Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n=89) or control (n=151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate.
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Πέμπτη 24 Ιανουαρίου 2019
Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity
Overheard: Helping Students with ASD Handle Real or Perceived Bullying
In an online chat, SLP Erin Mauldin discusses how to teach students with ASD strategies for understanding and responding to bullying. Participant: Would you give an example of backhanded bullying? Erin Mauldin: Backhanded bullying happens when someone uses kind gestures or words with the intent of misleading their victim. A bully may say something in a nice or kind manner but the message may be negative, which our students who lack social skills are sometimes unable to interpret. A bully may take advantage of their lack of understanding to trick them into a negative situation. Participant: Is there any research about whether to talk with and support the bully in these situations? Mauldin: A lot of the research I found was about talking to the victim of bullying and prov...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RMiYhb
Overheard: Helping Students with ASD Handle Real or Perceived Bullying
In an online chat, SLP Erin Mauldin discusses how to teach students with ASD strategies for understanding and responding to bullying. Participant: Would you give an example of backhanded bullying? Erin Mauldin: Backhanded bullying happens when someone uses kind gestures or words with the intent of misleading their victim. A bully may say something in a nice or kind manner but the message may be negative, which our students who lack social skills are sometimes unable to interpret. A bully may take advantage of their lack of understanding to trick them into a negative situation. Participant: Is there any research about whether to talk with and support the bully in these situations? Mauldin: A lot of the research I found was about talking to the victim of bullying and prov...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RMiYhb
The influence of different patient positions during rapid induction with severe regurgitation on the volume of aspirate and time to intubation: a prospective randomised manikin simulation study
Abstract
Background
Aspiration is a main contributor to morbidity and mortality in anaesthesia. The ideal patient positioning for rapid sequence induction remains controversial. A head-down tilt and full cervical spine extension (Sellick) might prevent aspiration but at the same time compromise airway management. We aimed to determine the influence of three different positions during induction of general anaesthesia on the volume of aspirate and on participants' airway management.
Methods
Eighty-four anaesthetic trainees and consultants participated in a prospective randomised simulation study. Anaesthesia was induced in reverse Trendelenburg position (+ 15°) in a manikin capable of dynamic fluid regurgitation. Participants were randomised to change to Trendelenburg position (− 15°) a) as soon as regurgitation was noticed, b) as soon as 'patient' had been anaesthetised, and c) as soon as 'patient' had been anaesthetised and with full cervical spine extension (Sellick). Primary endpoints were the aspirated volume and the time to intubation. Secondary endpoints were ratings of the laryngoscopic view and the intubation situation (0–100 mm).
Results
Combining head-down tilt with Sellick position significantly reduced aspiration (p < 0.005). Median time to intubate was longer in Sellick position (15 s [8–30]) as compared with the head in sniffing position (10 s [8–12.5]; p < 0.05). Participants found laryngoscopy more difficult in Sellick position (39.3 ± 27.9 mm) as compared with the sniffing position (23.1 ± 22.1 mm; p < 0.05). Both head-down tilt intubation situations were considered equally difficult: 34.8 ± 24.6 mm (Sniffing) vs. 44.2 ± 23.1 mm (Sellick; p = n.s).
Conclusions
In a simulated setting, using a manikin-based simulator capable of fluid regurgitation, a − 15° head-down tilt with Sellick position reduced the amount of aspirated fluid but increased the difficulty in visualising the vocal cords and prolonged the time taken to intubate. Assessing the airway management in the identical position in healthy patients without risk of aspiration might be a promising next step to take.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CGcs1o
Nickel by proxy
A 27‐year‐old Caucasian woman presented with an annular dermatitis on the flexor aspect of her right wrist. She had originally developed dermatitis on her left wrist, as she thought due to an allergic reaction to a metal watch and watch strap which she had recently acquired.
This article is protected by copyright. All rights reserved.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RMKTh3
The influence of different patient positions during rapid induction with severe regurgitation on the volume of aspirate and time to intubation: a prospective randomised manikin simulation study
Abstract
Background
Aspiration is a main contributor to morbidity and mortality in anaesthesia. The ideal patient positioning for rapid sequence induction remains controversial. A head-down tilt and full cervical spine extension (Sellick) might prevent aspiration but at the same time compromise airway management. We aimed to determine the influence of three different positions during induction of general anaesthesia on the volume of aspirate and on participants' airway management.
Methods
Eighty-four anaesthetic trainees and consultants participated in a prospective randomised simulation study. Anaesthesia was induced in reverse Trendelenburg position (+ 15°) in a manikin capable of dynamic fluid regurgitation. Participants were randomised to change to Trendelenburg position (− 15°) a) as soon as regurgitation was noticed, b) as soon as 'patient' had been anaesthetised, and c) as soon as 'patient' had been anaesthetised and with full cervical spine extension (Sellick). Primary endpoints were the aspirated volume and the time to intubation. Secondary endpoints were ratings of the laryngoscopic view and the intubation situation (0–100 mm).
Results
Combining head-down tilt with Sellick position significantly reduced aspiration (p < 0.005). Median time to intubate was longer in Sellick position (15 s [8–30]) as compared with the head in sniffing position (10 s [8–12.5]; p < 0.05). Participants found laryngoscopy more difficult in Sellick position (39.3 ± 27.9 mm) as compared with the sniffing position (23.1 ± 22.1 mm; p < 0.05). Both head-down tilt intubation situations were considered equally difficult: 34.8 ± 24.6 mm (Sniffing) vs. 44.2 ± 23.1 mm (Sellick; p = n.s).
Conclusions
In a simulated setting, using a manikin-based simulator capable of fluid regurgitation, a − 15° head-down tilt with Sellick position reduced the amount of aspirated fluid but increased the difficulty in visualising the vocal cords and prolonged the time taken to intubate. Assessing the airway management in the identical position in healthy patients without risk of aspiration might be a promising next step to take.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CGcs1o
Nickel by proxy
A 27‐year‐old Caucasian woman presented with an annular dermatitis on the flexor aspect of her right wrist. She had originally developed dermatitis on her left wrist, as she thought due to an allergic reaction to a metal watch and watch strap which she had recently acquired.
This article is protected by copyright. All rights reserved.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RMKTh3
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing—Reply
In Reply Critiques of our article by Folmer and Henry et al suggest the concerns we raised about the potential harmful effects of chronic exposure to broad-band noise (BBN) are overstated, citing a lack of clinical evidence demonstrating correspondence between human symptoms and maladaptive neuroplasticity recorded in animal studies. Although we acknowledged the paucity of human studies addressing these questions in our review, we do not think it is safe to assume humans will be exempt from substantial, negative impacts of chronic BBN exposure documented in the central auditory pathways of animals. A main goal of our report was to stimulate the audiology research and clinical communities to take these compelling animal studies more seriously—and to take on the long-delayed task of carefully documenting the impacts of chronic BBN exposure on residual human hearing, on accelerated aging, and on the evolution of tinnitus itself.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXHZ1S
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXHZ1S
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor Attarha et al recommended that sound therapies using white noise should be avoided as treatments for tinnitus. This advice might stem from the authors' collective lack of clinical experience assessing and treating patients with tinnitus, or from their unfamiliarity with tinnitus management techniques and associated literature. In any case, before recommending that white noise should be avoided by patients with tinnitus, Attarha et al should become more familiar with how a variety of sound therapies—including broadband sounds—often help this patient population.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWsK
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWsK
Bullous Pemphigoid Presenting as Oropharyngeal Hemorrhage
This is a case report of a man who presented with oropharyngeal hemorrhage and impending airway compromise as the initial presentation of mucosal bullous pemphigoid.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKNwA
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKNwA
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor Attarha et al recommended that sound therapies using white noise should be avoided as treatments for tinnitus. This advice might stem from the authors' collective lack of clinical experience assessing and treating patients with tinnitus, or from their unfamiliarity with tinnitus management techniques and associated literature. In any case, before recommending that white noise should be avoided by patients with tinnitus, Attarha et al should become more familiar with how a variety of sound therapies—including broadband sounds—often help this patient population.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWsK
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWsK
Association Between Migraine and Benign Paroxysmal Positional Vertigo in South Korea
This study evaluates representative patient data from the Korean National Health Insurance Service-National Sample Cohort to trace the incidence of benign paroxysmal positional vertigo among adults who experience migraine.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWce
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWce
Bullous Pemphigoid Presenting as Oropharyngeal Hemorrhage
This is a case report of a man who presented with oropharyngeal hemorrhage and impending airway compromise as the initial presentation of mucosal bullous pemphigoid.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKNwA
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKNwA
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing—Reply
In Reply Critiques of our article by Folmer and Henry et al suggest the concerns we raised about the potential harmful effects of chronic exposure to broad-band noise (BBN) are overstated, citing a lack of clinical evidence demonstrating correspondence between human symptoms and maladaptive neuroplasticity recorded in animal studies. Although we acknowledged the paucity of human studies addressing these questions in our review, we do not think it is safe to assume humans will be exempt from substantial, negative impacts of chronic BBN exposure documented in the central auditory pathways of animals. A main goal of our report was to stimulate the audiology research and clinical communities to take these compelling animal studies more seriously—and to take on the long-delayed task of carefully documenting the impacts of chronic BBN exposure on residual human hearing, on accelerated aging, and on the evolution of tinnitus itself.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXHZ1S
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FXHZ1S
