes of the magnesium level declines were significantly higher, and the absolute magnesium levels on POD1 and POD2 significantly lower, in patients developing hypocalcemia (n = 69).

Conclusion

Magnesium levels after total thyroidectomy demonstrate a downward trajectory which persists through POD2 and is highly correlated with hypocalcemia. Further study is required to determine if magnesium replacement can alter the course of hypocalcemia in hypocalcemic patients after total thyroidectomy.

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Perioperative magnesium levels in total thyroidectomy and relationship to hypocalcemia

Abstract

Background

We have previously shown an association between hypomagnesemia and hypocalcemia after thyroidectomy. However, little is known regarding the trend in magnesium levels in the days after thyroidectomy. Our objective was to study this trend in magnesium levels after thyroidectomy.

Methods

Retrospective review of 173 thyroidectomies with analysis of calcium and magnesium levels on postoperative day 1 (POD1) and POD2.

Results

Across the whole group, there was a highly significant decline in magnesium levels between preoperative (0.87 ± 0.06 mmol/L), POD1 (0.80 ± 0.07 mmol/L), and POD2 (0.78 ± 0.08 mmol/L) (P < .0001). The magnitudes of the magnesium level declines were significantly higher, and the absolute magnesium levels on POD1 and POD2 significantly lower, in patients developing hypocalcemia (n = 69).

Conclusion

Magnesium levels after total thyroidectomy demonstrate a downward trajectory which persists through POD2 and is highly correlated with hypocalcemia. Further study is required to determine if magnesium replacement can alter the course of hypocalcemia in hypocalcemic patients after total thyroidectomy.

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210Po sequential extraction applied to wetland soils at uranium mining sites

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): Thi-Hong-Hanh Le, Hervé Michel, Julie Champion

Abstract

Former uranium mining activities have led to the presence of naturally occurring nuclides embedded in soil. Such activities have also modified the secular equilibrium between radionuclides in ²³⁸U decay series. The objective of this paper is to quantify the long-term effect of former uranium mining activities on the behavior of the final radionuclide in the ²³⁸U-series, i.e. polonium-210 (²¹⁰Po), present in soils. Soil samples are extracted from two uranium sites in France, specifically a quarried site and a natural site. The polonium distribution is studied within the various soil fractions, namely: water soluble, exchangeable, bound to carbonates, bound to iron/manganese oxides, bound to organic matter, and residual. ²¹⁰Po is mainly found in the residual fraction of both study sites (87–90%), followed by the carbonates fraction (5–9%). The ²¹⁰Po activity in the other fractions is very small in comparison with total activity.

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210Po sequential extraction applied to wetland soils at uranium mining sites

Publication date: April 2019

Source: Journal of Environmental Radioactivity, Volumes 199–200

Author(s): Thi-Hong-Hanh Le, Hervé Michel, Julie Champion

Abstract

Former uranium mining activities have led to the presence of naturally occurring nuclides embedded in soil. Such activities have also modified the secular equilibrium between radionuclides in ²³⁸U decay series. The objective of this paper is to quantify the long-term effect of former uranium mining activities on the behavior of the final radionuclide in the ²³⁸U-series, i.e. polonium-210 (²¹⁰Po), present in soils. Soil samples are extracted from two uranium sites in France, specifically a quarried site and a natural site. The polonium distribution is studied within the various soil fractions, namely: water soluble, exchangeable, bound to carbonates, bound to iron/manganese oxides, bound to organic matter, and residual. ²¹⁰Po is mainly found in the residual fraction of both study sites (87–90%), followed by the carbonates fraction (5–9%). The ²¹⁰Po activity in the other fractions is very small in comparison with total activity.

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Number of remaining teeth and health-related quality of life: the Korean National Health and Nutrition Examination Survey 2010–2012

With the Euro-Qol-5 dimension (EQ-5D) system, we investigated the relationship between the number of remaining teeth and QoL using data from the Korean National Health and Nutrition Examination Survey (KNHANES...

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Number of remaining teeth and health-related quality of life: the Korean National Health and Nutrition Examination Survey 2010–2012

With the Euro-Qol-5 dimension (EQ-5D) system, we investigated the relationship between the number of remaining teeth and QoL using data from the Korean National Health and Nutrition Examination Survey (KNHANES...

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Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101

Summary

Background

The prevalence of lanolin contact allergy in dermatitis patients varies from 1.2% to 6.9%. Different lanolin derivatives are used in patch testing.

Objectives

To determine which combination of lanolin derivatives is most effective in patch testing for diagnosing lanolin contact allergy.

Methods

A retrospective analysis of patients patch tested between 2016 and 2017 was performed. Patients were eligible if tested with lanolin alcohol 30% pet., Amerchol L101 50% pet. and a supplementary series containing other lanolin derivatives. Lanolin alcohol and Amerchol L101 were tested in duplicate.

Results

Out of 594 patients, 28.6% (95% confidence interval [CI]: 25.1%‐32.3%) had a positive patch test reaction to at least one lanolin derivative. Reactions were common to lanolin alcohol (14.7%, 95% CI: 11.3%‐18.2%) and Amerchol L101 (15.0%, 95% CI: 11.5%‐18.5%) in the routinely tested series. Reactions to other test preparations were significantly less frequent (P < 0.05). The addition of Amerchol L101 to lanolin alcohol significantly increased the number of positive cases (odds ratio 1.79, P < 0.001).

Conclusions

The combination of lanolin alcohol and Amerchol L101 is effective in patch testing for diagnosing lanolin contact allergy. Routinely testing with other lanolin derivatives may not be worthwhile as it detects only few additional patients.

This article is protected by copyright. All rights reserved.

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Severe contact allergy to mupirocin in a polysensitized patient

Allergic contact dermatitis to mupirocin is rarely reported. We report a case a particularly severe case with a prolonged course associated with a polysensitization background.

