Perioperative Management of Disruptive Patients

No abstract available

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Efficacy of Intrathecal Fentanyl for Cesarean Delivery: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis

BACKGROUND: Fentanyl and morphine are the 2 most commonly added opioids to bupivacaine for spinal anesthesia during cesarean delivery. Numerous clinical trials have assessed efficacy and safety of different doses of fentanyl added to intrathecal bupivacaine for spinal anesthesia, yet its benefit, harm, and optimal dose remain unclear. This study aimed to systematically review the evidence of the efficacy of fentanyl when added to intrathecal bupivacaine alone and when added to bupivacaine with morphine for spinal anesthesia during cesarean delivery. METHODS: Key electronic databases (PubMed, Embase, and Cochrane Library) were searched for randomized controlled trials in the cesarean delivery population. The primary outcome was the failure rate of spinal anesthesia, as assessed by the need for either conversion to general anesthesia or intraoperative analgesic supplementation. Two reviewers independently extracted the data using a standardized electronic form. Results are expressed as relative risks or mean differences with 95% CIs. RESULTS: Seventeen randomized controlled clinical trials (most judged as low or unclear risk of bias) with 1064 participants provided data for the meta-analysis. Fentanyl added to intrathecal bupivacaine alone reduced the need for intraoperative supplemental analgesia (relative risk, 0.18; 95% CI, 0.11–0.27; number needed to treat, 4) and the incidence of nausea/vomiting (relative risk, 0.41; 95% CI, 0.24–0.70; number needed to treat, 6.5), with longer time to first postoperative analgesia request (mean difference, 91 minutes; 95% CI, 69–113). No difference was observed regarding the need for conversion to general anesthesia (relative risk, 0.67; 95% CI, 0.12–3.57), the incidence of hypotension, the onset of sensory block, or the duration of motor block. However, the addition of intrathecal fentanyl was associated with higher incidence of intraoperative pruritus (relative risk, 5.89; 95% CI, 2.07–16.79; number needed to harm, 13.5). The inclusion of fentanyl to intrathecal bupivacaine–morphine compared to intrathecal bupivacaine–morphine alone conferred a similar benefit, with a significantly reduced need for intraoperative supplemental analgesia (relative risk, 0.16; 95% CI, 0.03–0.95; number needed to treat, 9). Analysis using a funnel plot indicated a possibility of publication bias in included studies. CONCLUSIONS: Current evidence suggests a benefit of using fentanyl as both an additive to intrathecal bupivacaine alone and to intrathecal bupivacaine combined with morphine for cesarean delivery under spinal anesthesia. The possibility of publication bias, small sample size, and high risk of bias in some of the included studies warrant treating the results with caution. Accepted for publication November 5, 2018. Funding: This project received a $1200 support from the Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority, for statistical consultation. Conflicts of Interest: See Disclosures at the end of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://bit.ly/KegmMq). Trial registration number: International prospective register of systematic reviews 2016: CRD42016044075. Reprints will not be available from the authors. Address correspondence to Vishal Uppal, FRCA, Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority and Izaak Walton Killam Health Centre, 5th floor, Halifax Infirmary Site, Rm 5452, 1796, Summer St, Halifax, Nova Scotia, B3H 2Y9, Canada. Address e-mail to v.uppal@dal.ca. © 2019 International Anesthesia Research Society

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Comparing Nasal End-Tidal Carbon Dioxide Measurement Variation and Agreement While Delivering Pulsed and Continuous Flow Oxygen in Volunteers and Patients

BACKGROUND: Supplemental oxygen is administered during procedural sedation to prevent hypoxemia. Continuous flow oxygen, the most widespread method, is generally adequate but distorts capnography. Pulsed flow oxygen is novel and ideally will not distort capnography. We have developed a prototype oxygen administration system designed to try to facilitate end-tidal carbon dioxide (ETCO2) measurement. We conducted a volunteer study (ClinicalTrials.gov, NCT02886312) to determine how much nasal ETCO2 measurements vary with oxygen flow rate. We also conducted a clinical study (NCT02962570) to determine the median difference and limits of agreement between ETCO2 measurements made with and without administering oxygen. METHODS: Both studies were conducted at the University of Utah and participants acted as their own control. Inclusion criteria were age 18 years and older with an American Society of Anesthesiologists physical status of I–III. Exclusion criteria included acute respiratory distress syndrome, pneumonia, lung or cardiovascular disease, nasal/bronchial congestion, pregnancy, oxygen saturation measured by pulse oximetry

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Music Interventions in Pediatric Surgery (The Music Under Surgery In Children Study): A Randomized Clinical Trial

BACKGROUND: Perioperative music interventions have been shown to reduce anxiety and pain in adults. This inexpensive, easily applicable intervention could be of benefit to children as well. Our objective was to determine the effects of music interventions on distress, anxiety, and postoperative pain in infants undergoing surgery. METHODS: The Music Under Surgery In Children study was designed as a parallel, single-blind, randomized controlled trial with an a priori formulated hypothesis. Data were collected between August 2015 and October 2016 in a single tertiary care children's hospital. There was a 24-hour follow-up with blind primary outcome assessment. A random sample of 432 eligible 0–3 years of age infants admitted for orchidopexy, hypospadias, or inguinal hernia repair receiving general anesthesia and caudal block were asked for participation. Subjects were assigned to a preoperative music intervention, pre- and intraoperative music intervention, or no music intervention (control) via random allocation using a computer-generated list with the use of opaque envelopes. The main outcome measure was the postoperative level of distress assessed with the COMFORT-Behavior scale, which is an observational scale; furthermore, preoperative level of distress, preoperative anxiety, and physiological measurements such as heart rate (HR) and blood pressure were measured. The trial was registered at the Dutch Trial Register, number NTR5402 (www.trialregister.nl). RESULTS: One hundred ninety-five infants with median age 6.9 months (interquartile range, 3.3–11.1) were randomized, 178 of whom were included in the primary analysis. A nonsignificant difference in COMFORT-Behavior scale scores between the pre- and intraoperative music intervention group and control group at 4 hours after surgery was found (mean difference, −1.22; 95% CI, 2.60–0.17; P = .085). Additional analysis showed weak nonsignificant evidence for an interaction effect between music exposure and COMFORT-Behavior score at baseline (P = .027 with a Bonferroni-adjusted significance level of .025). General linear modeling showed a statistically significantly reduced HR after the preoperative music intervention in the holding area in the combined preoperative music intervention and intraoperative music intervention group compared to the control group (P = .003). The differences in HR among the 3 study arms at all time points were not statistically significant (P = .069). CONCLUSIONS: Music interventions do not seem to benefit all young infants undergoing surgery. The potential benefits of music interventions in the preoperative period and in more distressed children warrant further exploration. Accepted for publication November 13, 2018. Funding: This study was funded by Prins Bernhard Cultuurfonds, Amsterdam, the Netherlands, and by Stichting Swart van Essen, Rotterdam, the Netherlands. The funders of the study had no role in the study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication. The authors declare no conflicts of interest. Clinical trial number: Dutch Trial Register NTR5402; http://bit.ly/1hWFkGC. Reprints will not be available from the authors. Address correspondence to A. Y. Rosalie Kühlmann, MD, Department of Pediatric Surgery, Erasmus Medical Center–Sophia Children's Hospital, PO Box 2060, Room SK1264, 3000CA Rotterdam, the Netherlands. Address e-mail to a.kuhlmann@erasmusmc.nl/ rosaliekuhlmann@gmail.com. © 2019 International Anesthesia Research Society

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Ticker and The Ghost Map: Two Medical History Books That Reveal Much About Who We Were, and Still Are

No abstract available

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In Response

No abstract available

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Vascular Adhesion Protein-1 Is Associated With Acute Kidney Injury in High-Risk Patients After Cardiac Surgery