Association Between Migraine and Benign Paroxysmal Positional Vertigo in South Korea
This study evaluates representative patient data from the Korean National Health Insurance Service-National Sample Cohort to trace the incidence of benign paroxysmal positional vertigo among adults who experience migraine.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWce
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMXWce
Speech Functioning and Neurocognition Before Head and Neck Cancer
This cohort study examines neurocognitive functioning in patients with head and neck cancer before treatment and investigates the association between neurocognition and speech functioning.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FLAqvZ
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FLAqvZ
Speech Functioning and Neurocognition Before Head and Neck Cancer
This cohort study examines neurocognitive functioning in patients with head and neck cancer before treatment and investigates the association between neurocognition and speech functioning.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FLAqvZ
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FLAqvZ
The Increasing Role of Social Media in Otolaryngology
This Viewpoint examines the increasing role of social media in the practice of otolaryngology.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKAcM
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKAcM
The Increasing Role of Social Media in Otolaryngology
This Viewpoint examines the increasing role of social media in the practice of otolaryngology.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKAcM
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FVKAcM
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor We are writing in response to the article by Attarha, Bigelow, and Merzenich, which concluded, "Sound therapies using unstructured, random (white) noise should be avoided as a treatment for tinnitus."(E1) Their recommendation was based on animal studies that revealed long-term exposure to low-level broadband noise (BBN) resulted in central auditory changes that "bear striking phenomenological overlap with the persistent, widespread disinhibition of the auditory system thought to underlie tinnitus in humans."(E2) They noted that BBN delivered from ear-level devices to treat tinnitus produces the same type of acoustic stimuli used in the animal studies. It therefore seems plausible that continuous use of BBN could affect the human auditory system in the same manner as seen in animals, suggesting the need for research to evaluate the premise. The authors, however, pointed to the animal findings as justifying a broad recommendation against the use of ear-level noise generators.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJicLP
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJicLP
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor We are writing in response to the article by Attarha, Bigelow, and Merzenich, which concluded, "Sound therapies using unstructured, random (white) noise should be avoided as a treatment for tinnitus."(E1) Their recommendation was based on animal studies that revealed long-term exposure to low-level broadband noise (BBN) resulted in central auditory changes that "bear striking phenomenological overlap with the persistent, widespread disinhibition of the auditory system thought to underlie tinnitus in humans."(E2) They noted that BBN delivered from ear-level devices to treat tinnitus produces the same type of acoustic stimuli used in the animal studies. It therefore seems plausible that continuous use of BBN could affect the human auditory system in the same manner as seen in animals, suggesting the need for research to evaluate the premise. The authors, however, pointed to the animal findings as justifying a broad recommendation against the use of ear-level noise generators.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJicLP
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FJicLP
Improving Sensitivity on Identification and Delineation of Intracranial Hemorrhage Lesion Using Cascaded Deep Learning Models
Abstract
Highly accurate detection of the intracranial hemorrhage without delay is a critical clinical issue for the diagnostic decision and treatment in an emergency room. In the context of a study on diagnostic accuracy, there is a tradeoff between sensitivity and specificity. In order to improve sensitivity while preserving specificity, we propose a cascade deep learning model constructed using two convolutional neural networks (CNNs) and dual fully convolutional networks (FCNs). The cascade CNN model is built for identifying bleeding; hereafter the dual FCN is to detect five different subtypes of intracranial hemorrhage and to delineate their lesions. Using a total of 135,974 CT images including 33,391 images labeled as bleeding, each of CNN/FCN models was trained separately on image data preprocessed by two different settings of window level/width. One is a default window (50/100[level/width]) and the other is a stroke window setting (40/40). By combining them, we obtained a better outcome on both binary classification and segmentation of hemorrhagic lesions compared to a single CNN and FCN model. In determining whether it is bleeding or not, there was around 1% improvement in sensitivity (97.91% [± 0.47]) while retaining specificity (98.76% [± 0.10]). For delineation of bleeding lesions, we obtained overall segmentation performance at 80.19% in precision and 82.15% in recall which is 3.44% improvement compared to using a single FCN model.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WiMfiu
Improving Sensitivity on Identification and Delineation of Intracranial Hemorrhage Lesion Using Cascaded Deep Learning Models
Abstract
Highly accurate detection of the intracranial hemorrhage without delay is a critical clinical issue for the diagnostic decision and treatment in an emergency room. In the context of a study on diagnostic accuracy, there is a tradeoff between sensitivity and specificity. In order to improve sensitivity while preserving specificity, we propose a cascade deep learning model constructed using two convolutional neural networks (CNNs) and dual fully convolutional networks (FCNs). The cascade CNN model is built for identifying bleeding; hereafter the dual FCN is to detect five different subtypes of intracranial hemorrhage and to delineate their lesions. Using a total of 135,974 CT images including 33,391 images labeled as bleeding, each of CNN/FCN models was trained separately on image data preprocessed by two different settings of window level/width. One is a default window (50/100[level/width]) and the other is a stroke window setting (40/40). By combining them, we obtained a better outcome on both binary classification and segmentation of hemorrhagic lesions compared to a single CNN and FCN model. In determining whether it is bleeding or not, there was around 1% improvement in sensitivity (97.91% [± 0.47]) while retaining specificity (98.76% [± 0.10]). For delineation of bleeding lesions, we obtained overall segmentation performance at 80.19% in precision and 82.15% in recall which is 3.44% improvement compared to using a single FCN model.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WiMfiu
Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis
Abstract
Objective
This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients.
Methods
In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs.
Results
The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively).
Conclusions
The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HwbSbZ
Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis
Abstract
Objective
This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients.
Methods
In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs.
Results
The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively).
Conclusions
The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HwbSbZ
Considerations for Ophthalmic Complications
To the Editor I read with interest the article by Liu et al in JAMA Facial Plastic Surgery. The authors present a well-grounded study by demonstrating the vascular anatomy in the facial and ocular region in New Zealand white rabbits, and investigate the complications of visual impairment, blindness, and death through autologous fat injection. I would like to present some points for their consideration.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RKRRTU
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RKRRTU
A Practical Guide to Managing Body Dysmorphic Disorder in the Cosmetic Surgery Setting
This Viewpoint sets out a practical guide to recognizing and managing body dysmorphic disorder in the cosmetic surgery setting.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CFV3G6
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CFV3G6
Risk Factors Associated With Complications After Treatment of Mandible Fractures
This cohort study describes the risk factors associated with complications in patients undergoing treatment for mandible fracture.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RLl0OK
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RLl0OK
Considerations for Ophthalmic Complications
To the Editor I read with interest the article by Liu et al in JAMA Facial Plastic Surgery. The authors present a well-grounded study by demonstrating the vascular anatomy in the facial and ocular region in New Zealand white rabbits, and investigate the complications of visual impairment, blindness, and death through autologous fat injection. I would like to present some points for their consideration.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RKRRTU
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RKRRTU
A Practical Guide to Managing Body Dysmorphic Disorder in the Cosmetic Surgery Setting
This Viewpoint sets out a practical guide to recognizing and managing body dysmorphic disorder in the cosmetic surgery setting.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CFV3G6
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CFV3G6
Risk Factors Associated With Complications After Treatment of Mandible Fractures
This cohort study describes the risk factors associated with complications in patients undergoing treatment for mandible fracture.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RLl0OK
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RLl0OK
Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective
Abstract
Background
Emergency departments are playing an increasing role in cancer management. Emergency department utilization by patients with head and neck cancer, however, is unknown.
Methods
The 2009‐2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality.
Results
A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death.
Conclusion
These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S9wBq8
Follow‐up of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hu7QAR
Ultrasonographic swallowing examination for early detection of neopharyngeal fistula after salvage total laryngectomy: A preliminary study
Abstract
Background
The current study investigated the feasibility of ultrasonographic swallowing examination (USSE) for the evaluation of neopharynx and early detection of neopharyngeal fistula after salvage total laryngectomy.
Methods
A prospective case series‐based study involving 16 patients who underwent salvage total laryngectomy was conducted. USSE was performed on postoperative days 5‐7, and oral diet initiation was determined based on the USSE results.
Results
Fistula of the neopharynx was detected in four patients (25%) via USSE, as was the specific site of the fistula. In these patients, oral diet was delayed and immediate interventions including ultrasound‐guided fluid aspiration and compression dressing were applied, and all fistulas were subsequently closed. In the remaining 12 patients with no neopharyngeal fistula on USSE, an oral diet was started immediately and no fistula occurred.
Conclusions
USSE is a promising method for neopharynx evaluation and early detection of neopharyngeal fistula after salvage total laryngectomy.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S5fB4q
Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective
Abstract
Background
Emergency departments are playing an increasing role in cancer management. Emergency department utilization by patients with head and neck cancer, however, is unknown.