This article is protected by copyright. All rights reserved.

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Case report: Severe allergic contact dermatitis to topical bufexamac requiring hospitalization

Bufexamac is a topical non‐steroidal anti‐inflammatory drug (NSAID) used as a local treatment for various dermatoses despite a propensity to cause severe allergic contact dermatitis (ACD) and a reported lack of efficacy. Bufexamac is still included in medicaments in countries such as Australia and Switzerland despite being banned in the European Union, the United States, New Zealand and Japan.

This article is protected by copyright. All rights reserved.

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Diagnosing lanolin contact allergy with lanolin alcohol and Amerchol L101

Summary

Background

The prevalence of lanolin contact allergy in dermatitis patients varies from 1.2% to 6.9%. Different lanolin derivatives are used in patch testing.

Objectives

To determine which combination of lanolin derivatives is most effective in patch testing for diagnosing lanolin contact allergy.

Methods

A retrospective analysis of patients patch tested between 2016 and 2017 was performed. Patients were eligible if tested with lanolin alcohol 30% pet., Amerchol L101 50% pet. and a supplementary series containing other lanolin derivatives. Lanolin alcohol and Amerchol L101 were tested in duplicate.

Results

Out of 594 patients, 28.6% (95% confidence interval [CI]: 25.1%‐32.3%) had a positive patch test reaction to at least one lanolin derivative. Reactions were common to lanolin alcohol (14.7%, 95% CI: 11.3%‐18.2%) and Amerchol L101 (15.0%, 95% CI: 11.5%‐18.5%) in the routinely tested series. Reactions to other test preparations were significantly less frequent (P < 0.05). The addition of Amerchol L101 to lanolin alcohol significantly increased the number of positive cases (odds ratio 1.79, P < 0.001).

Conclusions

The combination of lanolin alcohol and Amerchol L101 is effective in patch testing for diagnosing lanolin contact allergy. Routinely testing with other lanolin derivatives may not be worthwhile as it detects only few additional patients.

This article is protected by copyright. All rights reserved.

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Severe contact allergy to mupirocin in a polysensitized patient

Allergic contact dermatitis to mupirocin is rarely reported. We report a case a particularly severe case with a prolonged course associated with a polysensitization background.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FmLeQ9

Case report: Severe allergic contact dermatitis to topical bufexamac requiring hospitalization

Bufexamac is a topical non‐steroidal anti‐inflammatory drug (NSAID) used as a local treatment for various dermatoses despite a propensity to cause severe allergic contact dermatitis (ACD) and a reported lack of efficacy. Bufexamac is still included in medicaments in countries such as Australia and Switzerland despite being banned in the European Union, the United States, New Zealand and Japan.

This article is protected by copyright. All rights reserved.

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Genetic associations of the response to inhaled corticosteroids in asthma: a systematic review

There is wide variability in the response to inhaled corticosteroids (ICS) in asthma. While some of this heterogeneity of response is due to adherence and environmental causes, genetic variation also influence...

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Genetic associations of the response to inhaled corticosteroids in asthma: a systematic review

There is wide variability in the response to inhaled corticosteroids (ICS) in asthma. While some of this heterogeneity of response is due to adherence and environmental causes, genetic variation also influence...

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Long-term speech and swallowing function after primary resection and sentinel node biopsy for early oral squamous cell carcinoma

Publication date: February 2019

Source: Oral Oncology, Volume 89

Author(s): C.A.E. Romer, M.A. Broglie Daeppen, M. Mueller, G.F. Huber, S. Guesewell, S.J. Stoeckli

Abstract

Objectives

Analysis of long-term speech and swallowing function and subjective quality of life (QOL) after primary resection and sentinel node biopsy (SNB) in patients with early stage (cT1/T2) oral squamous cell carcinomas (OSCC).

Material and Methods

Eighty-one consecutive patients treated primarily by transoral resection without flap reconstruction and SNB for a cT1/T2 OSCC were included. Completion neck dissection (CND) was indicated in case of occult disease in the sentinel nodes. Adjuvant radiation (aRT) was administered according to the ultimate lymph node status. All patients showed no evidence of disease at time of analysis. Speech and swallowing function were assessed using standardized clinical examinations (11-item, articulation test) and validated questionnaires on subjective QOL (MDADI, FIGS). Median follow-up was 60 months (range 13–159 months) after initial treatment.

Results

In all assessments for speech and swallowing, the entire study cohort achieved very high scores, with mean values located in the highest 10% of the scales. Neither tumor size nor site, age, pN-category, CND, and aRT had significant impact on functional outcomes and subjective QOL with the exception of lower scores in the global and physical scores of MDADI after CND or aRT, and articulation in the population over 60 years of age.

Conclusion

Transoral resection without reconstruction and SNB for early OSCC achieves excellent outcome with regard to speech, swallowing and subjective QOL.

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Lymph node ratio as prognostic variable in oral squamous cell carcinomas: Systematic review and meta-analysis

Publication date: February 2019

Source: Oral Oncology, Volume 89

Author(s): Ting Hsiang Huang, Kar Yan Li, Wing Shan Choi

Abstract

Lymph node ratio (LNR) has been shown to be an independent prognostic factor for oral squamous cell carcinoma (OSCC) in various centre-based studies recently. A range of cut-off values have been suggested. A meta-analysis was performed to evaluate the prognostic effects of LNR and to investigate the cut-off value.

Electronic search on Pubmed, Embase and Cochrane library and manual search were performed for studies up to January 2018. The outcomes were overall survival (OS), disease specific survival (DSS), disease free survival (DFS), local recurrence free survival (LF), locoregional disease free survival (LRF), and distant metastasis disease free survival (DM).