BACKGROUND: Acute kidney injury is a common complication after cardiac surgery, with a high impact on morbidity and mortality. Vascular adhesion protein-1 is involved in inflammation, which, in turn, is part of the development of acute kidney injury after cardiac surgery. METHODS: In this ancillary study to the RENal effects of Remote Ischemic Preconditioning in cardiac surgery trial, we investigated whether vascular adhesion protein-1 might be associated with the development of acute kidney injury in high-risk patients after cardiac surgery. In total, 114 patients were included in this data set. Acute kidney injury was defined by the Kidney Disease: Improving Global Outcomes criteria serum creatinine and/or urine output. Vascular adhesion protein-1 concentrations were measured at baseline (before surgery), 4 hours, and 12 hours after cardiopulmonary bypass. RESULTS: Vascular adhesion protein-1 levels at 12 hours were significantly higher in patients with acute kidney injury (no acute kidney injury, 271 ng/mL [Q1, Q3, 179, 364 ng/mL] versus acute kidney injury, 384 ng/mL [Q1, Q3, 311, 478 ng/mL]; P 99 ng/mL showed a higher occurrence rate of acute kidney injury (acute kidney injury, 78.6% versus no acute kidney injury, 31.5%; P

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Assessing Rapidity of Recovery After Cancer Surgeries in a Single Overnight Short-Stay Setting

BACKGROUND: In the short-stay surgery setting, where patients remain in hospital for a single overnight at most, it is unclear as to whether postoperative length of stay is a good surrogate for assessing rapidity of recovery. We hypothesized that length of stay would be a function of time of surgery and would be a poorer marker of recovery than time of discharge. METHODS: A cohort of 891 mastectomy and 538 prostatectomy patients had a planned single overnight stay after surgery at an ambulatory surgical hospital during 2016. The relationship between surgical start time and postoperative length of stay or discharge time was assessed. RESULTS: For both mastectomy and prostatectomy patients, 75% of patients were discharged between 10 AM and 12 noon and the median postoperative length of stay was 20 hours. There was a strong association between time of surgery and calculated length of stay. For mastectomies, having a surgery which begins at 6 PM vs 8 AM results in an estimated decrease of 8.8 hours (95% CI, 8.3–9.3) in postoperative length of stay but only 1.2 hours (95% CI, 0.77–1.6) later time of discharge. For prostatectomies, the estimated difference is a decrease of 6.9 hours (95% CI, 6.4–7.4) for postoperative length of stay and 2.5 hours (95% CI, 2.0–3.0) later discharge time. CONCLUSIONS: Postoperative length of stay is a poor outcome measure in a short-stay setting. When assessing rapidity of recovery for single overnight stay patients, we advocate the use of discharge time with adjustment for surgery start time. The effect of surgery start time on both postoperative length of stay and discharge time should be investigated to ascertain which is best to assess rapidity of recovery in other ambulatory care settings where recovery involves a single overnight stay. Accepted for publication November 19, 2018. Funding: This work was supported by National Cancer Institute (P50-CA92629 and P30-CA008748), the Sidney Kimmel Center for Prostate and Urologic Cancers, David H. Koch through the Prostate Cancer Foundation, the Richard Capri Foundation, and Ambulatory Cancer Care Electronic Symptom Self-Reporting for Surgical Patients (R-1602–34355 Patient-Centered Outcomes Research Institute). The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://bit.ly/KegmMq). Reprints will not be available from the authors. Address correspondence to Brett A. Simon, MD, PhD, Department of Surgery and Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, 1133 York Ave, 3rd Floor, Suite 314, New York, NY 10065. Address e-mail to simonb1@mskcc.org. © 2019 International Anesthesia Research Society

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Voice rest and sick leave after phonosurgical procedures: surveys among European laryngologists and phoniatricians

Abstract

Purpose

After surgery of vocal folds, almost every patient will need some voice rest. It is common to recommend total silence for some days, followed by less restricted voice use for variable periods. By now, we do not know how voice rest affects the healing process or the current practise in Europe.

Methods

Members of the European Laryngological Society (2012) and the Union of European Phoniatrics (2018) were sent a web-based questionnaire which included two patient cases with a short history and a still picture. The respondents were asked about the postoperative recommendation of absolute voice rest and sick leave.

Results

Over 90% of the respondents would recommend absolute voice rest after removing a polyp or after mucosal repair of Reinke's oedema. For both cases, the mean length of recommended absolute voice rest among UEP members was 4 days (range 0–10 days) and among ELS members was 5 days (range 0–14 days). The recommended sick leave ranged from 0 to 35 days. The mean figures suggested by ELS members for the receptionist with Reinke's oedema were 12 days and for the teacher with a polyp 13 days. On average, UEP members recommended 14 days of sick leave for both cases.

Conclusion

The present scientific evidence is scant, but does not support for prolonged (over 3 days) absolute voice rest after simple phonosurgery. So far, there are no studies that could show absolute voice rest to be superior over relative voice rest. According to the present survey, there is considerable variation in recommending voice rest and sick leave after the removal of benign mucosal lesions. Many European laryngologists suggest voice rest that is longer and stricter than the present scientific literature supports.

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Food Allergies: Common and Severe Among U.S. Adults (CME/CE)

(MedPage Today) -- Nearly half of respondents who reported food allergy symptoms consistent with IgE-mediated reactions developed food allergies as adults (Source: MedPage Today Allergy)

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The former party animal who is now 'allergic' to ALCOHOL: Mother, 42, quits drinking after reaction

Cass Bowman, 42, of Yorkshire, would drink  ten drinks a night, multiple times a week. Her skin would go red and blotchy all over her body and face after a drink. (Source: the Mail online | Health)

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Loading capacity of CAD/CAM‐fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants with different cements

Abstract

Objective

This study evaluated the loading capacity of CAD/CAM‐fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants with different cements.

Material and Methods

Fifty one‐piece zirconia implants were embedded in epoxy resin. The abutment aspect of one implant was optically scanned and a standardized upper canine was designed with CAD‐software. Fifty feldspathic ceramic crowns were milled, polished, and mounted on the implants either without any cement, with a temporary cement or with three different composite resin cements after surface pretreatment as recommended by the manufacturers (n = 10). After storage in distilled water at 37°C for 24 h, specimens were loaded until fracture on the palatal surface of the crown at an angle of 45° to the long axis of the implant and loads until fracture were detected and compared. Compressive strength of the investigated cement materials was determined. Statistical analyses were done with One‐way ANOVA followed by post‐hoc Fisher LSD test (α = 0.05).

Results

The cements revealed significantly different compressive strength values (temporary cement: 37.1 ± 7.0 MPa; composite resin cements: 185.8 ± 21.3 MPa, 277.9 ± 22.1 MPa and 389.0 ± 13.6 MPa, respectively). Load at fracture values had an overall mean value of 237.1 ± 58.2 N with no significant difference among the composite resin cements (p > 0.05). Fracture load values with the temporary cement or without cement were significantly lower (p < 0.002).

Conclusions

CAD/CAM fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants provide sufficient resistance to intraoral forces.

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The Effect of Optimism and Connectedness on Psychological Adjustment of Children With Cancer and Comparison Peers

ABSTRACT: Objective: The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers. Methods: Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness). Results: Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = −0.1387, 95% confidence interval [CI] [–0.2341 to −0.0515]; b peers = –0.2021, 95% CI [–0.3575 to −0.0818]; b friends = −0.0703, 95% CI [–0.1640 to −0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment. Conclusion: Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness. Address for reprints: Sean Phipps, PhD, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-740, Memphis, TN 38105; e-mail: sean.phipps@stjude.org. This study was funded, in part, by a Grant from the National Institutes of Health (R01 CA136782) and by the American Lebanese-Syrian Associated Charities (ALSAC). Disclosure: The authors declare no conflict of interest. Received April 25, 2018 Accepted November 06, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Food Allergies: Common and Severe Among U.S. Adults (CME/CE)

(MedPage Today) -- Nearly half of respondents who reported food allergy symptoms consistent with IgE-mediated reactions developed food allergies as adults (Source: MedPage Today Allergy)

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The former party animal who is now 'allergic' to ALCOHOL: Mother, 42, quits drinking after reaction

Cass Bowman, 42, of Yorkshire, would drink  ten drinks a night, multiple times a week. Her skin would go red and blotchy all over her body and face after a drink. (Source: the Mail online | Health)

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Loading capacity of CAD/CAM‐fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants with different cements

Abstract

Objective

This study evaluated the loading capacity of CAD/CAM‐fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants with different cements.