Methods
The 2009‐2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality.
Results
A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death.
Conclusion
These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S9wBq8
Follow‐up of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP)
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Hu7QAR
Ultrasonographic swallowing examination for early detection of neopharyngeal fistula after salvage total laryngectomy: A preliminary study
Abstract
Background
The current study investigated the feasibility of ultrasonographic swallowing examination (USSE) for the evaluation of neopharynx and early detection of neopharyngeal fistula after salvage total laryngectomy.
Methods
A prospective case series‐based study involving 16 patients who underwent salvage total laryngectomy was conducted. USSE was performed on postoperative days 5‐7, and oral diet initiation was determined based on the USSE results.
Results
Fistula of the neopharynx was detected in four patients (25%) via USSE, as was the specific site of the fistula. In these patients, oral diet was delayed and immediate interventions including ultrasound‐guided fluid aspiration and compression dressing were applied, and all fistulas were subsequently closed. In the remaining 12 patients with no neopharyngeal fistula on USSE, an oral diet was started immediately and no fistula occurred.
Conclusions
USSE is a promising method for neopharynx evaluation and early detection of neopharyngeal fistula after salvage total laryngectomy.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S5fB4q
Fetal brain development at 25–39 weeks gestational age: A preliminary study using intravoxel incoherent motion diffusion‐weighted imaging
Background
The fetal brain developmental changes of water diffusivity and perfusion has not been extensively explored.
Purpose/Hypothesis
To evaluate the fetal brain developmental changes of water diffusivity and perfusion using intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI).
Study Type
Prospective.
Population
Seventy‐nine normal singleton fetuses were scanned without sedation of healthy pregnant women.
Field Strength/Sequence
5 T MRI/T1/2‐weighted image and IVIM‐DWI.
Assessment
Pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were calculated in the frontal (FWM), temporal (TWM), parietal (PWM), and occipital white matter (OWM) as well as cerebellar hemisphere (CH), basal ganglia region (BGR), thalamus (TH), and pons using an IVIM model.
Statistical Tests
One‐way analysis of variable (ANOVA) followed by Bonferroni post‐hoc multiple comparison was employed to reveal the difference of IVIM parameters among the investigated brain regions. The linear and the nonlinear polynomial regression analyses were utilized to reveal the correlation between gestational age (GA) and IVIM parameters.
Results
There were significant differences in both D (F(7,623) = 96.64, P = 0.000) and f values (F(7,623) = 2.361, P = 0.0219), but not D* values among the varied brain regions. D values from TWM (r2 = 0.1402, P = 0.0002), PWM (r2 = 0.2245, P = 0.0002), OWM (r2 = 0.2519, P = 0.0002), CH (r2 = 0.2245, P = 0.0002), BGR (r2 = 0.3393, P = 0.0001), TH (r2 = 0.1259, P = 0.0001), and D* value from pons (r2 = 0.2206, P = 0.0002) were significantly correlated with GA using linear regression analysis. Quadratic regression analysis led to results similar to those using the linear regression model.
Data Conclusion
IVIM‐DWI parameters may indicate fetal brain developmental alterations but the conclusion is far from reached due to the not as high‐powered correlation between IVIM parameters and GA.
Level of Evidence: 2
Technical Efficacy Stage: 2
J. Magn. Reson. Imaging 2019.
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Fetal brain development at 25–39 weeks gestational age: A preliminary study using intravoxel incoherent motion diffusion‐weighted imaging
Background
The fetal brain developmental changes of water diffusivity and perfusion has not been extensively explored.
Purpose/Hypothesis
To evaluate the fetal brain developmental changes of water diffusivity and perfusion using intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI).
Study Type
Prospective.
Population
Seventy‐nine normal singleton fetuses were scanned without sedation of healthy pregnant women.
Field Strength/Sequence
5 T MRI/T1/2‐weighted image and IVIM‐DWI.
Assessment
Pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were calculated in the frontal (FWM), temporal (TWM), parietal (PWM), and occipital white matter (OWM) as well as cerebellar hemisphere (CH), basal ganglia region (BGR), thalamus (TH), and pons using an IVIM model.
Statistical Tests
One‐way analysis of variable (ANOVA) followed by Bonferroni post‐hoc multiple comparison was employed to reveal the difference of IVIM parameters among the investigated brain regions. The linear and the nonlinear polynomial regression analyses were utilized to reveal the correlation between gestational age (GA) and IVIM parameters.
Results
There were significant differences in both D (F(7,623) = 96.64, P = 0.000) and f values (F(7,623) = 2.361, P = 0.0219), but not D* values among the varied brain regions. D values from TWM (r2 = 0.1402, P = 0.0002), PWM (r2 = 0.2245, P = 0.0002), OWM (r2 = 0.2519, P = 0.0002), CH (r2 = 0.2245, P = 0.0002), BGR (r2 = 0.3393, P = 0.0001), TH (r2 = 0.1259, P = 0.0001), and D* value from pons (r2 = 0.2206, P = 0.0002) were significantly correlated with GA using linear regression analysis. Quadratic regression analysis led to results similar to those using the linear regression model.
Data Conclusion
IVIM‐DWI parameters may indicate fetal brain developmental alterations but the conclusion is far from reached due to the not as high‐powered correlation between IVIM parameters and GA.
Level of Evidence: 2
Technical Efficacy Stage: 2
J. Magn. Reson. Imaging 2019.
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Correction: Synthesis and antimicrobial photodynamic effect of methylene blue conjugated carbon nanotubes on E. coli and S. aureus
Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C9PP90008J, Correction
DOI: 10.1039/C9PP90008J, Correction
Open Access
This article is licensed under a Creative Commons Attribution 3.0 Unported Licence. Paramanantham Parasuraman, V. T. Anju, S. B. Sruthil Lal, Alok Sharan, Siddhardha Busi, K. Kaviyarasu, Mohammed Arshad, Turki M. S. Dawoud, Asad Syed
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
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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Correction: Synthesis and antimicrobial photodynamic effect of methylene blue conjugated carbon nanotubes on E. coli and S. aureus
Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C9PP90008J, Correction
DOI: 10.1039/C9PP90008J, Correction
Open Access This article is licensed under a Creative Commons Attribution 3.0 Unported Licence. Paramanantham Parasuraman, V. T. Anju, S. B. Sruthil Lal, Alok Sharan, Siddhardha Busi, K. Kaviyarasu, Mohammed Arshad, Turki M. S. Dawoud, Asad Syed
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
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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Replication of factors related to blackout incidence in U.S. high school students: A brief report
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Amie L. Haas, Sara Lorkiewicz, Byron L. Zamboanga
Abstract
Alcohol-related blackouts are a common, yet serious consequence that can result from heavy alcohol intake. This study tested a model examining whether factors identified in related samples (i.e., adolescents residing in the U.K. and U.S. college students) predicted blackouts in community-dwelling U.S. high school youth. Participants from a Northeastern U.S. high school with prior alcohol use (Mage = 16.0 years; 48.2% male, 78.0% White) completed a paper-and-pencil assessment including measures of demographics, alcohol and other substance use, externalizing behaviors, and injunctive norms about risky drinking behaviors. Hierarchical logistic regression examined which factors identified for U.K. residing adolescents (Block 1) replicated in the U.S. sample, and whether factors identified in samples of U.S. college students added additional explained variance (Block 2). Blackouts were reported by 35.6% of students. Regression results indicated that two variables previously identified in adolescents, female gender (OR = 3.26) and increased alcohol use (OR = 1.27) were associated with blackouts. College student risk factors of drinking game (DG) participation and, to a lesser degree injunctive norms for passing out, emerged as additional risk factors (ORs = 2.85 and 1.32, respectively), with the final model explaining 39% of the variance in blackouts. This study advances our understanding of blackouts in younger drinkers and identifies the importance of addressing blackouts within the context of intervention programming that addresses cognitions and high risk drinking practices like DGs.
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Reasons to use e-cigarettes among adults and youth in the Population Assessment of Tobacco and Health (PATH) study
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Nicole E. Nicksic, L. Morgan Snell, Andrew J. Barnes
Abstract
Background
While e-cigarette use is increasing, reasons to use e-cigarettes are poorly summarized in the literature. The objective of this study was to organize reasons to use e-cigarette items into factors and determine associations between these factors and e-cigarette user characteristics.
Methods
Data were drawn from youth (12–17) and adults (18+) in Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) study. Exploratory factor analysis was conducted on 13 reasons to use survey items from experimental and established adult e-cigarette users and past 30 day youth e-cigarette users to determine two factors – "alternative to cigarettes" and "larger social environment". Weighted linear regression models tested the associations between e-cigarette user group and sociodemographics and reasons to use factors among youth and adults.