19 studies between 2009 and 2017 were included. The total number of patients was 14,254 (range 19–3958). Data was grouped into Group A (with pathological nodal disease, pN+) and Group B (with and without pathological nodal disease, pN+ and pN−). In the meta-analysis, the high LNR was significantly related to short OS (A = HR 1.902; 95%CI: 1.453–2.488, B = HR 2.76; 95%CI: 2.13–3.59), DSS (A = HR 1.728; 95%CI: 1.159–2.579; B = HR 2.83; 95%CI: 1.8–4.44) and DFS (A = HR 2.27; 95%CI: 1.74–2.96; B = HR 2.01; 95%CI: 1.44–2.82) in both groups; and shorter LRF in Group B (HR 5.013; 95%CI: 3.584–7.011). In the analysis, all cut-off values were shown to be significant and there was no strong evidence to consider a possibility of a second significant value.

Based on our results, LNR is an independent prognostic factor in OSCC and may be considered in future oncologic staging systems.

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Malignant extrapleural solitary fibrous tumor arising in the sublingual gland: A case report and review of literature

Publication date: Available online 10 January 2019

Source: Oral Oncology

Author(s): Brigida Iorio, Andrea Ronchi, Marco Montella, Immacolata Cozzolino, Roberto De Luca, Mario Rusciano, Gianpaolo Tartaro, Giuseppe Colella, Renato Franco

Abstract

Solitary fibrous tumor is an uncommon neoplasm with unpredictable clinical behavior. Malignant solitary fibrous tumor is a rare morphological variant with more aggressive behavior and higher rates of local recurrences and distant metastasis, exceeding rare in oral cavity; our case occurred in the floor of the mouth in the sublingual gland.

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Lymph node ratio as prognostic variable in oral squamous cell carcinomas: Systematic review and meta-analysis

Publication date: February 2019

Source: Oral Oncology, Volume 89

Author(s): Ting Hsiang Huang, Kar Yan Li, Wing Shan Choi

Abstract

Lymph node ratio (LNR) has been shown to be an independent prognostic factor for oral squamous cell carcinoma (OSCC) in various centre-based studies recently. A range of cut-off values have been suggested. A meta-analysis was performed to evaluate the prognostic effects of LNR and to investigate the cut-off value.

Electronic search on Pubmed, Embase and Cochrane library and manual search were performed for studies up to January 2018. The outcomes were overall survival (OS), disease specific survival (DSS), disease free survival (DFS), local recurrence free survival (LF), locoregional disease free survival (LRF), and distant metastasis disease free survival (DM).

19 studies between 2009 and 2017 were included. The total number of patients was 14,254 (range 19–3958). Data was grouped into Group A (with pathological nodal disease, pN+) and Group B (with and without pathological nodal disease, pN+ and pN−). In the meta-analysis, the high LNR was significantly related to short OS (A = HR 1.902; 95%CI: 1.453–2.488, B = HR 2.76; 95%CI: 2.13–3.59), DSS (A = HR 1.728; 95%CI: 1.159–2.579; B = HR 2.83; 95%CI: 1.8–4.44) and DFS (A = HR 2.27; 95%CI: 1.74–2.96; B = HR 2.01; 95%CI: 1.44–2.82) in both groups; and shorter LRF in Group B (HR 5.013; 95%CI: 3.584–7.011). In the analysis, all cut-off values were shown to be significant and there was no strong evidence to consider a possibility of a second significant value.

Based on our results, LNR is an independent prognostic factor in OSCC and may be considered in future oncologic staging systems.

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Malignant extrapleural solitary fibrous tumor arising in the sublingual gland: A case report and review of literature

Publication date: Available online 10 January 2019

Source: Oral Oncology

Author(s): Brigida Iorio, Andrea Ronchi, Marco Montella, Immacolata Cozzolino, Roberto De Luca, Mario Rusciano, Gianpaolo Tartaro, Giuseppe Colella, Renato Franco

Abstract

Solitary fibrous tumor is an uncommon neoplasm with unpredictable clinical behavior. Malignant solitary fibrous tumor is a rare morphological variant with more aggressive behavior and higher rates of local recurrences and distant metastasis, exceeding rare in oral cavity; our case occurred in the floor of the mouth in the sublingual gland.

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Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system

Publication date: Available online 9 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Carlos Augusto de Souza Lima, Deborah Queiroz Freitas, Glaucia Maria Bovi Ambrosano, Francisco Haiter-Neto, Matheus Lima Oliveira

Abstract

Objectives

To evaluate interpretation conditions in the subjective in vitro assessment of dental tissue-equivalent radiographic contrast.

Study design

Radiographic images with the density of dental structures were randomized and arranged in 20 sequences with images juxtaposed and separated. Twelve observers interpreted the sequence between the most radiolucent and radiopaque images with three displays, three horizontal viewing angles (HVA), and three ambient light conditions. The evaluation time was recorded. The hit percentage was calculated for each evaluation. Three-way ANOVA with Tukey tests compared the conditions of interpretation. The intraclass correlation coefficient assessed agreement (α=0.05).

Results

No differences in hit percentages were found between the three displays or between the juxtaposed and separated images. Increased hit percentages were recorded for images assessed at 90° compared to 45° for all displays, and in high ambient light versus intermediate and low light at 90°. Increased evaluation time was recorded for the consumer-grade display under high ambient light, and for the separated images.

Conclusions

The subjective in vitro assessment of dental tissue-equivalent radiographic contrast is not influenced by the computer display, which should be viewed at an HVA of 90° and under high ambient light. Longer evaluation times may be expected with consumer-grade displays.