Material and Methods

Fifty one‐piece zirconia implants were embedded in epoxy resin. The abutment aspect of one implant was optically scanned and a standardized upper canine was designed with CAD‐software. Fifty feldspathic ceramic crowns were milled, polished, and mounted on the implants either without any cement, with a temporary cement or with three different composite resin cements after surface pretreatment as recommended by the manufacturers (n = 10). After storage in distilled water at 37°C for 24 h, specimens were loaded until fracture on the palatal surface of the crown at an angle of 45° to the long axis of the implant and loads until fracture were detected and compared. Compressive strength of the investigated cement materials was determined. Statistical analyses were done with One‐way ANOVA followed by post‐hoc Fisher LSD test (α = 0.05).

Results

The cements revealed significantly different compressive strength values (temporary cement: 37.1 ± 7.0 MPa; composite resin cements: 185.8 ± 21.3 MPa, 277.9 ± 22.1 MPa and 389.0 ± 13.6 MPa, respectively). Load at fracture values had an overall mean value of 237.1 ± 58.2 N with no significant difference among the composite resin cements (p > 0.05). Fracture load values with the temporary cement or without cement were significantly lower (p < 0.002).

Conclusions

CAD/CAM fabricated anterior feldspathic ceramic crowns bonded to one‐piece zirconia implants provide sufficient resistance to intraoral forces.

This article is protected by copyright. All rights reserved.

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The Effect of Optimism and Connectedness on Psychological Adjustment of Children With Cancer and Comparison Peers

ABSTRACT: Objective: The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers. Methods: Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness). Results: Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = −0.1387, 95% confidence interval [CI] [–0.2341 to −0.0515]; b peers = –0.2021, 95% CI [–0.3575 to −0.0818]; b friends = −0.0703, 95% CI [–0.1640 to −0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment. Conclusion: Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness. Address for reprints: Sean Phipps, PhD, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-740, Memphis, TN 38105; e-mail: sean.phipps@stjude.org. This study was funded, in part, by a Grant from the National Institutes of Health (R01 CA136782) and by the American Lebanese-Syrian Associated Charities (ALSAC). Disclosure: The authors declare no conflict of interest. Received April 25, 2018 Accepted November 06, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Clinicopathologic traits and prognostic factors associated with pediatric sinonasal rhabdomyosarcoma

Background

Pediatric sinonasal rhabdomyosarcoma (RMS) is an aggressive and rare malignancy. This is the first multi‐institutional study on the prognostic factors associated with outcomes in this population.

Methods

The National Cancer Database was queried for the period from 2004 to 2013 for all cases of malignant sinonasal RMS in the pediatric population. The impact of patients' demographics, tumor characteristics, and Intergroup Rhabdomyosarcoma Study Group (IRSG) staging on survival was assessed using chi‐square test, Fisher's exact test, Kaplan‐Meier test, and Cox regression analyses.

Results

A total of 157 cases of pediatric sinonasal RMS were identified. Mean age at diagnosis was 9.38 years and male patients comprised 48.4% of the cohort. The nasal cavity (31.8%) and maxillary sinus (30.6%) were the most common primary sites. Alveolar was the most common histology (49.7%), followed by embryonal type (32.5%). The majority of patients received solely chemoradiation (52.9%), followed by surgery with adjuvant chemoradiation (30.6%). Five‐year overall survival (OS) was 55.2% (±4.5%). Metastatic disease was associated with a poorer 5‐year OS rate (24.4% vs 61.5%; p = 0.010). Maxillary sinus site was associated with an improved survival (71.8% vs 47.6%; p = 0.009). On multivariate analysis, chemoradiation with or without surgery was an additional prognostic factor. Although IRSG clinical stages did not correlate with survival, high‐risk patients in the IRSG clinical risk groups were associated with poorer survival on multivariate analysis (hazard ratio [HR], 2.005; 95% confidence interval, 1.007‐3.993; p = 0.048).

Conclusion

To date, this is the largest study on pediatric sinonasal RMS. IRSG clinical risk groups may be useful in stratifying high‐risk patients with poor prognosis.

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Clarithromycin for the treatment of adult chronic rhinosinusitis: a systematic review and meta‐analysis

Background

The aim of this systematic review (SR) was to assess the safety and efficacy of oral clarithromycin for the treatment of chronic rhinosinusitis (CRS).

Methods

This SR and meta‐analysis was conducted based on the recommendations outlined in the Cochrane Handbook for SR of Interventions. The protocol was registered on PROSPERO, an international prospective register of SRs. English and Chinese electronic databases were searched, and only randomized controlled trials were included.

Results

Seventeen studies with 1738 patients were included. Eleven studies evaluated whether adding oral clarithromycin to intranasal steroid spray with or without nasal saline irrigation was more effective than intranasal steroid spray alone. This combined treatment regimens statistically significantly improve clinical symptoms in the medium term (1 to 3 months), the endoscopic and computed tomography (CT) scores in both the short term (<1 month) and medium term, and clinical symptoms and the endoscopic score in the long term (>3 months). The incidence of adverse events did not increase with the use of this combination therapy. No significant difference was identified between treatment with oral clarithromycin and intranasal steroid spray alone groups in term of symptoms, endoscopic score, and CT score.

Conclusion

For the treatment of CRS, adding oral clarithromycin to intranasal steroid spray with or without nasal saline irrigation may achieve better results than using intranasal steroid spray with or without nasal saline irrigation. There is insufficient evidence to confirm that oral clarithromycin alone may have similar efficacy as nasal glucocorticoid spray alone. High‐quality evidence in this area is needed.

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Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Background

It is hypothesized that uncontrolled inflammation is responsible for many of the manifestations and symptoms of chronic rhinosinusitis (CRS). Although earlier work has demonstrated an association between olfactory loss and mucus cytokines, the impact on other symptoms is unknown. In this study we investigated the relationship between cytokines, inflammatory cell counts, and patient‐reported outcomes measures to better understand how the inflammatory microenvironment correlates with CRS symptomatology.

Methods

The 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and 8‐item Short Form Health Survey (SF‐8) were administered to 76 patients undergoing endoscopic sinus surgery for CRS. Mucus was collected intraoperatively from the middle meatus and tested for 17 cytokines using a multiplex flow cytometric bead assay. Eosinophil/neutrophil counts were obtained from histopathologic slide review. Spearman correlations between cytokines, cell counts, and quality‐of‐life subdomain scores were assessed without multiple comparisons correction due to the small sample size.

Results

Interleukin‐4 (IL‐4) correlated significantly with the Rhinologic domain (R_s = 0.25, p = 0.03), whereas eosinophil and neutrophil counts were inversely correlated with the Extranasal Rhinologic domain (R_s = −0.32, p = 0.01; and R_s = −0.27, p = 0.03). Subgroup analysis for nasal polyposis (CRSwNP) showed significant correlations between IL‐6 and Total SF‐8 (R_s = 0.35, p = 0.02), General Health (R_s = 0.34, p = 0.03), and Emotional (R_s = 0.47, p = 0.002) scores. In patients without polyps (CRSsNP), IL‐21 correlated positively with Extranasal Rhinologic Symptoms domain (R_s = 0.41, p = 0.01).

Conclusion

This pilot study identifies possible pairwise correlations between mucus cytokine levels and baseline quality‐of‐life measures that need confirmation in larger, targeted studies. Due to the exploratory methodology, positive results may be spurious and should only be used as a starting point for future confirmatory work.

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The intraoperative accuracy of maxillary balloon dilation: a blinded trial

Background

Balloon sinus dilation (BSD) is a commonly performed sinus procedure in the United States. Several cadaveric studies have evaluated BSD accuracy and the maxillary sinus has consistently been shown to be the most challenging to cannulate. We designed an independent study to evaluate the intraoperative accuracy of maxillary sinus BSD.

