Time-resolved quantitative evaluation of diaphragmatic motion during forced breathing in a health screening cohort in a standing position: Dynamic chest phrenicography

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Tomoyuki Hida, Yoshitake Yamada, Masako Ueyama, Tetsuro Araki, Mizuki Nishino, Atsuko Kurosaki, Masahiro Jinzaki, Hiroshi Honda, Hiroto Hatabu, Shoji Kudoh

Abstract

Objective

To assess diaphragmatic motion during forced breathing in a health screening center cohort by time-resolved quantitative analysis using dynamic chest radiography and demonstrate the characteristics and associations with demographics and pulmonary function of participants.

Materials and methods

This prospective study includes 174 volunteers (99 males; median 57, range 36-93 years old) that underwent dynamic chest radiography with a flat panel detector system during forced breathing in a standing position. We automatically tracked and recorded the positions of the top of the diaphragms and the excursions on images of each participant and calculated peak motion speeds based on the data. We investigated the associations with demographics and pulmonary function statistically.

Results

The average excursions of the diaphragms during forced breathing were 49.1 ± 17.0 mm (right; mean ± standard deviation) and 52.1 ± 15.9 mm (left). The peak motion speeds were 26.7 ± 10.0 mm/s (right) and 32.2 ± 12.4 mm/s (left) in the inspiratory phase and 22.1 ± 12.7 mm/s (right) and 24.3 ± 10.3 mm/s (left) in the expiratory phase. Excursions and peak motion speeds of the left diaphragm were significantly greater than the right. Higher body mass index (BMI) and vital capacity (VC) were associated with greater excursions and faster peak motion speeds of the diaphragms.

Conclusions

Time-resolved quantitative analysis of the diaphragms with dynamic chest radiography demonstrated the characteristics of diaphragmatic motion during forced breathing in a health screening cohort. Higher BMI and VC were associated with excursions and peak motion speeds of the diaphragms.

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Does patellar alignment or trochlear morphology predict worsening of patellofemoral disease within the first 5 years after anterior cruciate ligament reconstruction?

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Erin M Macri, Brooke E Patterson, Kay M Crossley, Josh J Stefanik, Ali Guermazi, Evelina Blomqwist, Karim M Khan, Tim S Whitehead, Hayden G Morris, Adam G Culvenor

Abstract

Purpose

We described patellofemoral alignment and trochlear morphology at one and five years after anterior cruciate ligament reconstruction (ACLR), and evaluated the associations between alignment and trochlear morphology (at one year) and worsening patellofemoral osteoarthritis (OA) features by five years. We also evaluated the associations between alignment and morphology to self-reported pain and function (Knee injury and Osteoarthritis Outcome Score, KOOS) at five years.

Materials and methods

In this longitudinal observational study, we followed 73 participants (mean age 29[9] years, 40% women) from one- to five-years after ACLR. Using MRI, we measured alignment and morphology, and scored cartilage and bone marrow lesions at both time points. We used mixed effects and linear regression models to achieve our stated aims.

Results

Greater lateral patella displacement increased risk of cartilage worsening (Odds Ratio [95% CI]: 1.09 [1.01, 1.16]); while less lateral tilt (0.91 [0.83, 0.99]) and greater trochlear angle (0.88 [0.77, 1.00]) were protective. Greater medial trochlear inclination increased risk of bone marrow lesion worsening (1.12 [1.04, 1.19]); while greater trochlear angle was protective (0.80 [0.67, 0.96]). Greater lateral displacement was associated with worse self-reported KOOS sport and recreation scores (β [95% CI]: -11.0 [-20.9, -1.2]) and quality of life scores (-10.5 [-20.4, -0.7]).

Conclusions

Lateral displacement, lateral tilt, and morphology at 1 year post-ACLR altered the risk of worsening patellofemoral OA features four years later. Lateral displacement was the only measure associated with worse self-reported symptoms at five years. These findings may lead to novel treatment strategies for secondary prevention after ACLR.

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MR features based on LI-RADS identify cytokeratin 19 status of hepatocellular carcinomas

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Xin-Xing Hu, Wen-Tao Wang, Li Yang, Zhao-Xia Yang, He-Yue Liang, Ying Ding, Yuan Ji, Meng-Su Zeng, Sheng-Xiang Rao

Abstract

Objective

To retrospectively evaluate the value of MR features based on Liver Imaging Reporting and Data System (LI-RADS ver.2017) for identifying the status of cytokeratin (CK) 19 expression of HCC before surgery.

Methods

A total of 201 patients with 207 HCCs who underwent MR imaging were reviewed retrospectively. MR features based on LI-RADS ver.2017 as well as clinical data were compared between CK19-positive (n = 51) and CK19-negative (n = 156) HCCs groups. Potential predictive parameters were identified by univariate and multivariate logistic regression analysis and diagnostic odds ratios (ORs) were recorded.

Results

MR features including targetoid appearance (p = 0.001) was more frequently observed while non-peripheral "washout" (p < 0.0001) and non-rim arterial phase hyper-enhancement (p < 0.0001) were found less frequently in CK19-positive HCCs compared to CK19-negative HCCs. At multivariate analysis, serum alphafetoprotein (AFP)>20 ng/ml (OR = 5.9) and targetoid appearance (OR = 4.2) and non-peripheral "washout" (OR = 0.2) were significant independent predictors of CK19-positive HCCs.

Conclusion

Targetoid appearance and absence non-peripheral "washout" combined with elevated AFP were useful for differentiating CK19-positive HCCs from CK19-negative HCC.

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Medical-grade polycaprolactone scaffolds made by melt electrospinning writing for oral bone regeneration – a pilot study in vitro

Abstract

Background

The spectrum of indications for the use of membranes and scaffolds in the field of oral and maxillofacial surgery includes, amongst others, guided bone regeneration (GBR). Currently available membrane systems face certain disadvantages such as difficult clinical handling, inconsistent degradation, undirected cell growth and a lack of stability that often complicate their application. Therefore, new membranes which can overcome these issues are of great interest in this field.

Methods

In this pilot study, we investigated polycaprolactone (PCL) scaffolds intended to enhance oral wound healing by means of melt electrospinning writing (MEW), which allowed for three-dimensional (3D) printing of micron scale fibers and very exact fiber placement. A singular set of box-shaped scaffolds of different sizes consisting of medical-grade PCL was examined and the scaffolds' morphology was evaluated via scanning electron microscopy (SEM). Each prototype sample with box sizes of 225 μm, 300 μm, 375 μm, 450 μm and 500 μm was assessed for cytotoxicity and cell growth by seeding each scaffold with human osteoblast-like cell line MG63.

Results

All scaffolds demonstrated good cytocompatibility according to cell viability, protein concentration, and cell number. SEM analysis revealed an exact fiber placement of the MEW scaffolds and the growth of viable MG63 cells on them. For the examined box-shaped scaffolds with pore sizes between 225 μm and 500 μm, a preferred box size for initial osteoblast attachment could not be found.

Conclusions

These well-defined 3D scaffolds consisting of medical-grade materials optimized for cell attachment and cell growth hold the key to a promising new approach in GBR in oral and maxillofacial surgery.

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Deep Learning for Segmentation of 49 Selected Bones in CT Scans: First Step in Automated PET/CT-based 3D Quantification of Skeletal Metastases

Publication date: Available online 1 February 2019

Source: European Journal of Radiology

Author(s): Sarah Lindgren Belal, May Sadik, Reza Kaboteh, Olof Enqvist, Johannes Ulén, Mads H. Poulsen, Jane Simonsen, Poul F. Hoilund-Carlsen, Lars Edenbrandt, Elin Trägårdh

Abstract

Purpose

The aim of this study was to develop a deep learning-based method for segmentation of bones in CT scans and test its accuracy compared to manual delineation, as a first step in the creation of an automated PET/CT-based method for quantifying skeletal tumour burden.

Methods

Convolutional neural networks (CNNs) were trained to segment 49 bones using manual segmentations from 100 CT scans. After training, the CNN-based segmentation method was tested on 46 patients with prostate cancer, who had undergone ¹⁸F-choline-PET/CT and ¹⁸F-NaF PET/CT less than three weeks apart. Bone volumes were calculated from the segmentations. The network's performance was compared with manual segmentations of five bones made by an experienced physician. Accuracy of the spatial overlap between automated CNN-based and manual segmentations of these five bones was assessed using the Sørensen-Dice index (SDI). Reproducibility was evaluated applying the Bland-Altman method.

Results

The median (SD) volumes of the five selected bones were by CNN and manual segmentation: Th7 41 (3.8) and 36 (5.1), L3 76 (13) and 75 (9.2), sacrum 284 (40) and 283 (26), 7^th rib 33 (3.9) and 31 (4.8), sternum 80 (11) and 72 (9.2), respectively. Median SDIs were 0.86 (Th7), 0.85 (L3), 0.88 (sacrum), 0.84 (7^th rib) and 0.83 (sternum). The intraobserver volume difference was less with CNN-based than manual approach: Th7 2% and 14%, L3 7% and 8%, sacrum 1% and 3%, 7^th rib 1% and 6%, sternum 3% and 5%, respectively. The average volume difference measured as ratio volume difference/mean volume between the two CNN-based segmentations was 5-6% for the vertebral column and ribs and ≤3% for other bones.