Results
Adult current established e-cigarette users were associated with both alternative to cigarettes (β = 0.128, p < .001) and larger social environment (β = 0.063, p < .001) factors, while former established e-cigarette users were associated with alternative to cigarettes (β = 0.064, p < .001). Several adult sociodemographic characteristics were associated with one but not the other factor, or both but in opposite directions. Youth that used e-cigarettes earlier today were also associated with both reasons to use factors (β = 0.127–0.130, p < .01, each); however, youth using any other day in the past 30 days was not associated with either factor.
Conclusions
Reasons to use are associated with patterns of e-cigarette use among youth and adults. These factors could support a comprehensive approach to addressing rising e-cigarette use among youth and adults and target certain user populations.
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A review of EMA assessment period reporting for mood variables in substance use research: Expanding existing EMA guidelines
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Narayan B. Singh, Elin A. Björling
Abstract
Ecological Momentary Assessment (EMA) is an increasingly popular approach in substance use research for capturing reliable, in-situ, self-reported information about fluctuating variables, such as mood, over time. Current EMA guidelines do not sufficiently address the reporting of assessment periods (e.g., right now, past 30 min). Given the importance of time in EMA studies, variation and ambiguity in assessment period reporting risks misinterpretation of procedures and findings. The following study reviewed the methodological reporting of EMA assessment periods in substance use research. A search conducted in PsychINFO and PubMed using the terms "ecological momentary assessment" OR "EMA" AND "mood" AND "substance use" yielded 36 unique search results. The references of these results were hand searched and resulted in 126 additional studies. After deleting duplicates and applying inclusion criteria, 56 studies were included in the review. Review of these studies illustrated (1) variability and ambiguity in study assessment periods (2) within-study incongruence between assessment period descriptions and associated EMA prompts, (3) and a large temporal range of retrospective assessment periods across studies. Each of these findings are illustrated and discussed using examples from the literature. From these examples, assessment period reporting guidelines are proposed to improve EMA reporting clarity. Such improvements will facilitate increased synthesis of EMA research and position future researchers to investigate the validity and reliability of EMA data captured with different lengths of retrospection.
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Pain intensity and tobacco smoking among Latinx Spanish-speaking adult smokers
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Michael J. Zvolensky, Jafar Bakhshaie, Justin M. Shepherd, Nubia A. Mayorga, Natalia Giraldo-Santiago, Natalia Peraza, Andrew H. Rogers, Joseph W. Ditre, Jodi Berger-Cardoso
Abstract
Some research suggests that pain intensity is greater among Latinx persons compared to non-Hispanic-Whites, and that the experience of more intense pain among this group is related to poorer mental health and impairment. Yet, the degree to which pain-smoking relations generalize to Latinx smokers is unknown. The present study tested whether past-month pain intensity among adult Latinx smokers was related to cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage = 33.3 years, SD = 9.81). Consistent with prediction, current pain intensity was significantly related to greater cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. These novel data provide preliminary evidence that individual differences in the intensity of experienced pain in the past month is related to a range of clinically-significant smoking variables among a large sample of Latinx smokers. The findings suggest that pain intensity may be important to Latinx smokers, a group that often showcases pain-related disparities compared to other racial/ethnic groups.
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Cross-domain correlates of cannabis use disorder severity among young adults
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): Randi Melissa Schuster, Maya Hareli, Amelia D. Moser, Kelsey Lowman, Jodi Gilman, Christine Ulysse, David Schoenfeld, A. Eden Evins
Abstract
Background
Correlates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.
Methods
This study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.
Results
Of the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.
Conclusions
Cannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.
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Use of other combustible tobacco products among priority populations of smokers: Implications for U.S. tobacco regulatory policy
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): Claire Adams Spears, Dina M. Jones, Terry F. Pechacek, David L. Ashley
Abstract
Certain sub-populations (e.g., those living in poverty, racial/ethnic minorities, sexual minorities, and people with mental health conditions) experience profound tobacco-related health disparities. Ongoing surveillance of use of various combustible tobacco products by priority populations of cigarette smokers is needed, particularly in the changing U.S. tobacco regulatory landscape. In 2018 the FDA announced their consideration of a tobacco product standard that would limit the level of nicotine in combustible cigarettes, and such regulations should consider potential effects on tobacco-related disparities. If certain subgroups of cigarette smokers are also using other combustible products, they may be particularly likely to continue dual use or switch to exclusive use of those products if a nicotine reduction standard only applies to cigarettes. Accordingly, this study provided recent U.S. nationally representative data on use of other combustible tobacco products among current cigarette smokers by sociodemographic characteristics. Data were drawn from current cigarette smokers (n = 2559) in 2016 and 2017 U.S. nationally representative surveys. Associations between sociodemographic variables (poverty status, education, race/ethnicity, sexual orientation, and mental health status) with use of little cigars and cigarillos (LCCs), traditional cigars, and hookah were examined. Among current cigarette smokers, those living in poverty, racial/ethnic minorities, and those with mental health conditions were particularly likely to use LCCs. Racial/ethnic minority smokers were more likely to smoke traditional cigars. Non-heterosexual smokers, Hispanic smokers, and smokers with mental health conditions were particularly likely to use hookah. These findings have important implications for tobacco regulatory policy and other efforts to combat tobacco-related disparities.
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A tutorial on individual participant data meta-analysis using Bayesian multilevel modeling to estimate alcohol intervention effects across heterogeneous studies
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): David Huh, Eun-Young Mun, Scott T. Walters, Zhengyang Zhou, David C. Atkins
Abstract
This paper provides a tutorial companion for the methodological approach implemented in Huh et al. (2015) that overcame two major challenges for individual participant data (IPD) meta-analysis. Specifically, we show how to validly combine data from heterogeneous studies with varying numbers of treatment arms, and how to analyze highly-skewed count outcomes with many zeroes (e.g., alcohol and substance use outcomes) to estimate overall effect sizes. These issues have important implications for the feasibility, applicability, and interpretation of IPD meta-analysis but have received little attention thus far in the applied research literature. We present a Bayesian multilevel modeling approach for combining multi-arm trials (i.e., those with two or more treatment groups) in a distribution-appropriate IPD analysis. Illustrative data come from Project INTEGRATE, an IPD meta-analysis study of brief motivational interventions to reduce excessive alcohol use and related harm among college students. Our approach preserves the original random allocation within studies, combines within-study estimates across all studies, overcomes between-study heterogeneity in trial design (i.e., number of treatment arms) and/or study-level missing data, and derives two related treatment outcomes in a multivariate IPD meta-analysis. This methodological approach is a favorable alternative to collapsing or excluding intervention groups within multi-arm trials, making it possible to directly compare multiple treatment arms in a one-step IPD meta-analysis. To facilitate application of the method, we provide annotated computer code in R along with the example data used in this tutorial.
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Replication of factors related to blackout incidence in U.S. high school students: A brief report
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Amie L. Haas, Sara Lorkiewicz, Byron L. Zamboanga
Abstract
Alcohol-related blackouts are a common, yet serious consequence that can result from heavy alcohol intake. This study tested a model examining whether factors identified in related samples (i.e., adolescents residing in the U.K. and U.S. college students) predicted blackouts in community-dwelling U.S. high school youth. Participants from a Northeastern U.S. high school with prior alcohol use (Mage = 16.0 years; 48.2% male, 78.0% White) completed a paper-and-pencil assessment including measures of demographics, alcohol and other substance use, externalizing behaviors, and injunctive norms about risky drinking behaviors. Hierarchical logistic regression examined which factors identified for U.K. residing adolescents (Block 1) replicated in the U.S. sample, and whether factors identified in samples of U.S. college students added additional explained variance (Block 2). Blackouts were reported by 35.6% of students. Regression results indicated that two variables previously identified in adolescents, female gender (OR = 3.26) and increased alcohol use (OR = 1.27) were associated with blackouts. College student risk factors of drinking game (DG) participation and, to a lesser degree injunctive norms for passing out, emerged as additional risk factors (ORs = 2.85 and 1.32, respectively), with the final model explaining 39% of the variance in blackouts. This study advances our understanding of blackouts in younger drinkers and identifies the importance of addressing blackouts within the context of intervention programming that addresses cognitions and high risk drinking practices like DGs.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Mvda6a
Reasons to use e-cigarettes among adults and youth in the Population Assessment of Tobacco and Health (PATH) study
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Nicole E. Nicksic, L. Morgan Snell, Andrew J. Barnes
Abstract
Background
While e-cigarette use is increasing, reasons to use e-cigarettes are poorly summarized in the literature. The objective of this study was to organize reasons to use e-cigarette items into factors and determine associations between these factors and e-cigarette user characteristics.
Methods
Data were drawn from youth (12–17) and adults (18+) in Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) study. Exploratory factor analysis was conducted on 13 reasons to use survey items from experimental and established adult e-cigarette users and past 30 day youth e-cigarette users to determine two factors – "alternative to cigarettes" and "larger social environment". Weighted linear regression models tested the associations between e-cigarette user group and sociodemographics and reasons to use factors among youth and adults.