Methods

A prospective, single‐blinded trial evaluating the accuracy of maxillary sinus BSD was performed using 2 commercially available BSD systems (guidewire‐ and probe‐based systems) randomly assigned to patients undergoing endoscopic surgery for chronic rhinosinusitus without nasal polyps (CRSsNP) or a skullbase approach in patients without sinus disease. All patients underwent maxillary BSD followed by uncinectomy to reveal dilation of the natural maxillary sinus ostia. The recorded procedures were reviewed by 3 fellowship‐trained rhinologists from different institutions blinded to the BSD system utilized. The primary endpoint compared accuracy of maxillary BSD attempts. The secondary endpoint compared accuracy between the 2 systems.

Results

Twenty‐nine maxillary BSD procedures were performed in 18 patients (age range, 20‐79 years; mean, 51 years) without nasal polyposis undergoing maxillary antrostomy as part of a more extensive procedure. BSD was successful in 18 of 29 (62%) attempts and unsuccessful in 9 of 29 (31%) attempts, with statistically "almost perfect" interrater agreement (kappa = 0.86). There was no statistical difference between the 2 BSD systems (p = 0.81).

Conclusion

Maxillary BSD appeared to be less accurate in living patients when compared with findings from previously published cadaver studies. There were no differences in accuracy between the probe‐ and guidewire‐based systems. This is the first non‒industry‐sponsored study evaluating maxillary sinus BSD in living patients. Further studies are needed to investigate the clinical implications of our findings.

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Clinicopathologic traits and prognostic factors associated with pediatric sinonasal rhabdomyosarcoma

Background

Pediatric sinonasal rhabdomyosarcoma (RMS) is an aggressive and rare malignancy. This is the first multi‐institutional study on the prognostic factors associated with outcomes in this population.

Methods

The National Cancer Database was queried for the period from 2004 to 2013 for all cases of malignant sinonasal RMS in the pediatric population. The impact of patients' demographics, tumor characteristics, and Intergroup Rhabdomyosarcoma Study Group (IRSG) staging on survival was assessed using chi‐square test, Fisher's exact test, Kaplan‐Meier test, and Cox regression analyses.

Results

A total of 157 cases of pediatric sinonasal RMS were identified. Mean age at diagnosis was 9.38 years and male patients comprised 48.4% of the cohort. The nasal cavity (31.8%) and maxillary sinus (30.6%) were the most common primary sites. Alveolar was the most common histology (49.7%), followed by embryonal type (32.5%). The majority of patients received solely chemoradiation (52.9%), followed by surgery with adjuvant chemoradiation (30.6%). Five‐year overall survival (OS) was 55.2% (±4.5%). Metastatic disease was associated with a poorer 5‐year OS rate (24.4% vs 61.5%; p = 0.010). Maxillary sinus site was associated with an improved survival (71.8% vs 47.6%; p = 0.009). On multivariate analysis, chemoradiation with or without surgery was an additional prognostic factor. Although IRSG clinical stages did not correlate with survival, high‐risk patients in the IRSG clinical risk groups were associated with poorer survival on multivariate analysis (hazard ratio [HR], 2.005; 95% confidence interval, 1.007‐3.993; p = 0.048).

Conclusion

To date, this is the largest study on pediatric sinonasal RMS. IRSG clinical risk groups may be useful in stratifying high‐risk patients with poor prognosis.

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Clarithromycin for the treatment of adult chronic rhinosinusitis: a systematic review and meta‐analysis

Background

The aim of this systematic review (SR) was to assess the safety and efficacy of oral clarithromycin for the treatment of chronic rhinosinusitis (CRS).

Methods

This SR and meta‐analysis was conducted based on the recommendations outlined in the Cochrane Handbook for SR of Interventions. The protocol was registered on PROSPERO, an international prospective register of SRs. English and Chinese electronic databases were searched, and only randomized controlled trials were included.

Results

Seventeen studies with 1738 patients were included. Eleven studies evaluated whether adding oral clarithromycin to intranasal steroid spray with or without nasal saline irrigation was more effective than intranasal steroid spray alone. This combined treatment regimens statistically significantly improve clinical symptoms in the medium term (1 to 3 months), the endoscopic and computed tomography (CT) scores in both the short term (<1 month) and medium term, and clinical symptoms and the endoscopic score in the long term (>3 months). The incidence of adverse events did not increase with the use of this combination therapy. No significant difference was identified between treatment with oral clarithromycin and intranasal steroid spray alone groups in term of symptoms, endoscopic score, and CT score.

Conclusion

For the treatment of CRS, adding oral clarithromycin to intranasal steroid spray with or without nasal saline irrigation may achieve better results than using intranasal steroid spray with or without nasal saline irrigation. There is insufficient evidence to confirm that oral clarithromycin alone may have similar efficacy as nasal glucocorticoid spray alone. High‐quality evidence in this area is needed.

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Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Background

It is hypothesized that uncontrolled inflammation is responsible for many of the manifestations and symptoms of chronic rhinosinusitis (CRS). Although earlier work has demonstrated an association between olfactory loss and mucus cytokines, the impact on other symptoms is unknown. In this study we investigated the relationship between cytokines, inflammatory cell counts, and patient‐reported outcomes measures to better understand how the inflammatory microenvironment correlates with CRS symptomatology.

Methods

The 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and 8‐item Short Form Health Survey (SF‐8) were administered to 76 patients undergoing endoscopic sinus surgery for CRS. Mucus was collected intraoperatively from the middle meatus and tested for 17 cytokines using a multiplex flow cytometric bead assay. Eosinophil/neutrophil counts were obtained from histopathologic slide review. Spearman correlations between cytokines, cell counts, and quality‐of‐life subdomain scores were assessed without multiple comparisons correction due to the small sample size.

Results

Interleukin‐4 (IL‐4) correlated significantly with the Rhinologic domain (R_s = 0.25, p = 0.03), whereas eosinophil and neutrophil counts were inversely correlated with the Extranasal Rhinologic domain (R_s = −0.32, p = 0.01; and R_s = −0.27, p = 0.03). Subgroup analysis for nasal polyposis (CRSwNP) showed significant correlations between IL‐6 and Total SF‐8 (R_s = 0.35, p = 0.02), General Health (R_s = 0.34, p = 0.03), and Emotional (R_s = 0.47, p = 0.002) scores. In patients without polyps (CRSsNP), IL‐21 correlated positively with Extranasal Rhinologic Symptoms domain (R_s = 0.41, p = 0.01).

Conclusion

This pilot study identifies possible pairwise correlations between mucus cytokine levels and baseline quality‐of‐life measures that need confirmation in larger, targeted studies. Due to the exploratory methodology, positive results may be spurious and should only be used as a starting point for future confirmatory work.

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The intraoperative accuracy of maxillary balloon dilation: a blinded trial

Background

Balloon sinus dilation (BSD) is a commonly performed sinus procedure in the United States. Several cadaveric studies have evaluated BSD accuracy and the maxillary sinus has consistently been shown to be the most challenging to cannulate. We designed an independent study to evaluate the intraoperative accuracy of maxillary sinus BSD.

Methods

A prospective, single‐blinded trial evaluating the accuracy of maxillary sinus BSD was performed using 2 commercially available BSD systems (guidewire‐ and probe‐based systems) randomly assigned to patients undergoing endoscopic surgery for chronic rhinosinusitus without nasal polyps (CRSsNP) or a skullbase approach in patients without sinus disease. All patients underwent maxillary BSD followed by uncinectomy to reveal dilation of the natural maxillary sinus ostia. The recorded procedures were reviewed by 3 fellowship‐trained rhinologists from different institutions blinded to the BSD system utilized. The primary endpoint compared accuracy of maxillary BSD attempts. The secondary endpoint compared accuracy between the 2 systems.

