Parental asthma and risk of autism spectrum disorder in offspring: a population and family based case‐control study

Abstract

Background

Associations between parental asthma and prenatal exposure to asthma medications with offspring autism spectrum disorder (ASD) have been reported. However, the associations might be confounded by unmeasured (genetic and shared environmental) familial factors.

Objective

We investigated the association between (a) maternal/paternal asthma and offspring ASD, and (b) prenatal exposures to β2‐agonists, other asthma medications and offspring ASD using cases and controls selected from the population as well as biological relatives with different degrees of relatedness.

Methods

We included all children (N=1,579,263) born in Sweden 1992‐2007. A nested case‐control design was used to compare 22,894 ASD cases identified from the National Patient Register to (i) 228,940 age‐, county‐ and sex‐matched controls randomly selected from the population, (ii) their eligible full‐siblings (n=1,267), (iii) half‐siblings (n=1,323), (iv) full‐cousins (n=11,477), and (v) half‐cousins (n=3,337). Conditional logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for ASD in children differentially exposed to parental asthma or prenatal asthma medications.

Results

Maternal asthma was associated with increased risk of offspring ASD (OR 1.43, 95% CI 1.38‐1.49); there was a weaker association for paternal asthma (OR 1.17, 95% CI 1.11‐1.23). The risk of offspring ASD in mothers with asthma showed similar estimates when adjusting for shared familial factors among paternal half‐siblings (OR 1.20, 95% CI 0.80‐1.81), full‐cousins (OR 1.28, 95% CI 1.16‐1.41), and half‐cousins (OR 1.30, 95% CI 1.10‐1.54), albeit with wider confidence intervals. Prenatal exposure to asthma medications among subjects whose mothers had asthma was not associated with subsequent ASD.

Conclusions and clinical relevance

In this large observational study, parental asthma was associated with slightly elevated risk of ASD in offspring. More specifically, the increased risk by maternal asthma did not seem to be confounded by familial factors. There was no evidence of an association between asthma medications during pregnancy and offspring ASD.

This article is protected by copyright. All rights reserved.

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The Tooth Crossing the Confinement of Mandible: An Unique Expression of Central Variety of Dentigerous Cyst

We report a case of a 28  years old male diagnosed with an impacted mandibular third molar associated with DC and its surgical management. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

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The Tooth Crossing the Confinement of Mandible: An Unique Expression of Central Variety of Dentigerous Cyst

We report a case of a 28  years old male diagnosed with an impacted mandibular third molar associated with DC and its surgical management. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

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Macropinosomes as Units of Signal Transduction

Date: Tuesday, 02 19, 2019; Speaker: Joel A. Swanson, Professor, University of Michigan, Microbiology& Immunology; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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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Macropinosomes as Units of Signal Transduction

Date: Tuesday, 02 19, 2019; Speaker: Joel A. Swanson, Professor, University of Michigan, Microbiology& Immunology; 5625 Fishers Lane; 5th Floor (Source: NIH Calendar of Events)

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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Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort

Links between multimorbidity of allergic diseases and allergen sensitization are still under debate, especially in adults. This study aimed to establish a relationship between polysensitization and allergic mu...

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Ethnobotanical knowledge among the semi-pastoral Gujjar tribe in the high altitude (Adhwari’s) of Churah subdivision, district Chamba, Western Himalaya

The wild plants not only form an integral part of the culture and traditions of the Himalayan tribal communities but also contribute largely to the sustenance of these communities. The tribal people use large ...

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

Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort

Links between multimorbidity of allergic diseases and allergen sensitization are still under debate, especially in adults. This study aimed to establish a relationship between polysensitization and allergic mu...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RQP1rL

Ethnobotanical knowledge among the semi-pastoral Gujjar tribe in the high altitude (Adhwari’s) of Churah subdivision, district Chamba, Western Himalaya

The wild plants not only form an integral part of the culture and traditions of the Himalayan tribal communities but also contribute largely to the sustenance of these communities. The tribal people use large ...

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

Prevalence of asthma, allergic rhinitis and eczema in 6–7-year-old schoolchildren from Luanda, Angola

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): M. Arrais, O. Lulua, F. Quifica, J. Rosado-Pinto, J.M.R. Gama, L. Taborda-Barata

Abstract

Background

Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children.

Objective

To study the prevalence of asthma and other allergic diseases in Angolan children.

Methods

Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6–7-year-old children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software.

Results

A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19%, and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect.

Conclusion

Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented.