Conclusion

The new deep learning-based method for automated segmentation of bones in CT scans provided highly accurate bone volumes in a fast and automated way and, thus, appears to be a valuable first step in the development of a clinical useful processing procedure providing reliable skeletal segmentation as a key part of quantification of skeletal metastases.

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Hepatic capsular retraction: an updated MR imaging review

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Catherine E.P. Panick, Ryan D. Ward, Christopher Coppa, Peter S. Liu

Abstract

Hepatic capsular retraction is a morphologic descriptor that refers to invagination or focal flattening of the typical smooth contour of the liver capsule. It is an uncommon finding that, when combined with other imaging features and clinical context, can help to refine the differential diagnosis in patients with liver lesions. Although this descriptor has historically been used in reference to a small subset of benign and malignant lesions, the differential has since been expanded with the discovery of new entities causing capsular retraction as well as with novel and increased use of liver-directed treatment techniques. Additionally, modern imaging techniques now allow for improved detection and characterization of capsular retraction. In this review, we discuss these common and uncommon causes of capsular retraction, with an emphasis on findings from body MRI.

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Time-resolved quantitative evaluation of diaphragmatic motion during forced breathing in a health screening cohort in a standing position: Dynamic chest phrenicography

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Tomoyuki Hida, Yoshitake Yamada, Masako Ueyama, Tetsuro Araki, Mizuki Nishino, Atsuko Kurosaki, Masahiro Jinzaki, Hiroshi Honda, Hiroto Hatabu, Shoji Kudoh

Abstract

Objective

To assess diaphragmatic motion during forced breathing in a health screening center cohort by time-resolved quantitative analysis using dynamic chest radiography and demonstrate the characteristics and associations with demographics and pulmonary function of participants.

Materials and methods

This prospective study includes 174 volunteers (99 males; median 57, range 36-93 years old) that underwent dynamic chest radiography with a flat panel detector system during forced breathing in a standing position. We automatically tracked and recorded the positions of the top of the diaphragms and the excursions on images of each participant and calculated peak motion speeds based on the data. We investigated the associations with demographics and pulmonary function statistically.

Results

The average excursions of the diaphragms during forced breathing were 49.1 ± 17.0 mm (right; mean ± standard deviation) and 52.1 ± 15.9 mm (left). The peak motion speeds were 26.7 ± 10.0 mm/s (right) and 32.2 ± 12.4 mm/s (left) in the inspiratory phase and 22.1 ± 12.7 mm/s (right) and 24.3 ± 10.3 mm/s (left) in the expiratory phase. Excursions and peak motion speeds of the left diaphragm were significantly greater than the right. Higher body mass index (BMI) and vital capacity (VC) were associated with greater excursions and faster peak motion speeds of the diaphragms.

Conclusions

Time-resolved quantitative analysis of the diaphragms with dynamic chest radiography demonstrated the characteristics of diaphragmatic motion during forced breathing in a health screening cohort. Higher BMI and VC were associated with excursions and peak motion speeds of the diaphragms.

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Does patellar alignment or trochlear morphology predict worsening of patellofemoral disease within the first 5 years after anterior cruciate ligament reconstruction?

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Erin M Macri, Brooke E Patterson, Kay M Crossley, Josh J Stefanik, Ali Guermazi, Evelina Blomqwist, Karim M Khan, Tim S Whitehead, Hayden G Morris, Adam G Culvenor

Abstract

Purpose

We described patellofemoral alignment and trochlear morphology at one and five years after anterior cruciate ligament reconstruction (ACLR), and evaluated the associations between alignment and trochlear morphology (at one year) and worsening patellofemoral osteoarthritis (OA) features by five years. We also evaluated the associations between alignment and morphology to self-reported pain and function (Knee injury and Osteoarthritis Outcome Score, KOOS) at five years.

Materials and methods

In this longitudinal observational study, we followed 73 participants (mean age 29[9] years, 40% women) from one- to five-years after ACLR. Using MRI, we measured alignment and morphology, and scored cartilage and bone marrow lesions at both time points. We used mixed effects and linear regression models to achieve our stated aims.

Results

Greater lateral patella displacement increased risk of cartilage worsening (Odds Ratio [95% CI]: 1.09 [1.01, 1.16]); while less lateral tilt (0.91 [0.83, 0.99]) and greater trochlear angle (0.88 [0.77, 1.00]) were protective. Greater medial trochlear inclination increased risk of bone marrow lesion worsening (1.12 [1.04, 1.19]); while greater trochlear angle was protective (0.80 [0.67, 0.96]). Greater lateral displacement was associated with worse self-reported KOOS sport and recreation scores (β [95% CI]: -11.0 [-20.9, -1.2]) and quality of life scores (-10.5 [-20.4, -0.7]).

Conclusions

Lateral displacement, lateral tilt, and morphology at 1 year post-ACLR altered the risk of worsening patellofemoral OA features four years later. Lateral displacement was the only measure associated with worse self-reported symptoms at five years. These findings may lead to novel treatment strategies for secondary prevention after ACLR.

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MR features based on LI-RADS identify cytokeratin 19 status of hepatocellular carcinomas

Publication date: Available online 31 January 2019

Source: European Journal of Radiology

Author(s): Xin-Xing Hu, Wen-Tao Wang, Li Yang, Zhao-Xia Yang, He-Yue Liang, Ying Ding, Yuan Ji, Meng-Su Zeng, Sheng-Xiang Rao

Abstract

Objective

To retrospectively evaluate the value of MR features based on Liver Imaging Reporting and Data System (LI-RADS ver.2017) for identifying the status of cytokeratin (CK) 19 expression of HCC before surgery.

Methods

A total of 201 patients with 207 HCCs who underwent MR imaging were reviewed retrospectively. MR features based on LI-RADS ver.2017 as well as clinical data were compared between CK19-positive (n = 51) and CK19-negative (n = 156) HCCs groups. Potential predictive parameters were identified by univariate and multivariate logistic regression analysis and diagnostic odds ratios (ORs) were recorded.

Results

MR features including targetoid appearance (p = 0.001) was more frequently observed while non-peripheral "washout" (p < 0.0001) and non-rim arterial phase hyper-enhancement (p < 0.0001) were found less frequently in CK19-positive HCCs compared to CK19-negative HCCs. At multivariate analysis, serum alphafetoprotein (AFP)>20 ng/ml (OR = 5.9) and targetoid appearance (OR = 4.2) and non-peripheral "washout" (OR = 0.2) were significant independent predictors of CK19-positive HCCs.

Conclusion

Targetoid appearance and absence non-peripheral "washout" combined with elevated AFP were useful for differentiating CK19-positive HCCs from CK19-negative HCC.

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Medical-grade polycaprolactone scaffolds made by melt electrospinning writing for oral bone regeneration – a pilot study in vitro

Abstract

Background

The spectrum of indications for the use of membranes and scaffolds in the field of oral and maxillofacial surgery includes, amongst others, guided bone regeneration (GBR). Currently available membrane systems face certain disadvantages such as difficult clinical handling, inconsistent degradation, undirected cell growth and a lack of stability that often complicate their application. Therefore, new membranes which can overcome these issues are of great interest in this field.

Methods

In this pilot study, we investigated polycaprolactone (PCL) scaffolds intended to enhance oral wound healing by means of melt electrospinning writing (MEW), which allowed for three-dimensional (3D) printing of micron scale fibers and very exact fiber placement. A singular set of box-shaped scaffolds of different sizes consisting of medical-grade PCL was examined and the scaffolds' morphology was evaluated via scanning electron microscopy (SEM). Each prototype sample with box sizes of 225 μm, 300 μm, 375 μm, 450 μm and 500 μm was assessed for cytotoxicity and cell growth by seeding each scaffold with human osteoblast-like cell line MG63.

Results

All scaffolds demonstrated good cytocompatibility according to cell viability, protein concentration, and cell number. SEM analysis revealed an exact fiber placement of the MEW scaffolds and the growth of viable MG63 cells on them. For the examined box-shaped scaffolds with pore sizes between 225 μm and 500 μm, a preferred box size for initial osteoblast attachment could not be found.

Conclusions

These well-defined 3D scaffolds consisting of medical-grade materials optimized for cell attachment and cell growth hold the key to a promising new approach in GBR in oral and maxillofacial surgery.

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Is Image Interpretation a Sustainable Form of Advanced Practice in Medical Imaging?

Publication date: Available online 1 February 2019

Source: Journal of Medical Imaging and Radiation Sciences

Author(s): Christopher M. Hayre, Jerome Atutornu

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Is Image Interpretation a Sustainable Form of Advanced Practice in Medical Imaging?