Results

Twenty‐nine maxillary BSD procedures were performed in 18 patients (age range, 20‐79 years; mean, 51 years) without nasal polyposis undergoing maxillary antrostomy as part of a more extensive procedure. BSD was successful in 18 of 29 (62%) attempts and unsuccessful in 9 of 29 (31%) attempts, with statistically "almost perfect" interrater agreement (kappa = 0.86). There was no statistical difference between the 2 BSD systems (p = 0.81).

Conclusion

Maxillary BSD appeared to be less accurate in living patients when compared with findings from previously published cadaver studies. There were no differences in accuracy between the probe‐ and guidewire‐based systems. This is the first non‒industry‐sponsored study evaluating maxillary sinus BSD in living patients. Further studies are needed to investigate the clinical implications of our findings.

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Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases

Abstract

Background

Fluoroscopy time has been used as a surrogate for radiation dose monitoring in pediatric fluoroscopy; however it does not account for factors such as magnification or collimation. Dose–area product (DAP) is a more accurate measure of radiation exposure but its dependence on patient weight and body-part thickness is a challenge in children of varying ages.

Objective

To determine whether fluoroscopy time and DAP produce concurrent results when they are used to identify high-exposure cases, and to establish radiation dose thresholds for our institution.

Materials and methods

During a 2-year period we prospectively monitored pediatric fluoroscopy studies performed at the Children's Hospital at Montefiore. We recorded study type, fluoroscopy time, DAP, patient age, weight and height. We then calculated 90th percentile fluoroscopy time and DAP thresholds for weight and age.

Results

We evaluated 1,011 cases (453 upper gastrointestinal [UGI] series, 266 voiding cystourethrograms [VCUGs], 120 contrast enemas, 108 speech studies, and 64 esophagrams). Fluoroscopy time demonstrated moderate correlation with DAP (r_s=0.45, P<0.001, Spearman rank). DAP strongly correlated with patient weight (r_s=0.71, P<0.001) and age (r_s=0.70, P<0.001). Concordance of cases exceeding 90th percentile thresholds for fluoroscopy time and DAP were κ=0.27 for UGI series and κ=0.49 for VCUG for weight-based cutoffs, and κ=0.36 for UGI series and κ=0.40 for VCUG for age-based cutoffs.

Conclusion

The limited correlation of fluoroscopy time with DAP suggests these methods are not equivalent for dose monitoring. However, the strong correlation of DAP with patient weight and age presents a challenge for establishing DAP thresholds in children, who range widely in size. Despite controlling for weight or age, there was limited overlap of cases exceeding the 90th percentile threshold for fluoroscopy time and DAP. This further reinforces the non-overlapping outcome of these two methods and indicates that fluoroscopy time might be inadequate for dose monitoring.

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Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases

Abstract

Background

Fluoroscopy time has been used as a surrogate for radiation dose monitoring in pediatric fluoroscopy; however it does not account for factors such as magnification or collimation. Dose–area product (DAP) is a more accurate measure of radiation exposure but its dependence on patient weight and body-part thickness is a challenge in children of varying ages.

Objective

To determine whether fluoroscopy time and DAP produce concurrent results when they are used to identify high-exposure cases, and to establish radiation dose thresholds for our institution.

Materials and methods

During a 2-year period we prospectively monitored pediatric fluoroscopy studies performed at the Children's Hospital at Montefiore. We recorded study type, fluoroscopy time, DAP, patient age, weight and height. We then calculated 90th percentile fluoroscopy time and DAP thresholds for weight and age.

Results

We evaluated 1,011 cases (453 upper gastrointestinal [UGI] series, 266 voiding cystourethrograms [VCUGs], 120 contrast enemas, 108 speech studies, and 64 esophagrams). Fluoroscopy time demonstrated moderate correlation with DAP (r_s=0.45, P<0.001, Spearman rank). DAP strongly correlated with patient weight (r_s=0.71, P<0.001) and age (r_s=0.70, P<0.001). Concordance of cases exceeding 90th percentile thresholds for fluoroscopy time and DAP were κ=0.27 for UGI series and κ=0.49 for VCUG for weight-based cutoffs, and κ=0.36 for UGI series and κ=0.40 for VCUG for age-based cutoffs.

Conclusion

The limited correlation of fluoroscopy time with DAP suggests these methods are not equivalent for dose monitoring. However, the strong correlation of DAP with patient weight and age presents a challenge for establishing DAP thresholds in children, who range widely in size. Despite controlling for weight or age, there was limited overlap of cases exceeding the 90th percentile threshold for fluoroscopy time and DAP. This further reinforces the non-overlapping outcome of these two methods and indicates that fluoroscopy time might be inadequate for dose monitoring.

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Management of Hearing Loss Through Telemedicine

This Viewpoint explores the benefits telemedicine could have on hearing health care for all populations but especially those that are vulnerable or underserved.

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Red Blood Cell Distribution Width and Open Airway Reconstruction Outcomes

This case series study examines whether the ability to achieve a prosthesis-free airway in adults after open airway reconstruction is associated with red blood cell distribution width at the time of surgery.

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Traumatic Lower Lip Myiasis

This is the report of a case of a homeless man in his 50s who presented with traumatic lower lip myiasis.

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Management of Hearing Loss Through Telemedicine

This Viewpoint explores the benefits telemedicine could have on hearing health care for all populations but especially those that are vulnerable or underserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H616sY

Red Blood Cell Distribution Width and Open Airway Reconstruction Outcomes

This case series study examines whether the ability to achieve a prosthesis-free airway in adults after open airway reconstruction is associated with red blood cell distribution width at the time of surgery.

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Traumatic Lower Lip Myiasis

This is the report of a case of a homeless man in his 50s who presented with traumatic lower lip myiasis.

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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Effect of number of talkers and language of babble on acceptable noise level in Kannada listeners

. (Source: Hearing, Balance and Communication)

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Introduction of video head impulse testing to an ENT outpatient clinic: objective vestibular evaluation at first point of contact

. (Source: Hearing, Balance and Communication)

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The saccadic training for driving safety

. (Source: Hearing, Balance and Communication)

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Early cochlear implantation: Verbal working memory, vocabulary, speech intelligibility and participant variables

. (Source: Cochlear Implants International)

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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

Effect of number of talkers and language of babble on acceptable noise level in Kannada listeners

. (Source: Hearing, Balance and Communication)

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

Introduction of video head impulse testing to an ENT outpatient clinic: objective vestibular evaluation at first point of contact

. (Source: Hearing, Balance and Communication)

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

The saccadic training for driving safety

. (Source: Hearing, Balance and Communication)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SLH2NJ

Early cochlear implantation: Verbal working memory, vocabulary, speech intelligibility and participant variables

. (Source: Cochlear Implants International)

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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Prenatal ultrasonography of autosomal dominant polycystic kidney disease mimicking recessive type: case series

Abstract

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. This pathology has been increasingly diagnosed in utero and several sonographic patterns are well described in the literature.

Objective

To present a series of fetuses with an unusual imaging pattern of ADPKD, mimicking autosomal recessive polycystic kidney disease (ARPKD).

Materials and methods

We retrospectively reviewed second-line ultrasound (US) scans performed for suspicion of fetal kidney pathology between 2006 and 2018. Inclusion criteria were (1) proven ADPKD on the basis of a known family history and/or of genetic testing and (2) US features suggestive of ARPKD. We recorded the clinical, imaging, genetic and pathological findings in cases with pregnancy termination.

Results

Three out of 12 patients with proven ADPKD diagnosed in utero presented with US features suggestive of ARPKD. Furthermore, an additional patient observed at another institution was added to the series. History of familial ADPKD was present in three cases. US showed enlarged kidneys with increased cortical echogenicity, decreased corticomedullary differentiation, multiple medullary cysts and decreased amniotic fluid in all four cases. Pregnancy was terminated in two cases (histology confirmed features in keeping with ADPKD), one premature neonate died (histology in progress) and one child is alive. Genetic testing showed a homozygous mutation of the PKD1 gene in two patients, a heterozygous mutation of the PKD1 gene in one patient and was not performed in the remaining patient.