Results
Adult current established e-cigarette users were associated with both alternative to cigarettes (β = 0.128, p < .001) and larger social environment (β = 0.063, p < .001) factors, while former established e-cigarette users were associated with alternative to cigarettes (β = 0.064, p < .001). Several adult sociodemographic characteristics were associated with one but not the other factor, or both but in opposite directions. Youth that used e-cigarettes earlier today were also associated with both reasons to use factors (β = 0.127–0.130, p < .01, each); however, youth using any other day in the past 30 days was not associated with either factor.
Conclusions
Reasons to use are associated with patterns of e-cigarette use among youth and adults. These factors could support a comprehensive approach to addressing rising e-cigarette use among youth and adults and target certain user populations.
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A review of EMA assessment period reporting for mood variables in substance use research: Expanding existing EMA guidelines
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Narayan B. Singh, Elin A. Björling
Abstract
Ecological Momentary Assessment (EMA) is an increasingly popular approach in substance use research for capturing reliable, in-situ, self-reported information about fluctuating variables, such as mood, over time. Current EMA guidelines do not sufficiently address the reporting of assessment periods (e.g., right now, past 30 min). Given the importance of time in EMA studies, variation and ambiguity in assessment period reporting risks misinterpretation of procedures and findings. The following study reviewed the methodological reporting of EMA assessment periods in substance use research. A search conducted in PsychINFO and PubMed using the terms "ecological momentary assessment" OR "EMA" AND "mood" AND "substance use" yielded 36 unique search results. The references of these results were hand searched and resulted in 126 additional studies. After deleting duplicates and applying inclusion criteria, 56 studies were included in the review. Review of these studies illustrated (1) variability and ambiguity in study assessment periods (2) within-study incongruence between assessment period descriptions and associated EMA prompts, (3) and a large temporal range of retrospective assessment periods across studies. Each of these findings are illustrated and discussed using examples from the literature. From these examples, assessment period reporting guidelines are proposed to improve EMA reporting clarity. Such improvements will facilitate increased synthesis of EMA research and position future researchers to investigate the validity and reliability of EMA data captured with different lengths of retrospection.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MrQ3co
Pain intensity and tobacco smoking among Latinx Spanish-speaking adult smokers
Publication date: Available online 24 January 2019
Source: Addictive Behaviors
Author(s): Michael J. Zvolensky, Jafar Bakhshaie, Justin M. Shepherd, Nubia A. Mayorga, Natalia Giraldo-Santiago, Natalia Peraza, Andrew H. Rogers, Joseph W. Ditre, Jodi Berger-Cardoso
Abstract
Some research suggests that pain intensity is greater among Latinx persons compared to non-Hispanic-Whites, and that the experience of more intense pain among this group is related to poorer mental health and impairment. Yet, the degree to which pain-smoking relations generalize to Latinx smokers is unknown. The present study tested whether past-month pain intensity among adult Latinx smokers was related to cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage = 33.3 years, SD = 9.81). Consistent with prediction, current pain intensity was significantly related to greater cigarette dependence, perceived barriers for quitting, and problems experienced during past quit attempts. These novel data provide preliminary evidence that individual differences in the intensity of experienced pain in the past month is related to a range of clinically-significant smoking variables among a large sample of Latinx smokers. The findings suggest that pain intensity may be important to Latinx smokers, a group that often showcases pain-related disparities compared to other racial/ethnic groups.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sJIDIw
Cross-domain correlates of cannabis use disorder severity among young adults
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): Randi Melissa Schuster, Maya Hareli, Amelia D. Moser, Kelsey Lowman, Jodi Gilman, Christine Ulysse, David Schoenfeld, A. Eden Evins
Abstract
Background
Correlates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.
Methods
This study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.
Results
Of the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.
Conclusions
Cannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MsQXFx
Use of other combustible tobacco products among priority populations of smokers: Implications for U.S. tobacco regulatory policy
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): Claire Adams Spears, Dina M. Jones, Terry F. Pechacek, David L. Ashley
Abstract
Certain sub-populations (e.g., those living in poverty, racial/ethnic minorities, sexual minorities, and people with mental health conditions) experience profound tobacco-related health disparities. Ongoing surveillance of use of various combustible tobacco products by priority populations of cigarette smokers is needed, particularly in the changing U.S. tobacco regulatory landscape. In 2018 the FDA announced their consideration of a tobacco product standard that would limit the level of nicotine in combustible cigarettes, and such regulations should consider potential effects on tobacco-related disparities. If certain subgroups of cigarette smokers are also using other combustible products, they may be particularly likely to continue dual use or switch to exclusive use of those products if a nicotine reduction standard only applies to cigarettes. Accordingly, this study provided recent U.S. nationally representative data on use of other combustible tobacco products among current cigarette smokers by sociodemographic characteristics. Data were drawn from current cigarette smokers (n = 2559) in 2016 and 2017 U.S. nationally representative surveys. Associations between sociodemographic variables (poverty status, education, race/ethnicity, sexual orientation, and mental health status) with use of little cigars and cigarillos (LCCs), traditional cigars, and hookah were examined. Among current cigarette smokers, those living in poverty, racial/ethnic minorities, and those with mental health conditions were particularly likely to use LCCs. Racial/ethnic minority smokers were more likely to smoke traditional cigars. Non-heterosexual smokers, Hispanic smokers, and smokers with mental health conditions were particularly likely to use hookah. These findings have important implications for tobacco regulatory policy and other efforts to combat tobacco-related disparities.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sI1LXo
A tutorial on individual participant data meta-analysis using Bayesian multilevel modeling to estimate alcohol intervention effects across heterogeneous studies
Publication date: Available online 23 January 2019
Source: Addictive Behaviors
Author(s): David Huh, Eun-Young Mun, Scott T. Walters, Zhengyang Zhou, David C. Atkins
Abstract
This paper provides a tutorial companion for the methodological approach implemented in Huh et al. (2015) that overcame two major challenges for individual participant data (IPD) meta-analysis. Specifically, we show how to validly combine data from heterogeneous studies with varying numbers of treatment arms, and how to analyze highly-skewed count outcomes with many zeroes (e.g., alcohol and substance use outcomes) to estimate overall effect sizes. These issues have important implications for the feasibility, applicability, and interpretation of IPD meta-analysis but have received little attention thus far in the applied research literature. We present a Bayesian multilevel modeling approach for combining multi-arm trials (i.e., those with two or more treatment groups) in a distribution-appropriate IPD analysis. Illustrative data come from Project INTEGRATE, an IPD meta-analysis study of brief motivational interventions to reduce excessive alcohol use and related harm among college students. Our approach preserves the original random allocation within studies, combines within-study estimates across all studies, overcomes between-study heterogeneity in trial design (i.e., number of treatment arms) and/or study-level missing data, and derives two related treatment outcomes in a multivariate IPD meta-analysis. This methodological approach is a favorable alternative to collapsing or excluding intervention groups within multi-arm trials, making it possible to directly compare multiple treatment arms in a one-step IPD meta-analysis. To facilitate application of the method, we provide annotated computer code in R along with the example data used in this tutorial.
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Design and testing of a 24-channel head coil for MR imaging at 3 T
Publication date: Available online 23 January 2019
Source: Magnetic Resonance Imaging
Author(s): Ye Li, Jo Lee, Lei Zhang, Qiaoyan Chen, Changjun Tie, Chao Luo, Xiaoliang Zhang, Dong Liang, Xin Liu, Hairong Zheng
Abstract
Purpose
To offer the new head coil option (with a lower channel count) of an RF coil array that provides comparable performance to the commercial 32-channel head coil.
Methods
The coil system comprised an upper shield (ten channels) and bottom section (fourteen channels). Signal-to-noise ratio (SNR) values for 2D unaccelerated imaging and the g-factor with an acceleration factor of 2–4 were evaluated in a phantom study. SNR performance and human brain and intracranial vessel wall imaging were conducted as part of the in vivo study. Both studies were conducted using the commercial head coil on the Siemens Tim Trio 3 T system for comparison.
Results
In the phantom study, the new head coil had an 8% higher SNR than the commercial head coil and demonstrated less than a 1% difference in the g-factor with the acceleration factor 2–4 in the right-to-left and anterior-to-posterior directions. In the in vivo study, the performance matched the results seen in the phantom study and showed high reproducibility in several human experiments. Structural images of the brain and intracranial vessel wall with an isotropic spatial resolution of 0.5 mm can be acquired with the new head coil.
Conclusion
This study demonstrates that the new head coil is capable of providing good SNR performance in both phantom and human experiments, can achieve similar acceleration ability compared to the commercial head coil, and is capable of obtaining brain and intracranial vessel wall images.
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Design and testing of a 24-channel head coil for MR imaging at 3 T
Publication date: Available online 23 January 2019
Source: Magnetic Resonance Imaging
Author(s): Ye Li, Jo Lee, Lei Zhang, Qiaoyan Chen, Changjun Tie, Chao Luo, Xiaoliang Zhang, Dong Liang, Xin Liu, Hairong Zheng
Abstract
Purpose
To offer the new head coil option (with a lower channel count) of an RF coil array that provides comparable performance to the commercial 32-channel head coil.