Publication date: Available online 1 February 2019

Source: Journal of Medical Imaging and Radiation Sciences

Author(s): Christopher M. Hayre, Jerome Atutornu

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A Feasibility Study of a Patient-Centered Educational Strategy for Rampant Inhaler Misuse among Minority Children with Asthma

Publication date: Available online 31 January 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Anna Volerman, Madeleine M. Toups, Ashley Hull, Valerie G. Press

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The endoscopic endonasal approach for pediatric craniopharyngiomas

Publication date: Available online 1 February 2019

Source: Operative Techniques in Otolaryngology-Head and Neck Surgery

Author(s): Ian J. Koszewski, Hermes G. Garcia, William Parkes, Chandala Chitguppi, Mindy R. Rabinowitz, Gurston G. Nyquist, James J. Evans, Marc R. Rosen

Craniopharyngiomas are rare but challenging tumors of the ventral skull base affecting primarily pediatric patients. In select cases, the endoscopic endonasal approach represents an appropriate surgical option when tumor resection is favored. However, nuances of the pediatric nasal corridor must be carefully considered to optimize both tumor resection and skull base reconstruction. Here we review pertinent developmental details, options for creation of an optimal endonasal corridor, principles of tumor resection, and techniques for reconstruction. Considerations for intraoperative and postoperative patient care are also reviewed.

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Editorial Board

Publication date: February 2019

Source: Annales de Chirurgie Plastique Esthétique, Volume 64, Issue 1

Author(s):

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A Feasibility Study of a Patient-Centered Educational Strategy for Rampant Inhaler Misuse among Minority Children with Asthma

Publication date: Available online 31 January 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Anna Volerman, Madeleine M. Toups, Ashley Hull, Valerie G. Press

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The endoscopic endonasal approach for pediatric craniopharyngiomas

Publication date: Available online 1 February 2019

Source: Operative Techniques in Otolaryngology-Head and Neck Surgery

Author(s): Ian J. Koszewski, Hermes G. Garcia, William Parkes, Chandala Chitguppi, Mindy R. Rabinowitz, Gurston G. Nyquist, James J. Evans, Marc R. Rosen

Craniopharyngiomas are rare but challenging tumors of the ventral skull base affecting primarily pediatric patients. In select cases, the endoscopic endonasal approach represents an appropriate surgical option when tumor resection is favored. However, nuances of the pediatric nasal corridor must be carefully considered to optimize both tumor resection and skull base reconstruction. Here we review pertinent developmental details, options for creation of an optimal endonasal corridor, principles of tumor resection, and techniques for reconstruction. Considerations for intraoperative and postoperative patient care are also reviewed.

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Editorial Board

Publication date: February 2019

Source: Annales de Chirurgie Plastique Esthétique, Volume 64, Issue 1

Author(s):

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Automatic Breast and Fibroglandular Tissue Segmentation in Breast MRI Using Deep Learning by a Fully-Convolutional Residual Neural Network U-Net

Publication date: Available online 31 January 2019

Source: Academic Radiology

Author(s): Yang Zhang, Jeon-Hor Chen, Kai-Ting Chang, Vivian Youngjean Park, Min Jung Kim, Siwa Chan, Peter Chang, Daniel Chow, Alex Luk, Tiffany Kwong, Min-Ying Su

Rationale and Objectives

Breast segmentation using the U-net architecture was implemented and tested in independent validation datasets to quantify fibroglandular tissue volume in breast MRI.

Materials and Methods

Two datasets were used. The training set was MRI of 286 patients with unilateral breast cancer. The segmentation was done on the contralateral normal breasts. The ground truth for the breast and fibroglandular tissue (FGT) was obtained by using a template-based segmentation method. The U-net deep learning algorithm was implemented to analyze the training set, and the final model was obtained using 10-fold cross-validation. The independent validation set was MRI of 28 normal volunteers acquired using four different MR scanners. Dice Similarity Coefficient (DSC), voxel-based accuracy, and Pearson's correlation were used to evaluate the performance.

Results

For the 10-fold cross-validation in the initial training set of 286 patients, the DSC range was 0.83–0.98 (mean 0.95 ± 0.02) for breast and 0.73–0.97 (mean 0.91 ± 0.03) for FGT; and the accuracy range was 0.92–0.99 (mean 0.98 ± 0.01) for breast and 0.87–0.99 (mean 0.97 ± 0.01) for FGT. For the entire 224 testing breasts of the 28 normal volunteers in the validation datasets, the mean DSC was 0.86 ± 0.05 for breast, 0.83 ± 0.06 for FGT; and the mean accuracy was 0.94 ± 0.03 for breast and 0.93 ± 0.04 for FGT. The testing results for MRI acquired using four different scanners were comparable.

Conclusion

Deep learning based on the U-net algorithm can achieve accurate segmentation results for the breast and FGT on MRI. It may provide a reliable and efficient method to process large number of MR images for quantitative analysis of breast density.

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Automatic Breast and Fibroglandular Tissue Segmentation in Breast MRI Using Deep Learning by a Fully-Convolutional Residual Neural Network U-Net

Publication date: Available online 31 January 2019

Source: Academic Radiology

Author(s): Yang Zhang, Jeon-Hor Chen, Kai-Ting Chang, Vivian Youngjean Park, Min Jung Kim, Siwa Chan, Peter Chang, Daniel Chow, Alex Luk, Tiffany Kwong, Min-Ying Su

Rationale and Objectives

Breast segmentation using the U-net architecture was implemented and tested in independent validation datasets to quantify fibroglandular tissue volume in breast MRI.

Materials and Methods

Two datasets were used. The training set was MRI of 286 patients with unilateral breast cancer. The segmentation was done on the contralateral normal breasts. The ground truth for the breast and fibroglandular tissue (FGT) was obtained by using a template-based segmentation method. The U-net deep learning algorithm was implemented to analyze the training set, and the final model was obtained using 10-fold cross-validation. The independent validation set was MRI of 28 normal volunteers acquired using four different MR scanners. Dice Similarity Coefficient (DSC), voxel-based accuracy, and Pearson's correlation were used to evaluate the performance.

Results

For the 10-fold cross-validation in the initial training set of 286 patients, the DSC range was 0.83–0.98 (mean 0.95 ± 0.02) for breast and 0.73–0.97 (mean 0.91 ± 0.03) for FGT; and the accuracy range was 0.92–0.99 (mean 0.98 ± 0.01) for breast and 0.87–0.99 (mean 0.97 ± 0.01) for FGT. For the entire 224 testing breasts of the 28 normal volunteers in the validation datasets, the mean DSC was 0.86 ± 0.05 for breast, 0.83 ± 0.06 for FGT; and the mean accuracy was 0.94 ± 0.03 for breast and 0.93 ± 0.04 for FGT. The testing results for MRI acquired using four different scanners were comparable.

Conclusion

Deep learning based on the U-net algorithm can achieve accurate segmentation results for the breast and FGT on MRI. It may provide a reliable and efficient method to process large number of MR images for quantitative analysis of breast density.

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A novel training-free externally-regulated neurofeedback (ER-NF) system using phase-guided visual stimulation for alpha modulation

Publication date: Available online 1 February 2019

Source: NeuroImage

Author(s): Gan Huang, Jia Liu, Linling Li, Li Zhang, Yixuan Zeng, Lijie Ren, Shiqing Ye, Zhiguo Zhang

Abstract

The efficacy of neurofeedback is a point of great controversy, because a certain proportion of users cannot properly regulate their brain activities and thereby fail to benefit from neurofeedback. To address the neurofeedback inefficacy problem, the present study is aimed to design and implement a new neurofeedback system that can more effectively and consistently regulate users' brain activities than the conventional way of training users to voluntarily regulate brain activities. The new neurofeedback system delivers external visual stimuli continuously at a specific alpha phase, which is real-time decoded from ongoing alpha wave, to regulate the alpha wave. Experimental results show that the proposed training-free externally-regulated neurofeedback (ER-NF) system can achieve consistent (effective in almost all sessions for almost all users), flexible (either increasing or decreasing peak alpha frequency and alpha power), and immediate (taking or losing effect immediately after stimulation is on or off) modulation effects on alpha wave. Therefore, the ER-NF system holds great potential to be able to more reliably and flexibly modulate cognition and behavior.

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A novel training-free externally-regulated neurofeedback (ER-NF) system using phase-guided visual stimulation for alpha modulation

Publication date: Available online 1 February 2019

Source: NeuroImage

Author(s): Gan Huang, Jia Liu, Linling Li, Li Zhang, Yixuan Zeng, Lijie Ren, Shiqing Ye, Zhiguo Zhang

Abstract

The efficacy of neurofeedback is a point of great controversy, because a certain proportion of users cannot properly regulate their brain activities and thereby fail to benefit from neurofeedback. To address the neurofeedback inefficacy problem, the present study is aimed to design and implement a new neurofeedback system that can more effectively and consistently regulate users' brain activities than the conventional way of training users to voluntarily regulate brain activities. The new neurofeedback system delivers external visual stimuli continuously at a specific alpha phase, which is real-time decoded from ongoing alpha wave, to regulate the alpha wave. Experimental results show that the proposed training-free externally-regulated neurofeedback (ER-NF) system can achieve consistent (effective in almost all sessions for almost all users), flexible (either increasing or decreasing peak alpha frequency and alpha power), and immediate (taking or losing effect immediately after stimulation is on or off) modulation effects on alpha wave. Therefore, the ER-NF system holds great potential to be able to more reliably and flexibly modulate cognition and behavior.