Conclusion

This series describes an unusual sonographic prenatal presentation of ADPKD, not yet well described in the radiologic literature, mimicking ARPKD.

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'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been Crickets

Title: 'Sonic Attacks' on U.S. Embassy Staff in Cuba May Have Been CricketsCategory: Health NewsCreated: 1/7/2019 12:00:00 AMLast Editorial Review: 1/8/2019 12:00:00 AM (Source: MedicineNet Hearing General)

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

Prenatal ultrasonography of autosomal dominant polycystic kidney disease mimicking recessive type: case series

Abstract

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. This pathology has been increasingly diagnosed in utero and several sonographic patterns are well described in the literature.

Objective

To present a series of fetuses with an unusual imaging pattern of ADPKD, mimicking autosomal recessive polycystic kidney disease (ARPKD).

Materials and methods

We retrospectively reviewed second-line ultrasound (US) scans performed for suspicion of fetal kidney pathology between 2006 and 2018. Inclusion criteria were (1) proven ADPKD on the basis of a known family history and/or of genetic testing and (2) US features suggestive of ARPKD. We recorded the clinical, imaging, genetic and pathological findings in cases with pregnancy termination.

Results

Three out of 12 patients with proven ADPKD diagnosed in utero presented with US features suggestive of ARPKD. Furthermore, an additional patient observed at another institution was added to the series. History of familial ADPKD was present in three cases. US showed enlarged kidneys with increased cortical echogenicity, decreased corticomedullary differentiation, multiple medullary cysts and decreased amniotic fluid in all four cases. Pregnancy was terminated in two cases (histology confirmed features in keeping with ADPKD), one premature neonate died (histology in progress) and one child is alive. Genetic testing showed a homozygous mutation of the PKD1 gene in two patients, a heterozygous mutation of the PKD1 gene in one patient and was not performed in the remaining patient.

Conclusion

This series describes an unusual sonographic prenatal presentation of ADPKD, not yet well described in the radiologic literature, mimicking ARPKD.

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Advances in Face-lift Techniques 2013-2018

This systematic review of 84 articles published from 2013 to 2018 involving face-lift techniques examines advances in surgical and nonsurgical techniques in the past 5 years and assesses the level of evidence of articles that focus on these topics.

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Assessment of “Other-Race Effect” on Perception of Attractiveness Before and After Rhinoplasty

This survey study measures how the "other-race effect" influences perception of white and Latin American patients undergoing rhinoplasty by using eye-tracking technology and survey methodology.

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Perceiving Attractiveness and the Increasing Diversity in Facial Plastic Surgery

According to the American Academy of Facial Plastic and Reconstructive Surgery, the percentage of Asian American, Latin American, and African American patients requesting cosmetic procedures has increased by 200%, 323%, and 340%, respectively, from 1999 to 2001. This growth is of particular interest to facial plastic surgeons because some of the most popular procedures being sought by these ethnic groups include rhinoplasty, blepharoplasty, and injectable fillers. Specifically, African American and Latin American patients are more likely to request rhinoplasty (80% and 65%, respectively), Asian American patients blepharoplasty (44%) or rhinoplasty (41%), and white patients rhytidectomy (40%). Changes in the demographic composition of patients requesting facial plastic surgery procedures reflect changes in population growth and improvements in economic status among ethnic and racial minority groups.

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Advances in Face-lift Techniques 2013-2018

This systematic review of 84 articles published from 2013 to 2018 involving face-lift techniques examines advances in surgical and nonsurgical techniques in the past 5 years and assesses the level of evidence of articles that focus on these topics.

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

Assessment of “Other-Race Effect” on Perception of Attractiveness Before and After Rhinoplasty

This survey study measures how the "other-race effect" influences perception of white and Latin American patients undergoing rhinoplasty by using eye-tracking technology and survey methodology.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VI79XN

Perceiving Attractiveness and the Increasing Diversity in Facial Plastic Surgery

According to the American Academy of Facial Plastic and Reconstructive Surgery, the percentage of Asian American, Latin American, and African American patients requesting cosmetic procedures has increased by 200%, 323%, and 340%, respectively, from 1999 to 2001. This growth is of particular interest to facial plastic surgeons because some of the most popular procedures being sought by these ethnic groups include rhinoplasty, blepharoplasty, and injectable fillers. Specifically, African American and Latin American patients are more likely to request rhinoplasty (80% and 65%, respectively), Asian American patients blepharoplasty (44%) or rhinoplasty (41%), and white patients rhytidectomy (40%). Changes in the demographic composition of patients requesting facial plastic surgery procedures reflect changes in population growth and improvements in economic status among ethnic and racial minority groups.

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Photo-oxidative and photo-reductive capabilities of ilmenite-rich black sand concentrates using methyl orange as probe molecule

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00315G, Paper

Diana Marcela Cañas-Martínez, Gilles H Gauthier, Julio Andrés Pedraza-Avella
Ilmenite-rich black sands from an alluvial deposit of Barbacoas (Nariño, Colombia) were used as a natural source aiming to obtain a low cost and highly available photocatalyst. Mineral concentrates were...
The content of this RSS Feed (c) The Royal Society of Chemistry

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UV regulates the expression of phenylpropanoid biosynthesis genes in cucumber (Cucumis sativus L.) in an organ and spectrum dependent manner

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00480C, Paper

Minjie Qian, Irina Kalbina, Eva Rosenqvist, Marcel A. K. Jansen, Yuanwen Teng, Åke Strid
A combination of a substantial number of cis-acting regulatory elements (MREs, ACEs, and G-boxes) is present in promoters of copies of phenylpropanoid biosynthesis genes that show strongly enhanced expression under UV-B-containing light in Cucumis sativus.
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

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Heterodimers of zinc and free-base chlorophyll derivatives co-assembled in biomimetic chlorosomal J-aggregates

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00468D, Paper

Sunao Shoji, Yosaku Nomura, Hitoshi Tamiaki
Free-base chlorophyll derivatives covalently linked with their zinc complex accepted singlet excitation energy from chlorosomal self-aggregates in their co-assembly.
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

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Initial metal–metal bond breakage detected by fs X-ray scattering in the photolysis of Ru3(CO)12 in cyclohexane at 400 nm

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00420J, Paper

Q. Y. Kong, M. G. Laursen, K. Haldrup, K. S. Kjær, D. Khakhulin, E. Biasin, T. B. van Driel, M. Wulff, V. Kabanova, R. Vuilleumier, S. Bratos, M. M. Nielsen, K. J. Gaffney, T. C. Weng, M. H. J. Koch
fs X-ray solution scattering reveals selective metal–metal bond cleavage and a new intermediate in the photolysis of Ru₃(CO)₁₂ at 400 nm.
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/2H5YGKG

Photo-oxidative and photo-reductive capabilities of ilmenite-rich black sand concentrates using methyl orange as probe molecule

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00315G, Paper

Diana Marcela Cañas-Martínez, Gilles H Gauthier, Julio Andrés Pedraza-Avella
Ilmenite-rich black sands from an alluvial deposit of Barbacoas (Nariño, Colombia) were used as a natural source aiming to obtain a low cost and highly available photocatalyst. Mineral concentrates were...
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/2VID8r1

UV regulates the expression of phenylpropanoid biosynthesis genes in cucumber (Cucumis sativus L.) in an organ and spectrum dependent manner

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00480C, Paper

Minjie Qian, Irina Kalbina, Eva Rosenqvist, Marcel A. K. Jansen, Yuanwen Teng, Åke Strid
A combination of a substantial number of cis-acting regulatory elements (MREs, ACEs, and G-boxes) is present in promoters of copies of phenylpropanoid biosynthesis genes that show strongly enhanced expression under UV-B-containing light in Cucumis sativus.
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/2D0BycH

Heterodimers of zinc and free-base chlorophyll derivatives co-assembled in biomimetic chlorosomal J-aggregates

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00468D, Paper

Sunao Shoji, Yosaku Nomura, Hitoshi Tamiaki
Free-base chlorophyll derivatives covalently linked with their zinc complex accepted singlet excitation energy from chlorosomal self-aggregates in their co-assembly.
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/2D245yC