Methods
The coil system comprised an upper shield (ten channels) and bottom section (fourteen channels). Signal-to-noise ratio (SNR) values for 2D unaccelerated imaging and the g-factor with an acceleration factor of 2–4 were evaluated in a phantom study. SNR performance and human brain and intracranial vessel wall imaging were conducted as part of the in vivo study. Both studies were conducted using the commercial head coil on the Siemens Tim Trio 3 T system for comparison.
Results
In the phantom study, the new head coil had an 8% higher SNR than the commercial head coil and demonstrated less than a 1% difference in the g-factor with the acceleration factor 2–4 in the right-to-left and anterior-to-posterior directions. In the in vivo study, the performance matched the results seen in the phantom study and showed high reproducibility in several human experiments. Structural images of the brain and intracranial vessel wall with an isotropic spatial resolution of 0.5 mm can be acquired with the new head coil.
Conclusion
This study demonstrates that the new head coil is capable of providing good SNR performance in both phantom and human experiments, can achieve similar acceleration ability compared to the commercial head coil, and is capable of obtaining brain and intracranial vessel wall images.
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Feasibility of carbon‐ion radiotherapy for oral non‐squamous cell carcinomas
Abstract
Background
This study evaluated carbon‐ion radiotherapy (C‐ion RT) for oral non‐squamous cell carcinomas (non‐SCC).
Methods
We retrospectively obtained data from 74 patients who underwent C‐ion RT for oral malignancies between April 1997 and March 2016. The C‐ion RT was administered in 16 fractions at a total dose of 57.6 or 64.0 Gy (relative biological effectiveness).
Results
Forty‐three patients had salivary gland carcinomas, 29 patients had mucosal melanoma, and 2 patients had other types of pathologies. The tumors were classified as T1‐T3 (24 cases), T4a (21 cases), or T4b (29 cases). The median follow‐up was 49 months. The 5‐year rates were 78.8% for local control, 36.2% for progression‐free survival, and 58.3% for overall survival. Although 10 patients developed grade 3 osteoradionecrosis after C‐ion RT, all patients maintained their mastication and deglutition functions after sequestrectomy and prosthesis placement.
Conclusion
C‐ion RT was effective for oral non‐SCC and had acceptable toxicities.
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Feasibility of carbon‐ion radiotherapy for oral non‐squamous cell carcinomas
Abstract
Background
This study evaluated carbon‐ion radiotherapy (C‐ion RT) for oral non‐squamous cell carcinomas (non‐SCC).
Methods
We retrospectively obtained data from 74 patients who underwent C‐ion RT for oral malignancies between April 1997 and March 2016. The C‐ion RT was administered in 16 fractions at a total dose of 57.6 or 64.0 Gy (relative biological effectiveness).
Results
Forty‐three patients had salivary gland carcinomas, 29 patients had mucosal melanoma, and 2 patients had other types of pathologies. The tumors were classified as T1‐T3 (24 cases), T4a (21 cases), or T4b (29 cases). The median follow‐up was 49 months. The 5‐year rates were 78.8% for local control, 36.2% for progression‐free survival, and 58.3% for overall survival. Although 10 patients developed grade 3 osteoradionecrosis after C‐ion RT, all patients maintained their mastication and deglutition functions after sequestrectomy and prosthesis placement.
Conclusion
C‐ion RT was effective for oral non‐SCC and had acceptable toxicities.
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A comparison between collaborative and single surgeon approach in endoscopic endonasal surgery to sphenoid sinus
Abstract
Purpose
Endoscopic endonasal transsphenoidal surgery (EETS) requires abundant collaborative work between neurosurgeon and ear, nose, and throat (ENT) surgeon. In low-volume centers, however, the surgery may be carried out completely and solely by a neurosurgeon. The current study evaluates the differences in both technique and complications in the approach to the sphenoid sinus for endoscopic endonasal approach (EEA) performed solely by a single neurosurgeon compared to collaborative effort between neurosurgery and otolaryngology.
Methods
The study comprises 50 consecutive patients with intra-sellar pituitary lesions undergoing EETS. Half of the patients were operated completely by single neurosurgeon (group A) and the other half by collaboration between single ENT surgeon, as a primary surgeon during nasal step, and the neurosurgeon (group B). Both groups were assessed intra-operatively as to operative technique, average time of EEA to sphenoid sinus, and presence of endonasal structural difficulties and complications.
Results
A significant difference was recorded between both groups regarding average time of EEA to sphenoid sinus (P < 0.001) and incidence of intraoperative nasal complications (P = 0.006). There was a difference between ENT surgeon and neurosurgeon adopting the same approach to sphenoid sinus. Sphenoid sinus approaches from group B characterized by their short duration (mean 10 vs 22 min) and low incidence of intraoperative endonasal complications (4.8% vs 28%).
Conclusion
Study results emphasized the necessity of collaboration between neurosurgeon and ENT surgeon in endoscopic endonasal approaches, to efficiently deal with intraoperative endonasal difficulties and complications which pose difference for both surgeons performing the same surgical procedure.
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A comparison between collaborative and single surgeon approach in endoscopic endonasal surgery to sphenoid sinus
Abstract
Purpose
Endoscopic endonasal transsphenoidal surgery (EETS) requires abundant collaborative work between neurosurgeon and ear, nose, and throat (ENT) surgeon. In low-volume centers, however, the surgery may be carried out completely and solely by a neurosurgeon. The current study evaluates the differences in both technique and complications in the approach to the sphenoid sinus for endoscopic endonasal approach (EEA) performed solely by a single neurosurgeon compared to collaborative effort between neurosurgery and otolaryngology.
Methods
The study comprises 50 consecutive patients with intra-sellar pituitary lesions undergoing EETS. Half of the patients were operated completely by single neurosurgeon (group A) and the other half by collaboration between single ENT surgeon, as a primary surgeon during nasal step, and the neurosurgeon (group B). Both groups were assessed intra-operatively as to operative technique, average time of EEA to sphenoid sinus, and presence of endonasal structural difficulties and complications.
Results
A significant difference was recorded between both groups regarding average time of EEA to sphenoid sinus (P < 0.001) and incidence of intraoperative nasal complications (P = 0.006). There was a difference between ENT surgeon and neurosurgeon adopting the same approach to sphenoid sinus. Sphenoid sinus approaches from group B characterized by their short duration (mean 10 vs 22 min) and low incidence of intraoperative endonasal complications (4.8% vs 28%).
Conclusion
Study results emphasized the necessity of collaboration between neurosurgeon and ENT surgeon in endoscopic endonasal approaches, to efficiently deal with intraoperative endonasal difficulties and complications which pose difference for both surgeons performing the same surgical procedure.
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Depressive‐symptom‐associated IL‐1β and TNF‐α release correlates with impaired bronchodilator response and neutrophilic airway inflammation in asthma
Abstract
Background
Depressive symptoms worsen asthma outcomes; however, the mechanism remains largely unexplored.
Objective
This study aimed to determine whether depressive‐symptom‐associated immune‐inflammation correlates with impaired bronchodilator response (BDR) and airway inflammatory phenotypes.
Methods
Eligible adults with asthma (n=198) underwent clinical assessment, sputum induction, and blood sampling. Depressive symptoms were defined by scores on the depression subscale of the Hospital Anxiety and Depression Scale (HADS‐D). Pre‐ and post‐bronchodilator spirometry was performed for BDR. Airway inflammatory phenotypes were defined by sputum cell counts. CRP, IL‐1β, IL‐5, IL‐6, IL‐8, TNF‐α, IFN‐γ, CCL17 and CCL22 in serum and sputum were detected.
Results
Compared with the non‐depressive group (n=174), the depressive group (n=24) exhibited impaired BDR (P=0.032) and increased sputum neutrophils (P=0.023), which correlated with the HADS‐D scores (P=0.027 and P=0.029). Levels of IL‐1β, TNF‐α and IFN‐γ in the serum and those of IL‐1β and IFN‐γ in the sputum were elevated in the depressive group compared to those in the non‐depressive group (all P<0.05). Multiple regression models indicated that TNF‐α in the sputum and IL‐1β, IL‐6 and IFN‐γ in both the serum and sputum were inversely associated with BDR; TNF‐α in the sputum and IL‐1β in both the serum and sputum were positively correlated with sputum neutrophils. Mediation analyses revealed that IL‐1β and TNF‐α in the sputum and IL‐1β in both the serum and sputum mediate the correlations of the HADS‐D scores with BDR and sputum neutrophils, respectively.
Conclusions & Clinical Relevance
Asthma patients with depressive symptoms present worse asthma control, which is most likely explained by impaired BDR and neutrophilic airway inflammation. IL‐1β and TNF‐α, which are two key pro‐inflammatory cytokines that mediate the correlation of depressive symptoms with impaired BDR and neutrophilic airway inflammation, may serve as targeted biomarkers in the neuropsychological phenotype of asthma; however, this result needs to be further validated.