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Effect of ginger extract on expression of GATA3, T-bet and ROR-γt in peripheral blood mononuclear cells of patients with Allergic Asthma

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): M. Kardan, A. Rafiei, J. Ghafari, R. Valadan, Z. Morsaljahan, S.T. Haj-ghorbani

Abstract

Introduction and objectives

Allergic asthma is a chronic inflammatory disorder of the airways. Th1, Th2 and Th17 cells are the main cells involved in the pathophysiology of asthma. The function of these cells is affected by T-bet, GATA3 and RORγt transcription factors (respectively). Therefore, the aim of this study was to evaluate the effect of ginger (officinal Roscoe) extract on the expression of T-bet, GATA-3 and ROR-γ in peripheral blood mononuclear cells (PBMC) of asthmatic patients, in comparison with healthy volunteers as controls.

Materials and methods

In this case-control study, a total of 50 individuals including 25 patients with severe, moderate and mild allergic asthma and 25 unrelated healthy controls were involved. The PBMCs were isolated and divided into four groups: negative control, two positive controls (Budesonide and PHA) and ginger-extract treated group. After cell treatment and incubation for 48 h, PBMCs were isolated and cDNA was synthesized. Gene expressions of T-bet, GATA3 and ROR-γt were evaluated by Real-time PCR.

Results

According to the results of this study, hydroalcoholic extract of ginger could reduce the expression of GATA-3, ROR-γt, and T-bet in PBMCs of asthmatic patients in comparison with untreated PBMCs (P values = 0.001, 0.001, and 0.002, respectively). It was also shown that the ginger extract could affect T-bet/GATA-3, T-bet/ROR-γt, and ROR-γt/GATA-3 expression ratios.

Conclusions

This study showed that the use of ginger extract could control asthma and decrease the severity of this disease by affecting the main cells involving the symptoms of asthma in the airways.

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Predicting outgrowth of IgE-mediated cow's milk allergy: Diagnostic tests in children under two years of age

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): A. Uncuoglu, M.T. Cogurlu, I. Eser Simsek, N. Ergul, C. Baydemir, M. Aydogan

Abstract

Background

Limited studies conducted on children <2 years old and/or involving a skin prick test (SPT) for fresh milk (FM) have examined the predictive value of allergometric tests for outgrowth of cow's milk allergy (CMA). We investigated the optimal decision points for outgrowth (ODP^fo) with SPT for commercial cow's milk extract (CE) and FM and specific immunoglobulin E (sIgE) levels for milk proteins to predict outgrowing allergy in children <2 years old.

Methods

SPTs for CE and FM, tests for sIgEs (cow's milk, casein, α-lactoalbumin, β-lactoglobulin) and oral food challenges (OFC) were performed in children referred for evaluation of suspected CMA, and 15 months after diagnosis.

Results

Fifty-one children (median age, 7.5 months; range, 2–23 months) were enrolled. Five had a history of anaphylaxis and 26 of 48 children with a positive initial challenge underwent milk elimination. The last OFC was performed in 28 children of whom 13 reacted to milk. The initial SPT responses to CE and FM and milk sIgE levels of the patients with persistent CMA were higher at diagnosis, with ODP^fo of 7 mm, 9 mm, and 10.5 kU/L, respectively; these values remained higher with ODP^fo of 4 mm, 11 mm, and 10.5 kU/L at the last OFC.

Conclusion

Higher initial SPTs for FM and CE and higher initial sIgE levels for cow's milk proteins are associated with a reduced likelihood of outgrowth. Initial milk sIgE level <10.5 kU/L and initial SPT for fresh milk <9 mm are related to the acquisition of tolerance in the follow-up period.

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Prevalence of asthma, allergic rhinitis and eczema in 6–7-year-old schoolchildren from Luanda, Angola

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): M. Arrais, O. Lulua, F. Quifica, J. Rosado-Pinto, J.M.R. Gama, L. Taborda-Barata

Abstract

Background

Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children.

Objective

To study the prevalence of asthma and other allergic diseases in Angolan children.

Methods

Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6–7-year-old children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software.

Results

A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19%, and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect.

Conclusion

Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gjwov7

Effect of ginger extract on expression of GATA3, T-bet and ROR-γt in peripheral blood mononuclear cells of patients with Allergic Asthma

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): M. Kardan, A. Rafiei, J. Ghafari, R. Valadan, Z. Morsaljahan, S.T. Haj-ghorbani

Abstract

Introduction and objectives

Allergic asthma is a chronic inflammatory disorder of the airways. Th1, Th2 and Th17 cells are the main cells involved in the pathophysiology of asthma. The function of these cells is affected by T-bet, GATA3 and RORγt transcription factors (respectively). Therefore, the aim of this study was to evaluate the effect of ginger (officinal Roscoe) extract on the expression of T-bet, GATA-3 and ROR-γ in peripheral blood mononuclear cells (PBMC) of asthmatic patients, in comparison with healthy volunteers as controls.