Initial metal–metal bond breakage detected by fs X-ray scattering in the photolysis of Ru3(CO)12 in cyclohexane at 400 nm

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00420J, Paper

Q. Y. Kong, M. G. Laursen, K. Haldrup, K. S. Kjær, D. Khakhulin, E. Biasin, T. B. van Driel, M. Wulff, V. Kabanova, R. Vuilleumier, S. Bratos, M. M. Nielsen, K. J. Gaffney, T. C. Weng, M. H. J. Koch
fs X-ray solution scattering reveals selective metal–metal bond cleavage and a new intermediate in the photolysis of Ru₃(CO)₁₂ at 400 nm.
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

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This is not an interrogative: the prosody of “wh-questions” in Hebrew and the sources of their questioning and rhetorical interpretations

This study of wh-questions in natural Israeli Hebrew speech demonstrates that taking prosody into account makes this standard view untenable for Hebrew. The analysis of the accentuation of the wh-word and of the final intonation shows that the function of the utterance is compositionally constructed from its basic constituents. The construction is an expression of an open proposition, underspecified with respect to its "prototypical" function. The contribution of the utterance is constructed from the direct marking of a few designated categories, such as interest in gapped information and an appeal to the addressee. In this view, the concepts of "genuine" and different types of "rhetorical" questions break down into different combinations of the basic categories. Moreover, it i...

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Phoneme Boundary Detection from Speech: A Rule Based Approach

Publication date: Available online 9 January 2019Source: Speech CommunicationAuthor(s): Pravin Bhaskar Ramteke, Shashidhar G. KoolagudiAbstractIn this paper, a novel approach has been proposed for the automatic segmentation of speech signal into phonemes. In a well spoken word, phonemes can be characterized by the changes observed in speech waveform. To get phoneme boundaries, the signal level properties of speech waveform i.e. changes in the waveform during transformation from one phoneme to the other are explored. The problem of phoneme level segmentation has been addressed in this work from two aspects 1. Segmentation of phonemes between voiced and unvoiced portions and 2. Segmentation of phonemes within voiced and unvoiced regions. Pitch and zero-frequency filter signal are used to get...

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Change over time in the type and functions of crib speech around the fourth birthday

Publication date: July 2019Source: Language & Communication, Volume 67Author(s): Danielle L. Mead, Adam WinslerAbstractCrib speech, the monologue speech of a young child before s/he falls asleep, has been examined in very few studies to date. Private speech has been explored in relation to potential motivational and self-regulatory functions, but few studies have examined private speech in pretend play or pre-sleep contexts. This longitudinal case study examines the crib speech of a young girl between the ages of 46 and 50 months by exploring the content of her speech and how it changes over time, relations between types of speech content, and differences between the speech used on days when she did and did not fall asleep. A total of 57, 45-min recordings were collected over four months ...

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Screening and enrichment of desirable high lipid producing microalgal consortia

Publication date: Available online 9 January 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Jyoti Sharma, Smita S. Kumar, Narsi R. Bishnoi, Arivalagan PugazhendhiAbstractLipid content is the main parameter for the evaluation of microalgae towards biodiesel production. The present study was aimed at screening of desirable algal consortia based on lipid content for further processing into biofuel. Twenty different algal consortia were investigated for lipid content qualitatively by Nile Red and quantitatively by gravimetric method and FTIR. Nile Red is used as a fluorophore for physically characterizing the lipid body in algal cultures. The yellow fluorescence in all the samples confirmed the presence of lipid content when observed under a fluorescent microscope....

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Talking about mindfulness: An ethnography of communication analysis of two speech communities

Publication date: July 2019Source: Language & Communication, Volume 67Author(s): Daniel Stofleth, Valerie ManusovAbstractMindfulness as a concept and practice has gained significant recognition, referenced and employed in both academic studies and the popular press. Broad conclusions are drawn about its relationships to other variables and its impacts or benefits. Taking an Ethnography of Communication approach, we perform a communication codes analysis on two speech communities (popular press articles and academic journal articles) to determine what each references when writing about 'mindfulness.' Academic articles were more likely to include explicit definitions, tending to include both 'attention' and 'awareness'; popular article definitions emphasized awareness only and re...

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Therapeutic application of light emitting diode: Photo-oncomic approach

Publication date: Available online 9 January 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Phil-Sun Oh, Hwan-Jeong JeongAbstractAs a new light source, light emitting diode (LED) with high brightness and lower cost has been rapidly developed in medical application and light therapy. LED phototherapy can activate target cells with appropriate power and adequate energy density. This review provides general information on therapeutic applications of blue, green, yellow, red, and infrared LED in medical treatments for various physical abnormalities and on bio-imaging. The bio-imaging system is improved by decreasing the number of microscopes apparatuses including neutral-density filter, excitation filters and mechanical shutters. The numbers of excitation photons a...

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Bringing advanced speech processing technology to the clinical management of speech disorders

Volume 20, Issue 6, November 2018, Page 581-582 . (Source: International Journal of Speech-Language Pathology)

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Automatic speech recognition: A primer for speech-language pathology researchers

Volume 20, Issue 6, November 2018, Page 599-609 . (Source: International Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl4Ftn

Assessing automatic VOT annotation using unimpaired and impaired speech

Volume 20, Issue 6, November 2018, Page 624-634 . (Source: International Journal of Speech-Language Pathology)

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

Perception of Vietnamese back vowels contrasting in rounding by English listeners

Publication date: March 2019Source: Journal of Phonetics, Volume 73Author(s): Irina A. ShportAbstractThe perception of back vowels contrasting in rounding has not previously been examined in major theoretical frameworks of cross-language speech perception. In two experiments, Southern U.S. English speakers naïve to the contrast categorized the Vietnamese vowels [u o ɯ ɤ] in terms of their native vowel categories and identified oddball vowels in triads representing the contrasts [u]-[o], [ɯ]-[u], [ɯ]-[ɤ], and [o]-[ɤ]. The relationship between vowel categorization and discrimination was more accurately predicted when predominant and secondary categorization patterns were taken into account. Group results showed that Vietnamese [ɤ] and [u o] were perceived as being most similar to Eng...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fk7Wt0

The strength of L1 effects on tense and aspect: How German learners of L2 Spanish deal with acquisitional problems

. (Source: Language Acquisition: A Journal of Developmental Linguistics)

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A structured approach to train text messaging in an individual with aphasia

. (Source: Aphasiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl4rCx

The psychometric properties of the communicative competence scale for individuals with Aphasia using speech-generating devices

. (Source: Aphasiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FpiO84

This is not an interrogative: the prosody of “wh-questions” in Hebrew and the sources of their questioning and rhetorical interpretations

This study of wh-questions in natural Israeli Hebrew speech demonstrates that taking prosody into account makes this standard view untenable for Hebrew. The analysis of the accentuation of the wh-word and of the final intonation shows that the function of the utterance is compositionally constructed from its basic constituents. The construction is an expression of an open proposition, underspecified with respect to its "prototypical" function. The contribution of the utterance is constructed from the direct marking of a few designated categories, such as interest in gapped information and an appeal to the addressee. In this view, the concepts of "genuine" and different types of "rhetorical" questions break down into different combinations of the basic categories. Moreover, it i...