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Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

Publication date: Available online 1 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J.T. Zupnik, M. Ioshida, M. Yatabe, A.C.O. Ruellas, L.R. Gomes, S. Aronovich, E. Benavides, S.P. Edwards, B. Paniagua, L.H.S. Cevidanes

Abstract

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3 ± 9.47 years) and 14 patients with skeletal class III (mean age 25.6 ± 6.27 years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann–Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P = 0.002) and inferior (P = 0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P = 0.024) and superior (P = 0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P = 0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.

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

Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study

Publication date: Available online 1 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): W.G. van Nimwegen, G.M. Raghoebar, A. Vissink, H.J.A. Meijer

Abstract

Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1–3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preservation, delayed implant placement and immediate provisionalization, (4) delayed implant placement and guided bone regeneration with delayed provisionalization, (5) guided bone regeneration (extensive bone augmentation of the alveolar ridge), delayed implant placement, and delayed provisionalization. The patients were assessed regarding peri-implant hard and soft tissue parameters, aesthetic index score, and patient satisfaction. All treatment options showed good clinical and radiographic results and high patient satisfaction.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1f30g

Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

Publication date: Available online 1 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): J.T. Zupnik, M. Ioshida, M. Yatabe, A.C.O. Ruellas, L.R. Gomes, S. Aronovich, E. Benavides, S.P. Edwards, B. Paniagua, L.H.S. Cevidanes

Abstract

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3 ± 9.47 years) and 14 patients with skeletal class III (mean age 25.6 ± 6.27 years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann–Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P = 0.002) and inferior (P = 0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P = 0.024) and superior (P = 0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P = 0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.

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

Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study

Publication date: Available online 1 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): W.G. van Nimwegen, G.M. Raghoebar, A. Vissink, H.J.A. Meijer

Abstract

Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1–3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preservation, delayed implant placement and immediate provisionalization, (4) delayed implant placement and guided bone regeneration with delayed provisionalization, (5) guided bone regeneration (extensive bone augmentation of the alveolar ridge), delayed implant placement, and delayed provisionalization. The patients were assessed regarding peri-implant hard and soft tissue parameters, aesthetic index score, and patient satisfaction. All treatment options showed good clinical and radiographic results and high patient satisfaction.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1f30g

Susceptibility and perceptions of excessive internet use impact on health among Vietnamese youths

Publication date: Available online 31 January 2019

Source: Addictive Behaviors

Author(s): Ha Ngoc Do, Brenda Onyango, Roshni Prakash, Bach Xuan Tran, Quang Nhat Nguyen, Long Hoang Nguyen, Hoa Quynh Thi Nguyen, Anh Tuan Nguyen, Hiep Duy Nguyen, Thanh Phuong Bui, Thao Bich Thi Vu, Khiet Thanh Le, Dung Tuan Nguyen, Anh Kim Dang, Nam Ba Nguyen, Carl A. Latkin, Cyrus S.H. Ho, Roger C.M. Ho

Abstract

Studies performed worldwide show excessive Internet use could have a negative impact on health. However, Internet use studies in Vietnam are limited. In this study, we reported a high prevalence of frequent Internet usage among Vietnamese youth between 16 and 30 years old. Of 1200 participants, almost 65% reported using the Internet daily. Moreover, 34.3% of the participants reported feeling anxious or uncomfortable after not using the Internet for one day irrespective of their gender, and 40% believed using the Internet frequently did not affect their health. Of those, there was a higher proportion of women than men that held this belief (42.1% vs. 35.9%, respectively, p = .03). In this cohort, undergraduate students were more likely than blue-collar workers to believe that frequent Internet use could affect health. Yet, undergraduate [OR = 1.50, 95%CI = (1.08, 2.09), p < .05)] and high school students (OR = 1.54, 95%CI = 1.00, 2.37), p < .1) were more likely than blue collar workers to feel anxious or uncomfortable after a day without the Internet. Participants in urban areas were more than twice as likely than those from rural areas to believe the Internet did not affect their health [(OR = 0.60, 95%CI = (0.41,0.89), p < .01)]. Lastly, participants between 16 and 18 years old were less likely to believe in the negative impact of the Internet on health than older participants. A better understanding of factors underlying high Internet usage and low perception of its health effects among Vietnamese youth might help develop better intervention strategies for Internet Use Disorder and other Technology Related Use Disorders.

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

A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England

The quality of life of people receiving health and social care is an important indicator of service quality, but the relationship between patient experience and outcomes and regulator quality ratings in Englan...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RxlhA2

Psychometric properties of the Spanish version of the once-daily Urticaria Activity Score (UAS) in patients with chronic spontaneous urticaria managed in clinical practice (the EVALUAS study)

The daily diary Urticaria Activity Score (UAS) and its weekly score (UAS7) are widely used to assess signs and symptoms in patients with chronic spontaneous urticaria (CSU). The objective of this study was to ...

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

Susceptibility and perceptions of excessive internet use impact on health among Vietnamese youths

Publication date: Available online 31 January 2019

Source: Addictive Behaviors

Author(s): Ha Ngoc Do, Brenda Onyango, Roshni Prakash, Bach Xuan Tran, Quang Nhat Nguyen, Long Hoang Nguyen, Hoa Quynh Thi Nguyen, Anh Tuan Nguyen, Hiep Duy Nguyen, Thanh Phuong Bui, Thao Bich Thi Vu, Khiet Thanh Le, Dung Tuan Nguyen, Anh Kim Dang, Nam Ba Nguyen, Carl A. Latkin, Cyrus S.H. Ho, Roger C.M. Ho

Abstract

Studies performed worldwide show excessive Internet use could have a negative impact on health. However, Internet use studies in Vietnam are limited. In this study, we reported a high prevalence of frequent Internet usage among Vietnamese youth between 16 and 30 years old. Of 1200 participants, almost 65% reported using the Internet daily. Moreover, 34.3% of the participants reported feeling anxious or uncomfortable after not using the Internet for one day irrespective of their gender, and 40% believed using the Internet frequently did not affect their health. Of those, there was a higher proportion of women than men that held this belief (42.1% vs. 35.9%, respectively, p = .03). In this cohort, undergraduate students were more likely than blue-collar workers to believe that frequent Internet use could affect health. Yet, undergraduate [OR = 1.50, 95%CI = (1.08, 2.09), p < .05)] and high school students (OR = 1.54, 95%CI = 1.00, 2.37), p < .1) were more likely than blue collar workers to feel anxious or uncomfortable after a day without the Internet. Participants in urban areas were more than twice as likely than those from rural areas to believe the Internet did not affect their health [(OR = 0.60, 95%CI = (0.41,0.89), p < .01)]. Lastly, participants between 16 and 18 years old were less likely to believe in the negative impact of the Internet on health than older participants. A better understanding of factors underlying high Internet usage and low perception of its health effects among Vietnamese youth might help develop better intervention strategies for Internet Use Disorder and other Technology Related Use Disorders.

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

A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England

The quality of life of people receiving health and social care is an important indicator of service quality, but the relationship between patient experience and outcomes and regulator quality ratings in Englan...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RxlhA2

Psychometric properties of the Spanish version of the once-daily Urticaria Activity Score (UAS) in patients with chronic spontaneous urticaria managed in clinical practice (the EVALUAS study)

The daily diary Urticaria Activity Score (UAS) and its weekly score (UAS7) are widely used to assess signs and symptoms in patients with chronic spontaneous urticaria (CSU). The objective of this study was to ...

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

AQUApay (AQUA Predictive Ability in Youths): Study on the Predictive Ability of the Questionnaire AQUA © in Children and Adolescents

Condition:   Children and Adolescents Playing Professional Sport Activities Intervention:   Diagnostic Test: Questionnaire AQUA©, pediatric version Sponsor:   Istituto di Biomedicina e Immunologia Molecolare Alberto Monroy Not yet recruiting (Source: ClinicalTrials.gov)

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

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

Food Allergen Eliminations and Combined Protocols for Obesity Reduction: a Preliminary Comparison Study

Condition:   Obesity Intervention:   Behavioral: Food Allergy Elimination + Willis Exercise Sponsor:   Galveston Clinical Research Foundation Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8HiQf

Diagnostic Equivalence of the Skin Prick Test Tape vs. Conventional Skin PrickTest

Conditions:   Allergic Rhinitis;   Allergic Asthma;   Allergic Conjunctivitis;   Food Allergy Interventions:   Diagnostic Test: Skin Prick Test;   Diagnostic Test: Skin Prick Test TAPE Sponsor:   Prof. Dr. Claus Bachert BVBA Not yet recruiting (Source: ClinicalTrials.gov)

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

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

Blood Sampling of Healthy Volunteers for Immunological Research

Condition:   Healthy Volunteers Intervention:   Other: Blood sample Sponsor:   The Netherlands Cancer Institute Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8HbnN

Vaccination Coverage and Level of Protection in Patients at Risk

Conditions:   Diabetes;   Chronic Kidney Disease;   Allergy;   Cystic Fibrosis;   Heart Disease Intervention:   Sponsor:   Universitaire Ziekenhuizen Leuven Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrW6An

A Phase 1b Study of STMC-103H in Multi-Sensitized Allergic Subjects Who Are Otherwise Healthy

Condition:   Atopic Immunoglobulin E-Mediated Allergic Disorder Interventions:   Biological: STMC-103H;   Biological: Placebo Sponsors:   Siolta Therapeutics, Inc.;   Integrium Recruiting (Source: ClinicalTrials.gov)