Materials and methods

In this case-control study, a total of 50 individuals including 25 patients with severe, moderate and mild allergic asthma and 25 unrelated healthy controls were involved. The PBMCs were isolated and divided into four groups: negative control, two positive controls (Budesonide and PHA) and ginger-extract treated group. After cell treatment and incubation for 48 h, PBMCs were isolated and cDNA was synthesized. Gene expressions of T-bet, GATA3 and ROR-γt were evaluated by Real-time PCR.

Results

According to the results of this study, hydroalcoholic extract of ginger could reduce the expression of GATA-3, ROR-γt, and T-bet in PBMCs of asthmatic patients in comparison with untreated PBMCs (P values = 0.001, 0.001, and 0.002, respectively). It was also shown that the ginger extract could affect T-bet/GATA-3, T-bet/ROR-γt, and ROR-γt/GATA-3 expression ratios.

Conclusions

This study showed that the use of ginger extract could control asthma and decrease the severity of this disease by affecting the main cells involving the symptoms of asthma in the airways.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2IjNhI7

Predicting outgrowth of IgE-mediated cow's milk allergy: Diagnostic tests in children under two years of age

Publication date: Available online 10 February 2019

Source: Allergologia et Immunopathologia

Author(s): A. Uncuoglu, M.T. Cogurlu, I. Eser Simsek, N. Ergul, C. Baydemir, M. Aydogan

Abstract

Background

Limited studies conducted on children <2 years old and/or involving a skin prick test (SPT) for fresh milk (FM) have examined the predictive value of allergometric tests for outgrowth of cow's milk allergy (CMA). We investigated the optimal decision points for outgrowth (ODP^fo) with SPT for commercial cow's milk extract (CE) and FM and specific immunoglobulin E (sIgE) levels for milk proteins to predict outgrowing allergy in children <2 years old.

Methods

SPTs for CE and FM, tests for sIgEs (cow's milk, casein, α-lactoalbumin, β-lactoglobulin) and oral food challenges (OFC) were performed in children referred for evaluation of suspected CMA, and 15 months after diagnosis.

Results

Fifty-one children (median age, 7.5 months; range, 2–23 months) were enrolled. Five had a history of anaphylaxis and 26 of 48 children with a positive initial challenge underwent milk elimination. The last OFC was performed in 28 children of whom 13 reacted to milk. The initial SPT responses to CE and FM and milk sIgE levels of the patients with persistent CMA were higher at diagnosis, with ODP^fo of 7 mm, 9 mm, and 10.5 kU/L, respectively; these values remained higher with ODP^fo of 4 mm, 11 mm, and 10.5 kU/L at the last OFC.

Conclusion

Higher initial SPTs for FM and CE and higher initial sIgE levels for cow's milk proteins are associated with a reduced likelihood of outgrowth. Initial milk sIgE level <10.5 kU/L and initial SPT for fresh milk <9 mm are related to the acquisition of tolerance in the follow-up period.

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Chitosan hydrogel containing amelogenin-derived peptide: inhibition of cariogenic bacteria and promotion of remineralization of initial caries lesions

Publication date: Available online 10 February 2019

Source: Archives of Oral Biology

Author(s): Qian Ren, Longjiang Ding, Zhongcheng Li, Xiuqing Wang, Kun Wang, Sili Han, Wei Li, Xuedong Zhou, Linglin Zhang

Abstract

Objective

Nowadays, caries prevention focuses on controlling pathogenic bacteria, inhibiting demineralization and promoting re-mineralization. The aim of this study is to design a more clinically powerful anti-caries treatment by combining amelogenin-derived peptide QP5 with antibacterial chitosan in a hydrogel (CS-QP5 hydrogel), and characterize its effects on inhibition of cariogenic bacteria and promotion of remineralization of initial caries lesions.

Design

CS-QP5 interactions at different pH and chitosan concentrations were studied using UV–vis spectroscopy, fluorescence spectroscopy and circular dichroism. Antibacterial activity was measured using broth microdilution and biofilm assays. Remineralizing activity was measured using tests of surface micro-hardness(SMH), polarized light microscopy(PLM) and transverse microradiography(TMR) in a pH cycling model that simulates intra-oral pH conditions.