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HIV and salivary gland pathology: an update

Publication date: Available online 9 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Shabnum Meer

Abstract

Salivary gland disease is a common human immunodeficiency virus (HIV) manifestation, with a significant increase in prevalence over the last two decades. This review summarizes contemporary knowledge of non-neoplastic salivary gland disease in HIV infection. The aim is to update and focus on those lesions almost exclusive to salivary glands in the HIV setting. These include xerostomia or salivary gland hypofunction, Sjögren's syndrome-like illness, salivary gland enlargements including benign lymphoepithelial cysts (cystic lymphoid hyperplasia), diffuse infiltrative CD8⁺ lymphocytosis syndrome and mucous extravasation phenomena, especially ranula. Many of these conditions show considerable overlap, and thus the term HIV-associated salivary gland disease is used to designate an HIV-infected person with xerostomia or salivary gland hypofunction, enlargement of one or more of the major salivary glands, or both. These manifestations may allude to HIV infection, and prompt recognition is invaluable in diagnosis and treatment of both the salivary gland disease and HIV infection.

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Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system

Publication date: Available online 9 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Carlos Augusto de Souza Lima, Deborah Queiroz Freitas, Glaucia Maria Bovi Ambrosano, Francisco Haiter-Neto, Matheus Lima Oliveira

Abstract

Objectives

To evaluate interpretation conditions in the subjective in vitro assessment of dental tissue-equivalent radiographic contrast.

Study design

Radiographic images with the density of dental structures were randomized and arranged in 20 sequences with images juxtaposed and separated. Twelve observers interpreted the sequence between the most radiolucent and radiopaque images with three displays, three horizontal viewing angles (HVA), and three ambient light conditions. The evaluation time was recorded. The hit percentage was calculated for each evaluation. Three-way ANOVA with Tukey tests compared the conditions of interpretation. The intraclass correlation coefficient assessed agreement (α=0.05).

Results

No differences in hit percentages were found between the three displays or between the juxtaposed and separated images. Increased hit percentages were recorded for images assessed at 90° compared to 45° for all displays, and in high ambient light versus intermediate and low light at 90°. Increased evaluation time was recorded for the consumer-grade display under high ambient light, and for the separated images.

Conclusions

The subjective in vitro assessment of dental tissue-equivalent radiographic contrast is not influenced by the computer display, which should be viewed at an HVA of 90° and under high ambient light. Longer evaluation times may be expected with consumer-grade displays.

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HIV and salivary gland pathology: an update

Publication date: Available online 9 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Shabnum Meer

Abstract

Salivary gland disease is a common human immunodeficiency virus (HIV) manifestation, with a significant increase in prevalence over the last two decades. This review summarizes contemporary knowledge of non-neoplastic salivary gland disease in HIV infection. The aim is to update and focus on those lesions almost exclusive to salivary glands in the HIV setting. These include xerostomia or salivary gland hypofunction, Sjögren's syndrome-like illness, salivary gland enlargements including benign lymphoepithelial cysts (cystic lymphoid hyperplasia), diffuse infiltrative CD8⁺ lymphocytosis syndrome and mucous extravasation phenomena, especially ranula. Many of these conditions show considerable overlap, and thus the term HIV-associated salivary gland disease is used to designate an HIV-infected person with xerostomia or salivary gland hypofunction, enlargement of one or more of the major salivary glands, or both. These manifestations may allude to HIV infection, and prompt recognition is invaluable in diagnosis and treatment of both the salivary gland disease and HIV infection.

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Erratum

Publication date: Available online 9 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s):

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Clinical Communication: Systemic Capillary Leak Syndrome Due to Mast Cell Activation?

Publication date: Available online 9 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Robert C. Van Winkle, J. Jeffrey Malatack, Lawrence B. Schwartz, Stephen J. McGeady

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Spare roof technique in reduction rhinoplasty: Prospective study of the first one hundred patients

Objective

Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT).

Methods

Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides.

Results

The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides.

Conclusion

This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty.

Level of Evidence

2. Laryngoscope, 2019

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Three‐Dimensional endoscopy: The future of nasoendoscopic training

Objectives/Hypothesis

Three‐dimensional (3D) endoscopy is an emerging tool in surgery that provides real‐time depth perception. Its benefits have been investigated in surgical training, but the current literature lacks significant objective outcome data. We aimed to objectively compare the efficacy of two‐dimensional (2D) versus 3D high‐definition endoscopes in novice users.

Study Design

Prospective, randomized crossover study.

Methods

Ninety‐two novice medical students who used both 2D and 3D endoscopes to complete two validated tasks in a box trainer participated in the study. Time taken and error rates were measured, and subjective data were collected.

Results

Wilcoxon tests showed 3D technology was significantly faster than 2D (78 vs. 95 seconds, P = .004), and errors per task were significantly lower (3 vs. 5, P < .001). Sixty‐nine percent of participants preferred the 3D endoscope.

Conclusions

3D high‐definition endoscopy could be instrumental in training the next generation of endoscopic surgeons. Further research is required in a clinical setting.

Level of Evidence

2b Laryngoscope, 2019

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Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

Objective

To determine whether a smartphone adaptor can record laryngoscopic videos of adequate quality for clinical diagnosis and communication among otolaryngologists and assess the impact of recorded exams on patient satisfaction.

Methods

Twenty adult inpatients undergoing flexible laryngoscopy in a tertiary care medical center were prospectively enrolled. Each subject's larynx was visualized with the standard laryngoscope eyepiece and with an attached mobile phone adaptor with video recording capabilities. A 5‐point Likert scale was used by the resident performing the scope to grade the adaptor and eyepiece exams. The same scale was used by an offsite otolaryngology attending to grade the adaptor video. Patients were shown the video, and a satisfaction survey was administered.