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

Study to Evaluate the Efficacy and Safety of " Allergovac Poliplus " in Polysensitized Patients With Allergic Rhinitis/Rhinoconjunctivitis, With or Without Asthma

Conditions:   Rhinitis, Allergic;   Rhinoconjunctivitis Intervention:   Biological: Allergen Immunotherapy (AIT) Sponsor:   Roxall Medicina España S.A Recruiting (Source: ClinicalTrials.gov)

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

Post Transplant Cyclophosphamide in Matched Unrelated Donor Stem Cell Transplantation for Hematological Malignancies

Conditions:   Bone Marrow Transplant Complications;   Graft Versus Host Disease;   Infection Viral;   Engraft Failure;   Immunologic Suppression Interventions:   Drug: Cyclophosphamide;   Drug: ATG Sponsor:   Hospital Israelita Albert Einstein Recruiting (Source: ClinicalTrials.gov)

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

Pharmacokinetic Study to Evaluate Double-Dose Levonorgestrel Emergency Contraception in Combination With Efavirenz-Based Antiretroviral Therapy or Rifampicin-Containing Anti-Tuberculosis Therapy

Conditions:   HIV Infections;   Tuberculosis Intervention:   Drug: Levonorgestrel Emergency Contraception (LNG EC) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrVQ4n

Swedish Study of Immunotherapy for Milk Allergy in Children

Condition:   Milk Allergy Intervention:   Other: Milk protein in fresh milk Sponsor:   Umeå University Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8GVVR

Siderophore-profile in Allergic and Non-allergic Subjects

Conditions:   Allergy;   Healthy;   Allergic Sensitisation Intervention:   Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ToU5Fi

Iron and Pollen Allergy in Women

Conditions:   Allergy Pollen;   Healthy Interventions:   Dietary Supplement: ImmunoBon;   Dietary Supplement: Placebo Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8GQS3

Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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

AQUApay (AQUA Predictive Ability in Youths): Study on the Predictive Ability of the Questionnaire AQUA © in Children and Adolescents

Condition:   Children and Adolescents Playing Professional Sport Activities Intervention:   Diagnostic Test: Questionnaire AQUA©, pediatric version Sponsor:   Istituto di Biomedicina e Immunologia Molecolare Alberto Monroy Not yet recruiting (Source: ClinicalTrials.gov)

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

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

Food Allergen Eliminations and Combined Protocols for Obesity Reduction: a Preliminary Comparison Study

Condition:   Obesity Intervention:   Behavioral: Food Allergy Elimination + Willis Exercise Sponsor:   Galveston Clinical Research Foundation Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8HiQf

Diagnostic Equivalence of the Skin Prick Test Tape vs. Conventional Skin PrickTest

Conditions:   Allergic Rhinitis;   Allergic Asthma;   Allergic Conjunctivitis;   Food Allergy Interventions:   Diagnostic Test: Skin Prick Test;   Diagnostic Test: Skin Prick Test TAPE Sponsor:   Prof. Dr. Claus Bachert BVBA Not yet recruiting (Source: ClinicalTrials.gov)

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

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

Blood Sampling of Healthy Volunteers for Immunological Research

Condition:   Healthy Volunteers Intervention:   Other: Blood sample Sponsor:   The Netherlands Cancer Institute Not yet recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8HbnN

Vaccination Coverage and Level of Protection in Patients at Risk

Conditions:   Diabetes;   Chronic Kidney Disease;   Allergy;   Cystic Fibrosis;   Heart Disease Intervention:   Sponsor:   Universitaire Ziekenhuizen Leuven Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrW6An

A Phase 1b Study of STMC-103H in Multi-Sensitized Allergic Subjects Who Are Otherwise Healthy

Condition:   Atopic Immunoglobulin E-Mediated Allergic Disorder Interventions:   Biological: STMC-103H;   Biological: Placebo Sponsors:   Siolta Therapeutics, Inc.;   Integrium Recruiting (Source: ClinicalTrials.gov)

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

Study to Evaluate the Efficacy and Safety of " Allergovac Poliplus " in Polysensitized Patients With Allergic Rhinitis/Rhinoconjunctivitis, With or Without Asthma

Conditions:   Rhinitis, Allergic;   Rhinoconjunctivitis Intervention:   Biological: Allergen Immunotherapy (AIT) Sponsor:   Roxall Medicina España S.A Recruiting (Source: ClinicalTrials.gov)

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

Post Transplant Cyclophosphamide in Matched Unrelated Donor Stem Cell Transplantation for Hematological Malignancies

Conditions:   Bone Marrow Transplant Complications;   Graft Versus Host Disease;   Infection Viral;   Engraft Failure;   Immunologic Suppression Interventions:   Drug: Cyclophosphamide;   Drug: ATG Sponsor:   Hospital Israelita Albert Einstein Recruiting (Source: ClinicalTrials.gov)

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

Pharmacokinetic Study to Evaluate Double-Dose Levonorgestrel Emergency Contraception in Combination With Efavirenz-Based Antiretroviral Therapy or Rifampicin-Containing Anti-Tuberculosis Therapy

Conditions:   HIV Infections;   Tuberculosis Intervention:   Drug: Levonorgestrel Emergency Contraception (LNG EC) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrVQ4n

Swedish Study of Immunotherapy for Milk Allergy in Children

Condition:   Milk Allergy Intervention:   Other: Milk protein in fresh milk Sponsor:   Umeå University Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8GVVR

Siderophore-profile in Allergic and Non-allergic Subjects

Conditions:   Allergy;   Healthy;   Allergic Sensitisation Intervention:   Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ToU5Fi

Iron and Pollen Allergy in Women

Conditions:   Allergy Pollen;   Healthy Interventions:   Dietary Supplement: ImmunoBon;   Dietary Supplement: Placebo Sponsor:   Medical University of Vienna Recruiting (Source: ClinicalTrials.gov)

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B8GQS3

Dose, Safety, Tolerability and Immunogenicity of an Influenza H1 Stabilized Stem Ferritin Vaccine, VRCFLUNPF099-00-VP, in Healthy Adults

Condition:   Influenza Interventions:   Other: VRC-PBSPLA043-00-VP (phosphate buffered saline);   Biological: VRC-FLUNPF099-00-VP (H1ssF_3928) Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)

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

Force-induced decline of TEA domain family member 1 contributes to osteoclastogenesis via regulation of Osteoprotegerin

Publication date: Available online 31 January 2019

Source: Archives of Oral Biology

Author(s): Qian Li, Gaofeng Han, Dawei Liu, Yanheng Zhou

Abstract

Objective

This study aims to investigate the responsiveness of transcription factor TEA domain family member 1 (TEAD1) to mechanical force and its impact on osteoclastogenesis as well as expression of Osteoprotegerin (OPG), an inhibitor for osteoclastogenesis playing crucial roles in mechanical stress-induced bone remodeling and orthodontic tooth movement (OTM).

Methods

We first analyzed the correlation between several transcription factors and OPG expression in human periodontal ligament cells (PDLCs). Then dynamic expression changes of TEAD1 with force application were analyzed due to its high correlation with OPG. Loss-of-function experiments were performed to demonstrate the role of TEAD1 in regulation of RANKL/OPG, as well as osteoclastogenesis by tartrate-resistant acid phosphatase (TRAP) staining. Combination of bioinformatics analyzes and chromatin immunoprecipitation assay was utilized to investigate occupancy of TEAD1 on the enhancer elements of OPG and the dynamic change in response to force stimuli. Involvement of Hippo signaling in regulation of OPG was further demonstrated by pharmacologic inhibitors of several components.

Results

Expression of TEAD1 highly correlates with that of OPG and decreases in response to mechanical force in human PDLCs. Knockdown of TEAD1 downregulates expression of OPG and promotes osteoclast differentiation. Mechanical force induced decreased binding of TEAD1 on an enhancer element ˜22 kilobases upstream of OPG promoter. OPG was also affected by pharmaceutical disruption of Hippo signaling pathway.

Conclusions

TEAD1 is a novel mechano-responsive gene and plays an important role in force-induced osteoclastogenesis, which is dependent, as least partially, on transcriptional regulation of OPG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TvS5v7

Expression of activator protein-1 in papillary thyroid carcinoma and its clinical significance

The abnormal expression of activator protein-1(AP-1) has recently been investigated in a variety of tumors. While the relationship between AP-1 and thyroid cancer is poorly studied, our study was to evaluate t...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DMKu5z

Early reoperation following pancreaticoduodenectomy: impact on morbidity, mortality, and long-term survival

Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effec...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MO7C6U

Force-induced decline of TEA domain family member 1 contributes to osteoclastogenesis via regulation of Osteoprotegerin

Publication date: Available online 31 January 2019

Source: Archives of Oral Biology

Author(s): Qian Li, Gaofeng Han, Dawei Liu, Yanheng Zhou

Abstract

Objective

This study aims to investigate the responsiveness of transcription factor TEA domain family member 1 (TEAD1) to mechanical force and its impact on osteoclastogenesis as well as expression of Osteoprotegerin (OPG), an inhibitor for osteoclastogenesis playing crucial roles in mechanical stress-induced bone remodeling and orthodontic tooth movement (OTM).