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The roadmap for the Allergology specialty and allergy care in Europe and adjacent countries. An EAACI position paper
The high prevalence of allergic diseases warrants for sufficient health care provisions available to patients with allergic diseases. Allergy care should be delivered by well-trained specialists. However, the ...
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Depressive‐symptom‐associated IL‐1β and TNF‐α release correlates with impaired bronchodilator response and neutrophilic airway inflammation in asthma
Abstract
Background
Depressive symptoms worsen asthma outcomes; however, the mechanism remains largely unexplored.
Objective
This study aimed to determine whether depressive‐symptom‐associated immune‐inflammation correlates with impaired bronchodilator response (BDR) and airway inflammatory phenotypes.
Methods
Eligible adults with asthma (n=198) underwent clinical assessment, sputum induction, and blood sampling. Depressive symptoms were defined by scores on the depression subscale of the Hospital Anxiety and Depression Scale (HADS‐D). Pre‐ and post‐bronchodilator spirometry was performed for BDR. Airway inflammatory phenotypes were defined by sputum cell counts. CRP, IL‐1β, IL‐5, IL‐6, IL‐8, TNF‐α, IFN‐γ, CCL17 and CCL22 in serum and sputum were detected.
Results
Compared with the non‐depressive group (n=174), the depressive group (n=24) exhibited impaired BDR (P=0.032) and increased sputum neutrophils (P=0.023), which correlated with the HADS‐D scores (P=0.027 and P=0.029). Levels of IL‐1β, TNF‐α and IFN‐γ in the serum and those of IL‐1β and IFN‐γ in the sputum were elevated in the depressive group compared to those in the non‐depressive group (all P<0.05). Multiple regression models indicated that TNF‐α in the sputum and IL‐1β, IL‐6 and IFN‐γ in both the serum and sputum were inversely associated with BDR; TNF‐α in the sputum and IL‐1β in both the serum and sputum were positively correlated with sputum neutrophils. Mediation analyses revealed that IL‐1β and TNF‐α in the sputum and IL‐1β in both the serum and sputum mediate the correlations of the HADS‐D scores with BDR and sputum neutrophils, respectively.
Conclusions & Clinical Relevance
Asthma patients with depressive symptoms present worse asthma control, which is most likely explained by impaired BDR and neutrophilic airway inflammation. IL‐1β and TNF‐α, which are two key pro‐inflammatory cytokines that mediate the correlation of depressive symptoms with impaired BDR and neutrophilic airway inflammation, may serve as targeted biomarkers in the neuropsychological phenotype of asthma; however, this result needs to be further validated.
This article is protected by copyright. All rights reserved.
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The roadmap for the Allergology specialty and allergy care in Europe and adjacent countries. An EAACI position paper
The high prevalence of allergic diseases warrants for sufficient health care provisions available to patients with allergic diseases. Allergy care should be delivered by well-trained specialists. However, the ...
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Comparing Gelfoam vs. fat as a sealing material in stapedotomy; A prospective double blind randomized clinical trial
Abstract
Objectives
One research aspect of stapes surgery is various materials that are used to seal the oval window. Several materials are used to seal the oval window, for example; adipose tissue, perichondrium, vein graft, gelatin sponge (Gelfoam), blood clot, and soft connective tissue. Up to now, there has been no randomized clinical trial that has evaluated the effects of different types of sealing material on hearing outcomes after stapedotomy. Hence, the present study aimed to find out which of these materials; fat or Gelfoam was associated with better hearing outcome, when used as a sealing material.
Design
This prospective, double blind, randomized clinical trial was carried out on ears that had undergone stapedotomy.
Setting
Dasthgheib Hospital affiliated to Shiraz University of Medical Sciences, a referral otology center in southern Iran.
Participants
A total of 176 primary stapedotomies were analyzed. Fat harvested from the ear lobule was used in 86 ears and Gelfoam in 90 ears.
Main outcome measures
pre‐operative and post‐operative pure tone audiometric data and incidence of sensorineural hearing loss were evaluated.
Results
Total of 90.7% of all ears in the fat group and 87.8% of ears in Gelfoam group achieved postoperative ABG within 20 dB, and this difference was not significant. There was no case of sensorineural hearing loss (defined as 10 dB or more reduction in BC threshold) in both groups in mean frequencies of 0.5‐3 kHz. There were 9 cases of sensorineural hearing loss at 4 kHz in the fat group vs. 4 in the Gelfoam group. The occurrence of sensorineural hearing loss in different frequencies was not significant between the two groups (P>0.05). In addition, there was no case of dead ear in either group.
Conclusions
We found similarity between hearing outcome in the Gelfoam and fat as sealing materials in stapedotomy. We believe that the first limitation of this study was the short term follow up in stapedotomy. The other issue is that one has to be cautious when using our result, which might not be applicable in larger fenestra stapedectomy.
This article is protected by copyright. All rights reserved.
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Comparing Gelfoam vs. fat as a sealing material in stapedotomy; A prospective double blind randomized clinical trial
Abstract
Objectives
One research aspect of stapes surgery is various materials that are used to seal the oval window. Several materials are used to seal the oval window, for example; adipose tissue, perichondrium, vein graft, gelatin sponge (Gelfoam), blood clot, and soft connective tissue. Up to now, there has been no randomized clinical trial that has evaluated the effects of different types of sealing material on hearing outcomes after stapedotomy. Hence, the present study aimed to find out which of these materials; fat or Gelfoam was associated with better hearing outcome, when used as a sealing material.
Design
This prospective, double blind, randomized clinical trial was carried out on ears that had undergone stapedotomy.
Setting
Dasthgheib Hospital affiliated to Shiraz University of Medical Sciences, a referral otology center in southern Iran.
Participants
A total of 176 primary stapedotomies were analyzed. Fat harvested from the ear lobule was used in 86 ears and Gelfoam in 90 ears.
Main outcome measures
pre‐operative and post‐operative pure tone audiometric data and incidence of sensorineural hearing loss were evaluated.
Results
Total of 90.7% of all ears in the fat group and 87.8% of ears in Gelfoam group achieved postoperative ABG within 20 dB, and this difference was not significant. There was no case of sensorineural hearing loss (defined as 10 dB or more reduction in BC threshold) in both groups in mean frequencies of 0.5‐3 kHz. There were 9 cases of sensorineural hearing loss at 4 kHz in the fat group vs. 4 in the Gelfoam group. The occurrence of sensorineural hearing loss in different frequencies was not significant between the two groups (P>0.05). In addition, there was no case of dead ear in either group.
Conclusions
We found similarity between hearing outcome in the Gelfoam and fat as sealing materials in stapedotomy. We believe that the first limitation of this study was the short term follow up in stapedotomy. The other issue is that one has to be cautious when using our result, which might not be applicable in larger fenestra stapedectomy.
This article is protected by copyright. All rights reserved.
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Use of Dipstick Assay and Rapid PCR-DNA Analysis of Nasal Secretions for Diagnosis of Bacterial Sinusitis in Children With Chronic Cough.
| Related Articles |
Use of Dipstick Assay and Rapid PCR-DNA Analysis of Nasal Secretions for Diagnosis of Bacterial Sinusitis in Children With Chronic Cough.
Allergy Rhinol (Providence). 2019 Jan-Dec;10:2152656718821281
Authors: Song C, Chorath J, Pak Y, Redjal N
Abstract
Background: Chronic cough in children is a diagnostic challenge.
Objective: To discover the utility of nasal dipsticks and polymerase chain reaction (PCR)-DNA analysis in differentiating bacterial sinusitis from other causes of chronic cough and identifying pathogens from the nasal cavity.
Method: We recruited 22 patients under 15 years of age with cough lasting longer than 4 weeks (group 1), 7 controls with allergic rhinitis (group 2), and 10 controls without respiratory symptoms (group 3). Based on symptoms, the results of nasal secretion assays, and nasal endoscopy, a diagnosis of clinical bacterial sinusitis was made. We identified potential pathogens by quantitative PCR of nasal secretions.
Results: Group 1A (cough with clinical bacterial sinusitis n = 10): Eight (80%) patients had bacterial sinusitis associated with dominant potential pathogenic bacteria (PPB): Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Group 1B (cough without clinical bacterial sinusitis n = 12): None had dominant PPB. Group 2 (allergic rhinitis n = 7): None had dominant PPB. Group 3 (asymptomatic n = 10): None had dominant PPB. Twenty to 57% of all groups were colonized with Staphylococcus aureus. Fifty to 70% were colonized with Staphylococcus epidermidis, Corynebacterium pseudodiphtheriticum, and Dolosigranulum pigrum.
Conclusion: In children with chronic cough, clinicians can utilize a simple and inexpensive nasal secretion dipstick assay for rapid diagnosis of sinusitis and identify PPB by DNA-PCR test for specific antibiotic treatment.
PMID: 30671281 [PubMed]
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Use of Dipstick Assay and Rapid PCR-DNA Analysis of Nasal Secretions for Diagnosis of Bacterial Sinusitis in Children With Chronic Cough.
| Related Articles |
Use of Dipstick Assay and Rapid PCR-DNA Analysis of Nasal Secretions for Diagnosis of Bacterial Sinusitis in Children With Chronic Cough.