Results

In all patients, the adaptor was easy to use and required minimal setup. Ninety percent of patients reported an increase in satisfaction after watching the video of their exam. The eyepiece was superior to the adaptor in resolution, focus, color fidelity, brightness, and optical fluidity (P < 0.05). The video recording was deemed sufficient for clinical assessment in 90% of cases. The offsite reviewer determined that there would be "little" (15%) or "no value" (65%) in repeating the scope exam in the majority of patients. The laryngeal subsites were equally visible with the eyepiece and the adaptor ("full view," 85%–100%).

Conclusion

Laryngoscopy videos recorded by a portable smartphone adaptor are sufficient for clinical evaluation in the majority of cases. This technology may improve patient satisfaction and communication among clinicians.

Level of Evidence

4. Laryngoscope, 2019

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Optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer

Objective

To determine the optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer. The hypothesis was that concurrent chemoradiotherapy (CCRT) would be associated with improved overall survival (OS) compared to induction chemotherapy followed by radiotherapy (RT)/surgery (IC).

Methods

The National Cancer Database identified 8,154 patients with American Joint Commission on Cancer stage III/IV (excluding T1) laryngeal cancer between 2004 and 2013 treated with one of the established organ preservation techniques: CCRT or IC. The association between OS and total radiation dose (< 66 gray [Gy] or ≥ 66 Gy) was analyzed using the Kaplan‐Meier method, as was the association between OS and timing of IC (21–42, 43–100, or 101–120 days before RT). Hazard ratios (HR) adjusted for patient and clinical characteristics were computed using Cox regression modeling.

Results

The median follow‐up was 32.7 months. The estimated 5‐year OS for CCRT and IC was 49.9% and 50.6%, respectively (P = 0.653). On multivariate analysis, no difference was observed between the two regimens (IC, adjusted HR 0.96, 95% confidence interval [CI] 0.88–1.04, P = 0.268). Radiation dose ≥66 Gy had improved OS overall in CCRT group but not in IC patients. When comparing CCRT and IC in patients receiving ≥66 Gy, there was no difference in OS (adjusted HR 0.97, 95% CI 0.89–1.06, P = 0.552). Patients starting chemotherapy 21 to 42 or 101 to 120 days prior to RT had inferior OS compared to patients starting between 43 to 100 days.

Conclusion

For locally advanced laryngeal cancer, there is no difference in OS between CCRT and IC. Factors associated with survival included radiation dose and timing of induction chemotherapy before RT.

Level of Evidence

3b Laryngoscope, 2019

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Expert sampling of VR simulator metrics for automated assessment of mastoidectomy performance

Objective

Often the assessment of mastoidectomy performance requires time‐consuming manual rating. Virtual reality (VR) simulators offer potentially useful automated assessment and feedback but should be supported by validity evidence. We aimed to investigate simulator metrics for automated assessment based on the expert performance approach, comparison with an established assessment tool, and the consequences of standard setting.

Methods

The performances of 11 experienced otosurgeons and 37 otorhinolaryngology residents. Participants performed three mastoidectomies in the Visible Ear Simulator. Nine residents contributed additional data on repeated practice in the simulator. One hundred and twenty‐nine different performance metrics were collected by the simulator and final‐product files were saved. These final products were analyzed using a modified Welling Scale by two blinded raters.

Results

Seventeen metrics could discriminate between resident and experienced surgeons' performances. These metrics mainly expressed various aspects of efficiency: Experts demonstrated more goal‐directed behavior and less hesitancy, used less time, and selected large and sharp burrs more often. The combined metrics‐based score (MBS) demonstrated significant discriminative ability between experienced surgeons and residents with a mean difference of 16.4% (95% confidence interval [12.6–20.2], P << 0.001). A pass/fail score of 83.6% was established. The MBS correlated poorly with the final‐product score but excellently with the final‐product score per time.

Conclusion

The MBS mainly reflected efficiency components of the mastoidectomy procedure, and although it could have some uses in self‐directed training, it fails to measure and encourage safe routines. Supplemental approaches and feedback are therefore required in VR simulation training of mastoidectomy.

Level of Evidence

2b. Laryngoscope, 2019

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Quantitative second harmonic generation imaging of leporine, canine, and porcine vocal fold collagen

Objectives/Hypothesis

Vocal fold collagen composition is an important determinant of material properties and mucosal wave propagation. Collagen alignment and straightness are quantitatively characterized by second harmonic generation (SHG) imaging. We examined leporine, canined and porcine vocal folds showing collagen composition variation that is species, location, and strain specific.

Study Design

Animal model.

Methods

Leporine (n = 5), canine (n = 5), and porcine (n = 5) larynges were harvested and fixed in situ. Samples were transversely sectioned, and SHG images were collected for two inferior–superior sections along five anterior–posterior locations. Additional porcine samples were fixed and imaged under tensile strain (0%, 5%, 10%, 15%, 20%, n = 5 per group). Two‐way repeated measures (RM) analysis of variance (ANOVA) tested for section and location differences in each species. Multiway RM‐ANOVA tested for section, location, and strain differences in porcine samples.

Results

Alignment and straightness were higher inferiorly in the porcine (P = .0047, P = .002) and canine (P = .0011, P < .001) vocal folds, but not in leporine samples (P = .67652, P = .4831). There were significant interactions between elongation and superior–inferior section for both alignment (P = .0047) and straightness (P = .0371).

Conclusions

Our results correspond well to findings in the literature that the inferior vocal fold lip is stiffer in porcine and canine larynges. The absence of a collagen gradient in the leporine vocal fold is notable because rabbits are less vocal animals, indicating the collagen gradient may be a result of voice use and an important consideration in model selection when extracellular matrix is of interest. Strain results were also consistent with the role of collagen in strain stiffening behavior of vocal fold tissue.