Methods

We first analyzed the correlation between several transcription factors and OPG expression in human periodontal ligament cells (PDLCs). Then dynamic expression changes of TEAD1 with force application were analyzed due to its high correlation with OPG. Loss-of-function experiments were performed to demonstrate the role of TEAD1 in regulation of RANKL/OPG, as well as osteoclastogenesis by tartrate-resistant acid phosphatase (TRAP) staining. Combination of bioinformatics analyzes and chromatin immunoprecipitation assay was utilized to investigate occupancy of TEAD1 on the enhancer elements of OPG and the dynamic change in response to force stimuli. Involvement of Hippo signaling in regulation of OPG was further demonstrated by pharmacologic inhibitors of several components.

Results

Expression of TEAD1 highly correlates with that of OPG and decreases in response to mechanical force in human PDLCs. Knockdown of TEAD1 downregulates expression of OPG and promotes osteoclast differentiation. Mechanical force induced decreased binding of TEAD1 on an enhancer element ˜22 kilobases upstream of OPG promoter. OPG was also affected by pharmaceutical disruption of Hippo signaling pathway.

Conclusions

TEAD1 is a novel mechano-responsive gene and plays an important role in force-induced osteoclastogenesis, which is dependent, as least partially, on transcriptional regulation of OPG.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TvS5v7

Expression of activator protein-1 in papillary thyroid carcinoma and its clinical significance

The abnormal expression of activator protein-1(AP-1) has recently been investigated in a variety of tumors. While the relationship between AP-1 and thyroid cancer is poorly studied, our study was to evaluate t...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DMKu5z

Early reoperation following pancreaticoduodenectomy: impact on morbidity, mortality, and long-term survival

Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effec...

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Total thyroidectomy versus lobectomy for intermediate-risk papillary thyroid carcinoma: A single-institution matched-pair analysis

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Jie Liu, Zongmin Zhang, Hui Huang, Siyuan Xu, Yang Liu, Shaoyan Liu, Xiaolei Wang, Zhengang Xu

Abstract

Background

Total thyroidectomy (TT) is recommended by guidelines for intermediate-risk papillary thyroid carcinoma (PTC) but its survival advantage over lobectomy has not been proven. The aim of this study was to examine the association between the extent of surgery and the clinical outcome of patients with intermediate-risk PTC.

Methods

Adult patients with PTC in the institutional database from 1996 to 2008 were retrospectively reviewed. Intermediate-risk patients were defined according to the 2015 American Thyroid Association (ATA) guidelines. Patients who underwent TT and patients who underwent lobectomy were then matched according to individual risk factors. Survival analysis was performed within the two paired groups, focusing on recurrence-free survival (RFS) and disease-specific survival (DSS) rates.

Results

Among 4230 PTC patients, 1087 intermediate-risk patients were included, in total 341 pairs were matched based on sex, age, primary size, clinical nodes (cN), extrathyroidal extension (ETE), pathological lateral neck metastasis (pN1b) and lymph node ratio (LNR). For these paired cases, with a median follow-up of 125 months (46–192), the lobectomy and TT groups were similar with respect to both 10-year RFS rate (77.4% vs 80.2%, log rank = 0.244, p = 0.622) and DSS rate (97.2% vs 98.4%, log rank = 0.351, p = 0.554). When excluding pairs of cases (62 pairs) who received radioiodine ablation (RAI), survival results were also similar in lobectomy and TT groups with respect to 10-year RFS rate (81.2% vs 83.1%, log rank = 0.63, p = 0.42) and DSS rate (97.3% vs 98.1%, log rank = 0.95, p = 0.33).

Conclusions

For intermediate-risk PTC, no advantages of TT over lobectomy were found with respect to RFS rate or DSS rate.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Rw4P2R

Total thyroidectomy versus lobectomy for intermediate-risk papillary thyroid carcinoma: A single-institution matched-pair analysis

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Jie Liu, Zongmin Zhang, Hui Huang, Siyuan Xu, Yang Liu, Shaoyan Liu, Xiaolei Wang, Zhengang Xu

Abstract

Background

Total thyroidectomy (TT) is recommended by guidelines for intermediate-risk papillary thyroid carcinoma (PTC) but its survival advantage over lobectomy has not been proven. The aim of this study was to examine the association between the extent of surgery and the clinical outcome of patients with intermediate-risk PTC.

Methods

Adult patients with PTC in the institutional database from 1996 to 2008 were retrospectively reviewed. Intermediate-risk patients were defined according to the 2015 American Thyroid Association (ATA) guidelines. Patients who underwent TT and patients who underwent lobectomy were then matched according to individual risk factors. Survival analysis was performed within the two paired groups, focusing on recurrence-free survival (RFS) and disease-specific survival (DSS) rates.

Results

Among 4230 PTC patients, 1087 intermediate-risk patients were included, in total 341 pairs were matched based on sex, age, primary size, clinical nodes (cN), extrathyroidal extension (ETE), pathological lateral neck metastasis (pN1b) and lymph node ratio (LNR). For these paired cases, with a median follow-up of 125 months (46–192), the lobectomy and TT groups were similar with respect to both 10-year RFS rate (77.4% vs 80.2%, log rank = 0.244, p = 0.622) and DSS rate (97.2% vs 98.4%, log rank = 0.351, p = 0.554). When excluding pairs of cases (62 pairs) who received radioiodine ablation (RAI), survival results were also similar in lobectomy and TT groups with respect to 10-year RFS rate (81.2% vs 83.1%, log rank = 0.63, p = 0.42) and DSS rate (97.3% vs 98.1%, log rank = 0.95, p = 0.33).

Conclusions

For intermediate-risk PTC, no advantages of TT over lobectomy were found with respect to RFS rate or DSS rate.

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The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results

Abstract

Purpose of Review

This is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.

Recent Findings

PFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cure people affected. We successfully treated 90 cases of PFM and evaluated different surgical approaches.

Summary

GTR is the aim of the surgery as the extent of resection influences the rate of recurrence, which in turn influences the prognosis. Seventy percent (p < 0.001) of surgical patients achieved a GRT with low morbidity and no mortality.

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The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results

Abstract

Purpose of Review

This is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.

Recent Findings

PFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cure people affected. We successfully treated 90 cases of PFM and evaluated different surgical approaches.

Summary

GTR is the aim of the surgery as the extent of resection influences the rate of recurrence, which in turn influences the prognosis. Seventy percent (p < 0.001) of surgical patients achieved a GRT with low morbidity and no mortality.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bc6yFm

Exclusive: Teva's generic EpiPen launch stalls months after approval

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

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1kWuw

Exclusive: Teva's generic EpiPen launch stalls months after approval

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

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

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The adaption of the bony microstructure of the human glenoid cavity as a result of long-term biomechanical loading

Abstract

Structural arrangements of the bony microstructure of a joint through adaptational processes are thought to be determined by the biomechanical demands and its changes. Pursuing this theory of "form follows the biomechanical function", the load distribution of the glenoid cavity, as it is mirrored in its mineralization pattern, should link not only to its thickness distribution, but also will have an impact onto the trabecular network below. To prove and confirm this hypothesis, we analysed the mineral distribution in correlation to the subchondral bone plates thickness and the distribution of architectural parameters of the trabecular network below. Our findings clearly state an inhomogeneous but regular and reproducible mineral distribution pattern in respect to the biomechanical demands and a thickness of the subchondral bone plate which shows a significant correlation (78–93%). As for the trabecular network below, the distribution of the analysed parameters also revealed an inhomogeneous distribution with a regular pattern in correlation to the biomechanical impact. We found distinctive maxima of material distribution and stability (bone volume 79%, plate-like architecture 77%) situated below areas of high long-term load intake. With increasing depth, the trabecular network administers the expression of each structural parameter following the fact that the strain energy gets more and more evenly distributed and changes from a high degree of differentiation just beneath the SBP to a more equal distribution within the deeper areas. After all, the biomechanical situation of a joint directly influences the bony formation of the subchondral bone plate and the trabecular network below.

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

The adaption of the bony microstructure of the human glenoid cavity as a result of long-term biomechanical loading

Abstract

Structural arrangements of the bony microstructure of a joint through adaptational processes are thought to be determined by the biomechanical demands and its changes. Pursuing this theory of "form follows the biomechanical function", the load distribution of the glenoid cavity, as it is mirrored in its mineralization pattern, should link not only to its thickness distribution, but also will have an impact onto the trabecular network below. To prove and confirm this hypothesis, we analysed the mineral distribution in correlation to the subchondral bone plates thickness and the distribution of architectural parameters of the trabecular network below. Our findings clearly state an inhomogeneous but regular and reproducible mineral distribution pattern in respect to the biomechanical demands and a thickness of the subchondral bone plate which shows a significant correlation (78–93%). As for the trabecular network below, the distribution of the analysed parameters also revealed an inhomogeneous distribution with a regular pattern in correlation to the biomechanical impact. We found distinctive maxima of material distribution and stability (bone volume 79%, plate-like architecture 77%) situated below areas of high long-term load intake. With increasing depth, the trabecular network administers the expression of each structural parameter following the fact that the strain energy gets more and more evenly distributed and changes from a high degree of differentiation just beneath the SBP to a more equal distribution within the deeper areas. After all, the biomechanical situation of a joint directly influences the bony formation of the subchondral bone plate and the trabecular network below.