Allergy Rhinol (Providence). 2019 Jan-Dec;10:2152656718821281
Authors: Song C, Chorath J, Pak Y, Redjal N
Abstract
Background: Chronic cough in children is a diagnostic challenge.
Objective: To discover the utility of nasal dipsticks and polymerase chain reaction (PCR)-DNA analysis in differentiating bacterial sinusitis from other causes of chronic cough and identifying pathogens from the nasal cavity.
Method: We recruited 22 patients under 15 years of age with cough lasting longer than 4 weeks (group 1), 7 controls with allergic rhinitis (group 2), and 10 controls without respiratory symptoms (group 3). Based on symptoms, the results of nasal secretion assays, and nasal endoscopy, a diagnosis of clinical bacterial sinusitis was made. We identified potential pathogens by quantitative PCR of nasal secretions.
Results: Group 1A (cough with clinical bacterial sinusitis n = 10): Eight (80%) patients had bacterial sinusitis associated with dominant potential pathogenic bacteria (PPB): Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Group 1B (cough without clinical bacterial sinusitis n = 12): None had dominant PPB. Group 2 (allergic rhinitis n = 7): None had dominant PPB. Group 3 (asymptomatic n = 10): None had dominant PPB. Twenty to 57% of all groups were colonized with Staphylococcus aureus. Fifty to 70% were colonized with Staphylococcus epidermidis, Corynebacterium pseudodiphtheriticum, and Dolosigranulum pigrum.
Conclusion: In children with chronic cough, clinicians can utilize a simple and inexpensive nasal secretion dipstick assay for rapid diagnosis of sinusitis and identify PPB by DNA-PCR test for specific antibiotic treatment.
PMID: 30671281 [PubMed]
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A comparison of the reproducibility of two cine-derived strain software programmes in disease states
Publication date: Available online 23 January 2019
Source: European Journal of Radiology
Author(s): MP Graham-Brown, GS Gulsin, K Parke, J Wormleighton, FY Lai, L Athithan, JR Arnold, JO Burton, GP McCann, AS Singh
Abstract
Background
Systolic strain and peak-early diastolic strain rate (PEDSR) measure subclinical cardiac dysfunction. These parameters can be derived from cardiovascular magnetic resonance (CMR) cine images using new software packages, but the comparative test-retest reproducibility of these software in disease states is unknown. This study compared the test-retest reproducibility of strain measures derived from two software packages (feature-tracking software (FT) and tissue-tracking (TT)) in disease populations with preserved ejection fractions.
Methods
This was a prospective study of 10 patients with aortic stenosis (AS), 10 haemodialysis patients and 10 diabetic patients at 1.5 and 3-Tesla. 30 subjects underwent test-retest reproducibility scans of global circumferential strain (GCS), global longitudinal strain (GLS), circumferential-PEDSR and longitudinal-PEDSR calculated using TT and FT software.
Results
Test-retest reproducibility of GCS and GLS were similar for FT and TT across patient groups. Coefficient of variability (CoV) for FT-derived GCS 8.1%, 5% and 7.9% for AS, diabetic and haemodialysis patients, compared to 3.3%, 9.2% and 5.4% for TT-derived GCS, with CoV for FT-derived GLS 8%, 6.4% and 8.2% for AS, diabetic and haemodialysis patients, compared to 5.3%, 4.8% and 7% for TT-derived GLS). Reproducibility of FT-derived circumferential and longitudinal-PEDSR was worse than TT-derived circumferential and longitudinal-PEDSR (CoV for FT-derived circumferential-PEDSR 18.2%, 18% and 17.4% for AS, diabetic and haemodialysis patients, compared to 6.1%, 11.7% and 11% for TT-derived circumferential-PEDSR with CoV for FT-derived longitudinal PEDSR 18.2%, 18.9%, 18.3% for AS, diabetic and haemodialysis patients, compared to 8.9%, 9.1% and 11.4% for TT-derived longitudinal-PEDSR). Bland-Altman analysis revealed no systematic bias with tighter limits of agreement for TT-derived strain measures.
Conclusions
Reproducibility of GCS and GLS are excellent with FT and TT software across diseases. TT had superior test-retest reproducibility for quantification of longitudinal and circumferential-PEDSR than FT-derived PEDSR across diseases.
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A comparison of the reproducibility of two cine-derived strain software programmes in disease states
Publication date: Available online 23 January 2019
Source: European Journal of Radiology
Author(s): MP Graham-Brown, GS Gulsin, K Parke, J Wormleighton, FY Lai, L Athithan, JR Arnold, JO Burton, GP McCann, AS Singh
Abstract
Background
Systolic strain and peak-early diastolic strain rate (PEDSR) measure subclinical cardiac dysfunction. These parameters can be derived from cardiovascular magnetic resonance (CMR) cine images using new software packages, but the comparative test-retest reproducibility of these software in disease states is unknown. This study compared the test-retest reproducibility of strain measures derived from two software packages (feature-tracking software (FT) and tissue-tracking (TT)) in disease populations with preserved ejection fractions.
Methods
This was a prospective study of 10 patients with aortic stenosis (AS), 10 haemodialysis patients and 10 diabetic patients at 1.5 and 3-Tesla. 30 subjects underwent test-retest reproducibility scans of global circumferential strain (GCS), global longitudinal strain (GLS), circumferential-PEDSR and longitudinal-PEDSR calculated using TT and FT software.
Results
Test-retest reproducibility of GCS and GLS were similar for FT and TT across patient groups. Coefficient of variability (CoV) for FT-derived GCS 8.1%, 5% and 7.9% for AS, diabetic and haemodialysis patients, compared to 3.3%, 9.2% and 5.4% for TT-derived GCS, with CoV for FT-derived GLS 8%, 6.4% and 8.2% for AS, diabetic and haemodialysis patients, compared to 5.3%, 4.8% and 7% for TT-derived GLS). Reproducibility of FT-derived circumferential and longitudinal-PEDSR was worse than TT-derived circumferential and longitudinal-PEDSR (CoV for FT-derived circumferential-PEDSR 18.2%, 18% and 17.4% for AS, diabetic and haemodialysis patients, compared to 6.1%, 11.7% and 11% for TT-derived circumferential-PEDSR with CoV for FT-derived longitudinal PEDSR 18.2%, 18.9%, 18.3% for AS, diabetic and haemodialysis patients, compared to 8.9%, 9.1% and 11.4% for TT-derived longitudinal-PEDSR). Bland-Altman analysis revealed no systematic bias with tighter limits of agreement for TT-derived strain measures.
Conclusions
Reproducibility of GCS and GLS are excellent with FT and TT software across diseases. TT had superior test-retest reproducibility for quantification of longitudinal and circumferential-PEDSR than FT-derived PEDSR across diseases.
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A case of dedifferentiated carcinoma occurring in adenoid cystic carcinoma of the submandibular gland with multiple metastasis
Publication date: Available online 23 January 2019
Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Kazutaka Kimura, Yuichi Ohnishi, Tomoko Fujii, Kenji Kakudo, Masaki Akane
Abstract
Dedifferentiated adenoid cystic carcinoma (ACC) are rare variant of ACC characterized histologically by two components: conventional low-grade ACC and high-grade "dedifferentiated" carcinoma. We report a case of dedifferentiated carcinoma occurring in ACC of the submandibular gland with multiple distant metastasis. The patient, a 39-year-old woman was referred to our hospital because of submandibular gland carcinoma with multiple distant metastasis. We underwent a right neck dissection and right submandibular gland tumor resection. Histologically, the low-grade ACC merged gradually into an extensive dedifferentiated component that was composed of solid sheets and cords of anaplastic tumor cells with focal gland formation, and distant metastasis contained dedifferentiated component. We planned the treatment of postoperative radiotherapy and chemotherapy. But the patient is a Chinese living in Japan, so she wish to receive the treatment of post-operative in China and she returned to China.
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Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta‐analysis
Abstract
Objective
To assess the prevalence of oral mucosal disorders during pregnancy.
Methods
Observational studies were selected by two reviewers in a two‐phase process. Search strategies were applied at CINAHL, LILACS, LIVIVO, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated by the software R Statistics version 3.5.1 (The R Foundation, Vienna, Austria). Confidence in cumulative evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.
Results
Fifteen studies met the eligibility criteria and were selected for qualitative synthesis and meta‐analysis, of which 5,935 participants were enrolled. The overall prevalence of oral mucosal disorders was 11.8%. Gingival hyperplasia (17.1%), morsicatio buccarum (10%), oral candidiasis (4.4%), pyogenic granuloma (3%), and benign migratory glossitis (2.8%) were the most prevalent lesions. The overall risk of bias was considered moderate and the quality of evidence was very low.
Conclusion
Disorders of the oral mucosa were present in approximately 1 out of 10 pregnant women. Gingival hyperplasia was the most prevalent lesion. Further studies should apply homogeneous methodology to improve the quality of evidence.
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