Level of Evidence

NA Laryngoscope, 2019

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Excessive inflammation portends complications: Wound cytokines and head and neck surgery outcomes

Objectives/Hypothesis

Postoperative wound‐healing complications can be devastating after head and neck surgery. Whereas many patients are expected to have more complications, few objective indicators predict these poorer outcomes. We evaluated wound healing in this population by studying the association between biomarkers and surgical outcomes.

Study Design

Prospective cohort study.

Methods

A study was performed of head and neck surgery patients at our tertiary care center, from 2012 to 2015. Postsurgical drain fluid was collected 24 hours postoperatively. Biomarkers of wound healing were assayed. These included interleukin (IL)‐1, ‐6, and ‐8; tumor necrosis factor (TNF)‐α; transforming growth factor β; epidermal growth factor; fibroblast growth factor; C‐reactive protein (CRP); vascular endothelial growth factor (VEGF); soluble fms‐like tyrosine kinase‐1; and placental growth factor. Patient characteristics and clinical outcomes were recorded. Two‐sample, two‐sided t tests evaluated differences in cytokine levels by clinical outcomes.

Results

Twenty‐eight patients were enrolled with drain fluid collection. IL‐1β, IL‐8, and matrix metalloproteinase (MMP)‐9 were significantly higher in the wound fluid of subjects with complications. Patients with longer length of stay in days had statistically higher levels of TNF‐α (P = .011), IL‐6 (P = .021), IL‐8 (P = .004), IL‐1β (P = .004), MMP‐1 (P = .002), MMP‐2 (P = .022), VEGF‐A (P = .038), and CRP (P < .001), and longer length of stay was associated with malignancy. There were no statistically significant associations between baseline clinical characteristics and post‐operative complications.

Conclusions

In this head and neck surgical cohort, higher IL‐1β, IL‐8, and MMP‐9 levels in wound fluid were associated with postoperative complications, and elevation of multiple proinflammatory cytokines was associated with longer length of stay. These findings suggest excessive inflammation in early wound healing may portend poorer clinical outcomes after head and neck surgery.

Level of Evidence

2b Laryngoscope, 2019

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Clinical Communication: Systemic Capillary Leak Syndrome Due to Mast Cell Activation?

Publication date: Available online 9 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Robert C. Van Winkle, J. Jeffrey Malatack, Lawrence B. Schwartz, Stephen J. McGeady

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Spare roof technique in reduction rhinoplasty: Prospective study of the first one hundred patients

Objective

Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT).

Methods

Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides.

Results

The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides.

Conclusion

This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty.

Level of Evidence

2. Laryngoscope, 2019

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Three‐Dimensional endoscopy: The future of nasoendoscopic training

Objectives/Hypothesis

Three‐dimensional (3D) endoscopy is an emerging tool in surgery that provides real‐time depth perception. Its benefits have been investigated in surgical training, but the current literature lacks significant objective outcome data. We aimed to objectively compare the efficacy of two‐dimensional (2D) versus 3D high‐definition endoscopes in novice users.

Study Design

Prospective, randomized crossover study.

Methods

Ninety‐two novice medical students who used both 2D and 3D endoscopes to complete two validated tasks in a box trainer participated in the study. Time taken and error rates were measured, and subjective data were collected.

Results

Wilcoxon tests showed 3D technology was significantly faster than 2D (78 vs. 95 seconds, P = .004), and errors per task were significantly lower (3 vs. 5, P < .001). Sixty‐nine percent of participants preferred the 3D endoscope.

Conclusions

3D high‐definition endoscopy could be instrumental in training the next generation of endoscopic surgeons. Further research is required in a clinical setting.

Level of Evidence

2b Laryngoscope, 2019

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

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

Objective

To determine whether a smartphone adaptor can record laryngoscopic videos of adequate quality for clinical diagnosis and communication among otolaryngologists and assess the impact of recorded exams on patient satisfaction.

Methods

Twenty adult inpatients undergoing flexible laryngoscopy in a tertiary care medical center were prospectively enrolled. Each subject's larynx was visualized with the standard laryngoscope eyepiece and with an attached mobile phone adaptor with video recording capabilities. A 5‐point Likert scale was used by the resident performing the scope to grade the adaptor and eyepiece exams. The same scale was used by an offsite otolaryngology attending to grade the adaptor video. Patients were shown the video, and a satisfaction survey was administered.

Results

In all patients, the adaptor was easy to use and required minimal setup. Ninety percent of patients reported an increase in satisfaction after watching the video of their exam. The eyepiece was superior to the adaptor in resolution, focus, color fidelity, brightness, and optical fluidity (P < 0.05). The video recording was deemed sufficient for clinical assessment in 90% of cases. The offsite reviewer determined that there would be "little" (15%) or "no value" (65%) in repeating the scope exam in the majority of patients. The laryngeal subsites were equally visible with the eyepiece and the adaptor ("full view," 85%–100%).

Conclusion

Laryngoscopy videos recorded by a portable smartphone adaptor are sufficient for clinical evaluation in the majority of cases. This technology may improve patient satisfaction and communication among clinicians.

Level of Evidence

4. Laryngoscope, 2019

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2M4knJS

Optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer

Objective

To determine the optimal sequencing of chemoradiotherapy for locally advanced laryngeal cancer. The hypothesis was that concurrent chemoradiotherapy (CCRT) would be associated with improved overall survival (OS) compared to induction chemotherapy followed by radiotherapy (RT)/surgery (IC).

Methods

The National Cancer Database identified 8,154 patients with American Joint Commission on Cancer stage III/IV (excluding T1) laryngeal cancer between 2004 and 2013 treated with one of the established organ preservation techniques: CCRT or IC. The association between OS and total radiation dose (< 66 gray [Gy] or ≥ 66 Gy) was analyzed using the Kaplan‐Meier method, as was the association between OS and timing of IC (21–42, 43–100, or 101–120 days before RT). Hazard ratios (HR) adjusted for patient and clinical characteristics were computed using Cox regression modeling.