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

Exclusive: Teva's generic EpiPen launch stalls months after approval

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

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1kWuw

Exclusive: Teva's generic EpiPen launch stalls months after approval

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

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1kWuw

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Abstract

Background

Local control rate (LCR) of early glottic cancer is high after radiation therapy or transoral laser microsurgery (TLM). The aim of this study was to investigate functional voice outcome after TLM using a microvessel‐ablative potassium‐titanyl‐phosphate (KTP) laser in comparison with a gold standard cutting CO₂ laser.

Methods

The primary end point of this prospective, randomized, single‐blinded, clinical phase II study with control group was voice outcome during a follow‐up of 6 months assayed by Voice Handicap Index (VHI‐30)‐questionnaires in patients with unilateral high‐grade dysplasia, carcinoma in situ or early glottic cancer undergoing TLM‐KTP (n = 8) or TLM‐CO₂ (n = 12). The secondary end point was LCR.

Results

Starting from the 9‐week‐follow‐up visit, TLM‐KTP yielded significantly reduced VHI scores compared to TLM‐CO₂. No relapse occurred after TLM‐KTP in contrast to one recurrence after TLM‐CO₂ within 6 months.

Conclusion

Multicenter phase II or III studies on voice outcome or local control rate after TLM‐KTP in early glottic cancer are warranted enrolling larger patient cohorts.

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Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Abstract

Background

Local control rate (LCR) of early glottic cancer is high after radiation therapy or transoral laser microsurgery (TLM). The aim of this study was to investigate functional voice outcome after TLM using a microvessel‐ablative potassium‐titanyl‐phosphate (KTP) laser in comparison with a gold standard cutting CO₂ laser.

Methods

The primary end point of this prospective, randomized, single‐blinded, clinical phase II study with control group was voice outcome during a follow‐up of 6 months assayed by Voice Handicap Index (VHI‐30)‐questionnaires in patients with unilateral high‐grade dysplasia, carcinoma in situ or early glottic cancer undergoing TLM‐KTP (n = 8) or TLM‐CO₂ (n = 12). The secondary end point was LCR.

Results

Starting from the 9‐week‐follow‐up visit, TLM‐KTP yielded significantly reduced VHI scores compared to TLM‐CO₂. No relapse occurred after TLM‐KTP in contrast to one recurrence after TLM‐CO₂ within 6 months.

Conclusion

Multicenter phase II or III studies on voice outcome or local control rate after TLM‐KTP in early glottic cancer are warranted enrolling larger patient cohorts.

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Seed storage 2S albumins are predictive indicators of exclusive Anacardiaceae cross‐reactivity

Abstract

Pistachio (Pistachio vera) and cashew nut (Anacardium occidentale), members of the Anacardiaceae family, account for a significant percentage of food allergies worldwide [1]. Nuts are one of the main causes of food anaphylaxis, eliciting a significant number of life‐threatening reactions, which are aggravated by the fact that these allergens are often hidden in processed foods. Variability of allergic phenotypes to nut allergens with complex cross‐reactivity profiles complicates clinical management of the patient [2]. In this sense, several allergenic patterns have been defined according to different factors such as geographical area, age, eating habits, pollinosis, and so on.

This article is protected by copyright. All rights reserved.

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

Seed storage 2S albumins are predictive indicators of exclusive Anacardiaceae cross‐reactivity

Abstract

Pistachio (Pistachio vera) and cashew nut (Anacardium occidentale), members of the Anacardiaceae family, account for a significant percentage of food allergies worldwide [1]. Nuts are one of the main causes of food anaphylaxis, eliciting a significant number of life‐threatening reactions, which are aggravated by the fact that these allergens are often hidden in processed foods. Variability of allergic phenotypes to nut allergens with complex cross‐reactivity profiles complicates clinical management of the patient [2]. In this sense, several allergenic patterns have been defined according to different factors such as geographical area, age, eating habits, pollinosis, and so on.

This article is protected by copyright. All rights reserved.

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Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell’s palsy

Abstract

Purpose

Patients with Ramsay-Hunt syndrome have a poorer prognosis than patients with Bell's palsy. Factors of metabolic syndrome affecting prognosis were therefore compared between patients with Ramsay-Hunt syndrome and those with Bell's palsy.

Methods

This retrospective study included 106 with Ramsay-Hunt syndrome and 182 with Bell's palsy. Age, sex, body mass index, blood pressure, blood test results, and ENoG results, stratified by House–Brackmann grade, were compared in patients with Ramsay-Hunt syndrome and Bell's palsy. Both groups of patients were treated with steroids and the antiviral agent famciclovir.

Results

Age, sex, body mass index, dyslipidemia, triglyceride, diabetes, hypertension, and onset of palsy did not differ in patients with Ramsay-Hunt syndrome and Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and DM were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy and were also lower in low-weight, normal weight, and overweight patients with Ramsay-Hunt syndrome than with Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and normal HDL, as well as in patients with severe facial palsy and < 10% ENoG, were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy.

Conclusions

Among patients with severe facial palsy, along with diabetes and < 10% ENoG, unfavorable recovery rates were significantly higher in those with Ramsay-Hunt syndrome than with Bell's palsy.

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

Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell’s palsy

Abstract

Purpose

Patients with Ramsay-Hunt syndrome have a poorer prognosis than patients with Bell's palsy. Factors of metabolic syndrome affecting prognosis were therefore compared between patients with Ramsay-Hunt syndrome and those with Bell's palsy.

Methods

This retrospective study included 106 with Ramsay-Hunt syndrome and 182 with Bell's palsy. Age, sex, body mass index, blood pressure, blood test results, and ENoG results, stratified by House–Brackmann grade, were compared in patients with Ramsay-Hunt syndrome and Bell's palsy. Both groups of patients were treated with steroids and the antiviral agent famciclovir.

Results

Age, sex, body mass index, dyslipidemia, triglyceride, diabetes, hypertension, and onset of palsy did not differ in patients with Ramsay-Hunt syndrome and Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and DM were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy and were also lower in low-weight, normal weight, and overweight patients with Ramsay-Hunt syndrome than with Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and normal HDL, as well as in patients with severe facial palsy and < 10% ENoG, were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy.

Conclusions

Among patients with severe facial palsy, along with diabetes and < 10% ENoG, unfavorable recovery rates were significantly higher in those with Ramsay-Hunt syndrome than with Bell's palsy.

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Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Background

Postcontrast‐enhanced MRI is currently the reference standard for synovial proliferation in rheumatoid arthritis (RA). However, the technique is somewhat invasive due to the use of gadolinium contrast agents, which may cause severe adverse/side effects. Intravoxel incoherent motion (IVIM) simultaneously permits quantification of perfusion as well as diffusion using a single imaging scan.

Purpose/Hypothesis

To test the capability of IVIM MRI for noninvasive discrimination of synovial proliferation in hand arthritis.

Study Type

Prospective.

Subjects

Seven suspected RA patients (three women and four men; mean age, 61 years; range, 26–74 years).

Field Strength/Sequence

3 T/short tau inversion recovery (STIR), IVIM, postcontrast‐enhanced MRI.

Assessment

Region of interest (ROI) was identified based on STIR. Contrast‐enhanced MRI was evaluated using a 5‐point grading scale of 0 (water) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. For each ROI, we calculated the apparent diffusion coefficient (ADC) and IVIM parameters (molecular diffusion coefficient [D], perfusion fraction [f], and perfusion‐related diffusion coefficient [D*]). These parameters were subsequently compared with ROI contrast enhancement grades.

Statistical Tests

Spearman's rank correlation test and a receiver operating characteristic (ROC) curve.

Results

A total of 90 ROIs of suspected synovial proliferation and/or joint effusion were identified. ROI grades were correlated with ADC and D values (r _S = –0.385, P < 0.001, r _S = –0.458, P < 0.0001, respectively), but not with the f and D* values (r _S = –0.010, P = 0.936, r _S = –0.084, P = 0.505, respectively). The area under the curves (AUCs) of D values (0.708–0.888, P = 0.002–0.0002) were slightly larger than those of ADC values (0.692–0.791, P = 0.013–0.001) when comparing low‐ vs. high‐contrast enhancement grades.

Data Conclusion

The IVIM parameter D and ADC may be useful for the noninvasive identification of synovial proliferation in hand arthritis.

Level of Evidence: 2

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2019.

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MRI in pregnancy: Indications and practical considerations

There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed.

Level of Evidence 5.

Technical Efficacy Stage 5.

J. Magn. Reson. Imaging 2019.

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Survival impact of treatment‐related time intervals in nasopharyngeal carcinoma in the United States

Objective

To determine if delayed or prolonged treatment‐related time intervals (TRTIs) was associated with survival in patients with nasopharyngeal carcinoma (NPC) undergoing curative‐intent concurrent chemoradiation (CCRT). The TRTIs investigated were duration of radiation treatment (RTd), time to radiation start (TTR), and time to chemotherapy start (TTC).