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

Phoneme Boundary Detection from Speech: A Rule Based Approach

Publication date: Available online 9 January 2019Source: Speech CommunicationAuthor(s): Pravin Bhaskar Ramteke, Shashidhar G. KoolagudiAbstractIn this paper, a novel approach has been proposed for the automatic segmentation of speech signal into phonemes. In a well spoken word, phonemes can be characterized by the changes observed in speech waveform. To get phoneme boundaries, the signal level properties of speech waveform i.e. changes in the waveform during transformation from one phoneme to the other are explored. The problem of phoneme level segmentation has been addressed in this work from two aspects 1. Segmentation of phonemes between voiced and unvoiced portions and 2. Segmentation of phonemes within voiced and unvoiced regions. Pitch and zero-frequency filter signal are used to get...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl56E1

Change over time in the type and functions of crib speech around the fourth birthday

Publication date: July 2019Source: Language & Communication, Volume 67Author(s): Danielle L. Mead, Adam WinslerAbstractCrib speech, the monologue speech of a young child before s/he falls asleep, has been examined in very few studies to date. Private speech has been explored in relation to potential motivational and self-regulatory functions, but few studies have examined private speech in pretend play or pre-sleep contexts. This longitudinal case study examines the crib speech of a young girl between the ages of 46 and 50 months by exploring the content of her speech and how it changes over time, relations between types of speech content, and differences between the speech used on days when she did and did not fall asleep. A total of 57, 45-min recordings were collected over four months ...

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

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

Screening and enrichment of desirable high lipid producing microalgal consortia

Publication date: Available online 9 January 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Jyoti Sharma, Smita S. Kumar, Narsi R. Bishnoi, Arivalagan PugazhendhiAbstractLipid content is the main parameter for the evaluation of microalgae towards biodiesel production. The present study was aimed at screening of desirable algal consortia based on lipid content for further processing into biofuel. Twenty different algal consortia were investigated for lipid content qualitatively by Nile Red and quantitatively by gravimetric method and FTIR. Nile Red is used as a fluorophore for physically characterizing the lipid body in algal cultures. The yellow fluorescence in all the samples confirmed the presence of lipid content when observed under a fluorescent microscope....

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl5oL7

Talking about mindfulness: An ethnography of communication analysis of two speech communities

Publication date: July 2019Source: Language & Communication, Volume 67Author(s): Daniel Stofleth, Valerie ManusovAbstractMindfulness as a concept and practice has gained significant recognition, referenced and employed in both academic studies and the popular press. Broad conclusions are drawn about its relationships to other variables and its impacts or benefits. Taking an Ethnography of Communication approach, we perform a communication codes analysis on two speech communities (popular press articles and academic journal articles) to determine what each references when writing about 'mindfulness.' Academic articles were more likely to include explicit definitions, tending to include both 'attention' and 'awareness'; popular article definitions emphasized awareness only and re...

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

Therapeutic application of light emitting diode: Photo-oncomic approach

Publication date: Available online 9 January 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Phil-Sun Oh, Hwan-Jeong JeongAbstractAs a new light source, light emitting diode (LED) with high brightness and lower cost has been rapidly developed in medical application and light therapy. LED phototherapy can activate target cells with appropriate power and adequate energy density. This review provides general information on therapeutic applications of blue, green, yellow, red, and infrared LED in medical treatments for various physical abnormalities and on bio-imaging. The bio-imaging system is improved by decreasing the number of microscopes apparatuses including neutral-density filter, excitation filters and mechanical shutters. The numbers of excitation photons a...

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

Bringing advanced speech processing technology to the clinical management of speech disorders

Volume 20, Issue 6, November 2018, Page 581-582 . (Source: International Journal of Speech-Language Pathology)

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

Automatic speech recognition: A primer for speech-language pathology researchers

Volume 20, Issue 6, November 2018, Page 599-609 . (Source: International Journal of Speech-Language Pathology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl4Ftn

Assessing automatic VOT annotation using unimpaired and impaired speech

Volume 20, Issue 6, November 2018, Page 624-634 . (Source: International Journal of Speech-Language Pathology)

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

Perception of Vietnamese back vowels contrasting in rounding by English listeners

Publication date: March 2019Source: Journal of Phonetics, Volume 73Author(s): Irina A. ShportAbstractThe perception of back vowels contrasting in rounding has not previously been examined in major theoretical frameworks of cross-language speech perception. In two experiments, Southern U.S. English speakers naïve to the contrast categorized the Vietnamese vowels [u o ɯ ɤ] in terms of their native vowel categories and identified oddball vowels in triads representing the contrasts [u]-[o], [ɯ]-[u], [ɯ]-[ɤ], and [o]-[ɤ]. The relationship between vowel categorization and discrimination was more accurately predicted when predominant and secondary categorization patterns were taken into account. Group results showed that Vietnamese [ɤ] and [u o] were perceived as being most similar to Eng...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fk7Wt0

The strength of L1 effects on tense and aspect: How German learners of L2 Spanish deal with acquisitional problems

. (Source: Language Acquisition: A Journal of Developmental Linguistics)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fpj07i

A structured approach to train text messaging in an individual with aphasia

. (Source: Aphasiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Fl4rCx

The psychometric properties of the communicative competence scale for individuals with Aphasia using speech-generating devices

. (Source: Aphasiology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FpiO84

Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey

Abstract

Background

Dental caries in preschool children is prevalent worldwide, but data regarding its magnitude and associated factors were not available for preschool children in Zhejiang Province, China. This study examines the dental caries situation and its associated factors in Zhejiang Province.

Methods

A total of 1591 children aged 3–5 years and their parents or caregivers were enrolled in this study. The condition of their teeth was assessed by three dental technicians qualified to WHO 2013 criteria. A structured questionnaire was completed by the children's parents or caregivers. A logistic regression analysis was used to analyze the risk factors that may be associated with dental caries occurring among preschool children.

Results

Caries prevalence (dmft> 0) of 3–5 year old children in Zhejiang Province was 70.4%. The mean decayed, missing and filled teeth (dmft) scores of the 3, 4 or 5 year old children surveyed were 2.96 ± 4.07, 4.42 ± 4.66, and 5.75 ± 5.19 respectively. The negative binomial regression model found that higher dental caries prevalence was found in children as age increased, with lower body mass index (BMI), with longer breastfeeding duration and with fewer hours of sleep.

Conclusions

The dental caries prevalence and dmft score of 3–5-year-old children in Zhejiang Province was high, and it was associated with age, BMI, breastfeeding duration and hours slept.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2D05tlg

Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey

Abstract

Background

Dental caries in preschool children is prevalent worldwide, but data regarding its magnitude and associated factors were not available for preschool children in Zhejiang Province, China. This study examines the dental caries situation and its associated factors in Zhejiang Province.

Methods

A total of 1591 children aged 3–5 years and their parents or caregivers were enrolled in this study. The condition of their teeth was assessed by three dental technicians qualified to WHO 2013 criteria. A structured questionnaire was completed by the children's parents or caregivers. A logistic regression analysis was used to analyze the risk factors that may be associated with dental caries occurring among preschool children.

Results

Caries prevalence (dmft> 0) of 3–5 year old children in Zhejiang Province was 70.4%. The mean decayed, missing and filled teeth (dmft) scores of the 3, 4 or 5 year old children surveyed were 2.96 ± 4.07, 4.42 ± 4.66, and 5.75 ± 5.19 respectively. The negative binomial regression model found that higher dental caries prevalence was found in children as age increased, with lower body mass index (BMI), with longer breastfeeding duration and with fewer hours of sleep.

Conclusions

The dental caries prevalence and dmft score of 3–5-year-old children in Zhejiang Province was high, and it was associated with age, BMI, breastfeeding duration and hours slept.

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Exploring Disease Immunogenicity and the Immunological Effects of Hypomethylating Agents in Acute Myeloid Leukemia

Condition:   Acute Myeloid Leukemia Intervention:   Genetic: Immunogenic profile Sponsor:   Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori Not yet recruiting (Source: ClinicalTrials.gov)

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Multiple Drug Hypersensitivity Syndrome

Condition:   Drug Allergy Intervention:   Sponsor:   University Hospital, Montpellier Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2smzaH6

Exploring Disease Immunogenicity and the Immunological Effects of Hypomethylating Agents in Acute Myeloid Leukemia

Condition:   Acute Myeloid Leukemia Intervention:   Genetic: Immunogenic profile Sponsor:   Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2M1fLUY

Multiple Drug Hypersensitivity Syndrome

Condition:   Drug Allergy Intervention:   Sponsor:   University Hospital, Montpellier Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2smzaH6

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.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2smMHy4

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.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2smMHy4

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.

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

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.

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

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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