Results

The median follow‐up was 32.7 months. The estimated 5‐year OS for CCRT and IC was 49.9% and 50.6%, respectively (P = 0.653). On multivariate analysis, no difference was observed between the two regimens (IC, adjusted HR 0.96, 95% confidence interval [CI] 0.88–1.04, P = 0.268). Radiation dose ≥66 Gy had improved OS overall in CCRT group but not in IC patients. When comparing CCRT and IC in patients receiving ≥66 Gy, there was no difference in OS (adjusted HR 0.97, 95% CI 0.89–1.06, P = 0.552). Patients starting chemotherapy 21 to 42 or 101 to 120 days prior to RT had inferior OS compared to patients starting between 43 to 100 days.

Conclusion

For locally advanced laryngeal cancer, there is no difference in OS between CCRT and IC. Factors associated with survival included radiation dose and timing of induction chemotherapy before RT.

Level of Evidence

3b Laryngoscope, 2019

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

Expert sampling of VR simulator metrics for automated assessment of mastoidectomy performance

Objective

Often the assessment of mastoidectomy performance requires time‐consuming manual rating. Virtual reality (VR) simulators offer potentially useful automated assessment and feedback but should be supported by validity evidence. We aimed to investigate simulator metrics for automated assessment based on the expert performance approach, comparison with an established assessment tool, and the consequences of standard setting.

Methods

The performances of 11 experienced otosurgeons and 37 otorhinolaryngology residents. Participants performed three mastoidectomies in the Visible Ear Simulator. Nine residents contributed additional data on repeated practice in the simulator. One hundred and twenty‐nine different performance metrics were collected by the simulator and final‐product files were saved. These final products were analyzed using a modified Welling Scale by two blinded raters.

Results

Seventeen metrics could discriminate between resident and experienced surgeons' performances. These metrics mainly expressed various aspects of efficiency: Experts demonstrated more goal‐directed behavior and less hesitancy, used less time, and selected large and sharp burrs more often. The combined metrics‐based score (MBS) demonstrated significant discriminative ability between experienced surgeons and residents with a mean difference of 16.4% (95% confidence interval [12.6–20.2], P << 0.001). A pass/fail score of 83.6% was established. The MBS correlated poorly with the final‐product score but excellently with the final‐product score per time.

Conclusion

The MBS mainly reflected efficiency components of the mastoidectomy procedure, and although it could have some uses in self‐directed training, it fails to measure and encourage safe routines. Supplemental approaches and feedback are therefore required in VR simulation training of mastoidectomy.

Level of Evidence

2b. Laryngoscope, 2019

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2M0efT0

Quantitative second harmonic generation imaging of leporine, canine, and porcine vocal fold collagen

Objectives/Hypothesis

Vocal fold collagen composition is an important determinant of material properties and mucosal wave propagation. Collagen alignment and straightness are quantitatively characterized by second harmonic generation (SHG) imaging. We examined leporine, canined and porcine vocal folds showing collagen composition variation that is species, location, and strain specific.

Study Design

Animal model.

Methods

Leporine (n = 5), canine (n = 5), and porcine (n = 5) larynges were harvested and fixed in situ. Samples were transversely sectioned, and SHG images were collected for two inferior–superior sections along five anterior–posterior locations. Additional porcine samples were fixed and imaged under tensile strain (0%, 5%, 10%, 15%, 20%, n = 5 per group). Two‐way repeated measures (RM) analysis of variance (ANOVA) tested for section and location differences in each species. Multiway RM‐ANOVA tested for section, location, and strain differences in porcine samples.

Results

Alignment and straightness were higher inferiorly in the porcine (P = .0047, P = .002) and canine (P = .0011, P < .001) vocal folds, but not in leporine samples (P = .67652, P = .4831). There were significant interactions between elongation and superior–inferior section for both alignment (P = .0047) and straightness (P = .0371).

Conclusions

Our results correspond well to findings in the literature that the inferior vocal fold lip is stiffer in porcine and canine larynges. The absence of a collagen gradient in the leporine vocal fold is notable because rabbits are less vocal animals, indicating the collagen gradient may be a result of voice use and an important consideration in model selection when extracellular matrix is of interest. Strain results were also consistent with the role of collagen in strain stiffening behavior of vocal fold tissue.

Level of Evidence

NA Laryngoscope, 2019

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

Excessive inflammation portends complications: Wound cytokines and head and neck surgery outcomes

Objectives/Hypothesis

Postoperative wound‐healing complications can be devastating after head and neck surgery. Whereas many patients are expected to have more complications, few objective indicators predict these poorer outcomes. We evaluated wound healing in this population by studying the association between biomarkers and surgical outcomes.

Study Design

Prospective cohort study.

Methods

A study was performed of head and neck surgery patients at our tertiary care center, from 2012 to 2015. Postsurgical drain fluid was collected 24 hours postoperatively. Biomarkers of wound healing were assayed. These included interleukin (IL)‐1, ‐6, and ‐8; tumor necrosis factor (TNF)‐α; transforming growth factor β; epidermal growth factor; fibroblast growth factor; C‐reactive protein (CRP); vascular endothelial growth factor (VEGF); soluble fms‐like tyrosine kinase‐1; and placental growth factor. Patient characteristics and clinical outcomes were recorded. Two‐sample, two‐sided t tests evaluated differences in cytokine levels by clinical outcomes.

Results

Twenty‐eight patients were enrolled with drain fluid collection. IL‐1β, IL‐8, and matrix metalloproteinase (MMP)‐9 were significantly higher in the wound fluid of subjects with complications. Patients with longer length of stay in days had statistically higher levels of TNF‐α (P = .011), IL‐6 (P = .021), IL‐8 (P = .004), IL‐1β (P = .004), MMP‐1 (P = .002), MMP‐2 (P = .022), VEGF‐A (P = .038), and CRP (P < .001), and longer length of stay was associated with malignancy. There were no statistically significant associations between baseline clinical characteristics and post‐operative complications.