Methods

Observational cohort study using the National Cancer Database (NCDB). In this observational cohort study, 3,893 eligible patients with NPC were identified from the NCDB. Patients received CCRT of at least 66 grays and radiation treatment time of at least 40 days. Separate univariable Cox regression model was used to analyze overall survival (OS) as a function of TRTIs, as well as for Charlson/Deyo Score, tumor classification, node classification, histological type, ethnicity, age, sex, and facility type. Upon finding significance at P < 0.05, the multivariable Cox regression analysis with backward elimination was performed to yield the final prediction model. Results were considered statistically significant when P < 0.05.

Results

Radiation treatment was significantly associated with OS in the univariable analysis (hazard ratio: 1.006, 95% confidence interval = 1.004–1.008, P < 0.001). However, RTd was not related to OS in the multivariable analysis (P = 0.19). The TTR and TTC variables were not associated with OS in the univariable analysis (P = 0.88 and P = 0.88, respectively).

Conclusion

TRTIs were not independently associated with OS in this cohort of NPC patients in the NCDB. Future research into the association of TRTI with other disease outcomes, such as disease‐free survival and locoregional control, is needed.

Level of Evidence

NA. Laryngoscope, 2019

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The evidence‐based preoperative assessment for the otolaryngologist

There is a narrow window of opportunity between surgical scheduling and the operative date to optimize patients for an elective surgical procedure. Traditionally, preoperative care has involved extended routine testing batteries with intermittent referrals for medical clearance. These traditions are costly, inefficient, and yield no clear reduction in perioperative morbidity and mortality. Evidence, which has evolved over the past decade, suggests that optimal preoperative care requires a patient‐centric, personalized, and often multidisciplinary approach. We present an up‐to‐date overview of this literature with a focus on the otolaryngologic surgical population. An algorithmic approach to preoperative patient assessment is also proposed in hopes of both optimizing patient outcome and streamlining routine clinical workflow. Laryngoscope, 2019

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How to Hire an Audiology Rock Star

No abstract available (Source: The Hearing Journal)

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

Benefits of Annual Hearing Aid Exams to Patients and Practice

No abstract available (Source: The Hearing Journal)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BeNB4O

The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

AbstractAlthough modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric bi...

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Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Background

Postcontrast‐enhanced MRI is currently the reference standard for synovial proliferation in rheumatoid arthritis (RA). However, the technique is somewhat invasive due to the use of gadolinium contrast agents, which may cause severe adverse/side effects. Intravoxel incoherent motion (IVIM) simultaneously permits quantification of perfusion as well as diffusion using a single imaging scan.

Purpose/Hypothesis

To test the capability of IVIM MRI for noninvasive discrimination of synovial proliferation in hand arthritis.

Study Type

Prospective.

Subjects

Seven suspected RA patients (three women and four men; mean age, 61 years; range, 26–74 years).

Field Strength/Sequence

3 T/short tau inversion recovery (STIR), IVIM, postcontrast‐enhanced MRI.

Assessment

Region of interest (ROI) was identified based on STIR. Contrast‐enhanced MRI was evaluated using a 5‐point grading scale of 0 (water) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. For each ROI, we calculated the apparent diffusion coefficient (ADC) and IVIM parameters (molecular diffusion coefficient [D], perfusion fraction [f], and perfusion‐related diffusion coefficient [D*]). These parameters were subsequently compared with ROI contrast enhancement grades.

Statistical Tests

Spearman's rank correlation test and a receiver operating characteristic (ROC) curve.

Results

A total of 90 ROIs of suspected synovial proliferation and/or joint effusion were identified. ROI grades were correlated with ADC and D values (r _S = –0.385, P < 0.001, r _S = –0.458, P < 0.0001, respectively), but not with the f and D* values (r _S = –0.010, P = 0.936, r _S = –0.084, P = 0.505, respectively). The area under the curves (AUCs) of D values (0.708–0.888, P = 0.002–0.0002) were slightly larger than those of ADC values (0.692–0.791, P = 0.013–0.001) when comparing low‐ vs. high‐contrast enhancement grades.

Data Conclusion

The IVIM parameter D and ADC may be useful for the noninvasive identification of synovial proliferation in hand arthritis.

Level of Evidence: 2

Technical Efficacy Stage: 2

J. Magn. Reson. Imaging 2019.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BdXEa5

MRI in pregnancy: Indications and practical considerations

There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed.

Level of Evidence 5.

Technical Efficacy Stage 5.

J. Magn. Reson. Imaging 2019.

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

The evidence‐based preoperative assessment for the otolaryngologist

There is a narrow window of opportunity between surgical scheduling and the operative date to optimize patients for an elective surgical procedure. Traditionally, preoperative care has involved extended routine testing batteries with intermittent referrals for medical clearance. These traditions are costly, inefficient, and yield no clear reduction in perioperative morbidity and mortality. Evidence, which has evolved over the past decade, suggests that optimal preoperative care requires a patient‐centric, personalized, and often multidisciplinary approach. We present an up‐to‐date overview of this literature with a focus on the otolaryngologic surgical population. An algorithmic approach to preoperative patient assessment is also proposed in hopes of both optimizing patient outcome and streamlining routine clinical workflow. Laryngoscope, 2019

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MI7C8o

Genetic Testing for Hearing Loss Empowers Audiology Practice

No abstract available (Source: The Hearing Journal)

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How to Hire an Audiology Rock Star

No abstract available (Source: The Hearing Journal)

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

Benefits of Annual Hearing Aid Exams to Patients and Practice

No abstract available (Source: The Hearing Journal)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BeNB4O

Prolonged time between intravenous contrast administration and image acquisition results in increased synovial thickness at magnetic resonance imaging in patients with juvenile idiopathic arthritis

Abstract

Background

Post-contrast synovial thickness measurement is necessary for scoring disease activity in juvenile idiopathic arthritis (JIA). However, the timing of post-contrast sequences varies widely among institutions. This variation in timing could influence thickness measurements.

Objective

To measure thickness of the synovial membrane on early and late post-contrast knee magnetic resonance (MR) images of patients with JIA.

Materials and methods

Dynamic contrast-enhanced T1-weighted knee MR images of 53 children with JIA with current or past knee arthritis were used to study synovial thickness at time point 1 (about 1 min) and time point 2 (about 5 min after contrast administration). Two experienced readers, who were blinded for the time point, independently measured synovial thickness at a predefined, marked location in the patellofemoral compartment on randomized images. Synovial thickness at the two time points was compared using the Wilcoxon signed rank test. Repeatibility of the synovial thickness measurements was studied using intraclass correlation coefficients and Bland-Altman plots.

Results

Median synovial thickness of the 53 patients (median age: 13.5 years, 59% female) increased with prolonged post-contrast interval with a synovial thickness of 1.4 mm at time point 1 and a synovial thickness of 1.5 mm at time point 2 (P<0.001). Repeated synovial thickness measurements showed an intraclass correlation coefficient (ICC) of 0.75, P<0.05 for time point 1 and an ICC of 0.91, P<0.05 for time point 2.

Conclusion

Post-contrast synovial membrane thickness measurements are time-dependent. Therefore, standardization of post-contrast image acquisition timing is important to achieve consistent grading of synovial inflammation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t14fjI

Prolonged time between intravenous contrast administration and image acquisition results in increased synovial thickness at magnetic resonance imaging in patients with juvenile idiopathic arthritis

Abstract

Background

Post-contrast synovial thickness measurement is necessary for scoring disease activity in juvenile idiopathic arthritis (JIA). However, the timing of post-contrast sequences varies widely among institutions. This variation in timing could influence thickness measurements.

Objective

To measure thickness of the synovial membrane on early and late post-contrast knee magnetic resonance (MR) images of patients with JIA.

Materials and methods

Dynamic contrast-enhanced T1-weighted knee MR images of 53 children with JIA with current or past knee arthritis were used to study synovial thickness at time point 1 (about 1 min) and time point 2 (about 5 min after contrast administration). Two experienced readers, who were blinded for the time point, independently measured synovial thickness at a predefined, marked location in the patellofemoral compartment on randomized images. Synovial thickness at the two time points was compared using the Wilcoxon signed rank test. Repeatibility of the synovial thickness measurements was studied using intraclass correlation coefficients and Bland-Altman plots.

Results

Median synovial thickness of the 53 patients (median age: 13.5 years, 59% female) increased with prolonged post-contrast interval with a synovial thickness of 1.4 mm at time point 1 and a synovial thickness of 1.5 mm at time point 2 (P<0.001). Repeated synovial thickness measurements showed an intraclass correlation coefficient (ICC) of 0.75, P<0.05 for time point 1 and an ICC of 0.91, P<0.05 for time point 2.

Conclusion

Post-contrast synovial membrane thickness measurements are time-dependent. Therefore, standardization of post-contrast image acquisition timing is important to achieve consistent grading of synovial inflammation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t14fjI

The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results

Abstract

Purpose of Review

This is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.

Recent Findings

PFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cure people affected. We successfully treated 90 cases of PFM and evaluated different surgical approaches.

Summary

GTR is the aim of the surgery as the extent of resection influences the rate of recurrence, which in turn influences the prognosis. Seventy percent (p < 0.001) of surgical patients achieved a GRT with low morbidity and no mortality.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bc6yFm