Conclusions

In this head and neck surgical cohort, higher IL‐1β, IL‐8, and MMP‐9 levels in wound fluid were associated with postoperative complications, and elevation of multiple proinflammatory cytokines was associated with longer length of stay. These findings suggest excessive inflammation in early wound healing may portend poorer clinical outcomes after head and neck surgery.

Level of Evidence

2b Laryngoscope, 2019

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2M0efCu

Tolerance-based capecitabine dose escalation after DPYD genotype-guided dosing in heterozygote DPYD variant carriers: a single-center observational study

Objective Certain polymorphisms of the DPYD gene encoding for the dihydropyrimidine dehydrogenase (DPD) enzyme are associated with fluoropyrimidine-induced toxicity. Dose reductions of the fluoropyrimidine prodrug capecitabine are recommended for patients carrying these DPYD variants to prevent toxicities. Capecitabine dose escalation after an initial genotype-guided dose reduction is advocated when treatment is well tolerated. However, practical guidelines on how to implement these dose escalations are lacking. We implemented a protocol for tolerance-guided capecitabine dosing in DPYD variant carriers and aimed to explore its effect on toxicity of treatment. Patients and methods Patients receiving capecitabine-based chemotherapy for different types of solid tumors were identified retrospectively. Capecitabine doses were reduced in case of a DPYD variant (DPYD*2A, c.2846A>T, DPYD*13, or c.1236G>A) and subsequently adjusted on the basis of tolerance. Outcome was evaluated by clinical chart review and dosing characteristics from the hospital pharmacy. Results were compared with a cohort of capecitabine-treated DPYD wild-type patients. Results Of 185 patients eligible for analysis, 11 patients were heterozygous for a DPYD variant. A median dose escalation of 8.5% was achieved using the prespecified protocol. One DPYD variant carrier experienced a grade 3 toxicity after a dose escalation. Overall, DPYD variant carriers did not experience more, or more severe toxicities than DPYD wild-type patients. The total prevalence of severe toxicities in the wild-type group was 43.1% and is comparable with the literature. Conclusion Tolerance-based capecitabine dose escalation did not lead to more toxicity in DPYD variant carriers compared with wild-type patients. Our results can guide future prospective research. Correspondence to Johan M. van Rooijen, MD, Department of Internal Medicine, Martini Hospital, van Swietenplein 1, 9728NT Groningen, The Netherlands Tel: +31 50 524 6283; fax: +31 50 524 5889; e-mail: j.vanrooijen@mzh.nl Received August 12, 2018 Accepted December 27, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Traditional use of ethnomedicinal native plants in the Kingdom of Saudi Arabia

The Arabian Peninsula is recognized as an arid area dominated by deserts and poor biodiversity. However, the Kingdom of Saudi Arabia (henceforth abbreviated into KSA) has a wide range of flora, consisting of d...

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Wild edible plants used by communities in and around selected forest reserves of Teso-Karamoja region, Uganda

The consumption of wild plants is an ancient tradition which serves multiple purposes. Cognizant that Teso-Karamoja region is frequently affected by food scarcity and is not adequately surveyed for its flora, ...

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UV-A screening in Cladophora sp. lowers internal UV-A availability and photoreactivation as compared to non-UV screening in Ulva intestinalis

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00432C, Paper

Frauke Pescheck
UV-A screening reduces UV-A-driven photoreactivation of UV-B-induced DNA damage in the green macroalga Cladophora sp.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://rsc.li/2FkfewW

Traditional use of ethnomedicinal native plants in the Kingdom of Saudi Arabia

The Arabian Peninsula is recognized as an arid area dominated by deserts and poor biodiversity. However, the Kingdom of Saudi Arabia (henceforth abbreviated into KSA) has a wide range of flora, consisting of d...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VGFYg7

Wild edible plants used by communities in and around selected forest reserves of Teso-Karamoja region, Uganda

The consumption of wild plants is an ancient tradition which serves multiple purposes. Cognizant that Teso-Karamoja region is frequently affected by food scarcity and is not adequately surveyed for its flora, ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QBq3M7

Effects of a simulated system of straw phonation on the complete phonatory range of excised canine larynges

Abstract

Purpose

This study investigated the effects of straw phonation therapy on the aerodynamic and acoustic parameters of the vocal folds at different levels of elongation and subglottal pressure.

Methods

20 excised canine larynges were used in both experimental (straw phonation therapy simulation) and control conditions. Aerodynamic parameters, including phonation threshold pressure (PTP), phonation instability pressure (PIP), phonation pressure range (PPR), phonation threshold flow (PTF), phonation instability flow (PIF), phonation flow range (PFR), were obtained at different levels of vocal fold elongation (0%, 10%, 20%). Acoustic parameters, including fundamental frequency (F0), jitter, shimmer, signal noise ratio (SNR) were detected at different levels of vocal fold elongation (0%, 10%, 20%) and subglottal pressure (15 cmH₂O, 20 cmH₂O, 25 cmH₂O).

Results

Significant decreases in PTP and PTF and significant increases in PIP, PIF, PPR, and PFR occurred in experimental condition at all levels of elongation when compared with control condition. However, no significant changes of acoustic parameters were obtained between conditions at all levels.

Conclusion

At different levels of vocal fold elongation, straw phonation not only lowered the onset of normal voice, but also elevated the onset of chaotic voice, indicating a better voice economy and voice control. Moreover, the improved phonatory range demonstrated that straw phonation had the potential to prevent voice users who have high voice demand from voice fatigue and vocal damage.

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