Results

The results of UV–vis spectroscopy, fluorescence spectroscopy and circular dichroism analyses suggest that the micro-environment of QP5 changes upon addition of chitosan and the interaction between QP5 and chitosan is reversible and dependent on pH. CS-QP5 hydrogel showed good antibacterial potency towards Streptococcus mutans with MIC/MBC of 5 mg/mL, reducing adhesion and biofilm formation up to 95.43% and nearly 100% respectively. According to the results of remineralizing studies, CS-QP5 hydrogel demonstrated 50.06% surface micro-hardness recovery, shallower lesion depth, significantly less mineral loss and more mineral content at different depth in the lesion body after pH cycling.

Conclusions

The hydrogel showed promise as a dual-action caries control agent in vitro, whether it could present good effects in vivo still needs to be determined, which requires further study. Nonetheless, the new design of bioactive hydrogel with antibacterial and remineralizing properties has the potential to substantially benefit oral health.

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Chitosan hydrogel containing amelogenin-derived peptide: inhibition of cariogenic bacteria and promotion of remineralization of initial caries lesions

Publication date: Available online 10 February 2019

Source: Archives of Oral Biology

Author(s): Qian Ren, Longjiang Ding, Zhongcheng Li, Xiuqing Wang, Kun Wang, Sili Han, Wei Li, Xuedong Zhou, Linglin Zhang

Abstract

Objective

Nowadays, caries prevention focuses on controlling pathogenic bacteria, inhibiting demineralization and promoting re-mineralization. The aim of this study is to design a more clinically powerful anti-caries treatment by combining amelogenin-derived peptide QP5 with antibacterial chitosan in a hydrogel (CS-QP5 hydrogel), and characterize its effects on inhibition of cariogenic bacteria and promotion of remineralization of initial caries lesions.

Design

CS-QP5 interactions at different pH and chitosan concentrations were studied using UV–vis spectroscopy, fluorescence spectroscopy and circular dichroism. Antibacterial activity was measured using broth microdilution and biofilm assays. Remineralizing activity was measured using tests of surface micro-hardness(SMH), polarized light microscopy(PLM) and transverse microradiography(TMR) in a pH cycling model that simulates intra-oral pH conditions.

Results

The results of UV–vis spectroscopy, fluorescence spectroscopy and circular dichroism analyses suggest that the micro-environment of QP5 changes upon addition of chitosan and the interaction between QP5 and chitosan is reversible and dependent on pH. CS-QP5 hydrogel showed good antibacterial potency towards Streptococcus mutans with MIC/MBC of 5 mg/mL, reducing adhesion and biofilm formation up to 95.43% and nearly 100% respectively. According to the results of remineralizing studies, CS-QP5 hydrogel demonstrated 50.06% surface micro-hardness recovery, shallower lesion depth, significantly less mineral loss and more mineral content at different depth in the lesion body after pH cycling.

Conclusions

The hydrogel showed promise as a dual-action caries control agent in vitro, whether it could present good effects in vivo still needs to be determined, which requires further study. Nonetheless, the new design of bioactive hydrogel with antibacterial and remineralizing properties has the potential to substantially benefit oral health.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BvNd1Y

Predictive values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other prognostic factors in pediatric idiopathic sudden sensorineural hearing loss

Publication date: Available online 11 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Ryun Ha, Byeoung Woo Lim, Dong Hyun Kim, Jung Woo Park, Chang Hyun Cho, Ju Hyoung Lee

Abstract

Background and Objectives

No consensus has been reached regarding the optimum treatment or factors affecting prognosis in pediatric idiopathic sudden sensorineural hearing loss (ISSNHL) due to its rarity. In the present study, treatment outcomes and prognostic factors of ISSNHL were investigated in pediatric patients who underwent steroid therapy.

Subjects

and Methods: Forty-two patients diagnosed with ISSNHL were enrolled in this retrospective study and compared with 39 normal healthy controls with respect to demography and complete blood cell count test results. In addition, prognosis factors were sought by dividing the 42 ISSNHL patients to 3 groups according to their response to the treatment.

Results

Neutrophil-to-lymphocyte ratio (NLR) value in the ISSNHL group were significantly higher than in the control group. NLR value in the three treatment response groups differed significantly. Early treatment with steroid and accompanying tinnitus were positive prognostic factor for hearing recovery. Other characteristics were not significant.

Conclusion

The results of this study suggest that good hearing recovery in children may be associated with early time of initial treatment and accompanying tinnitus. Also, NLR value might be useful readily accessible prognostic markers in pediatric ISSNHL patients. Further studies are required to confirm prognostic factors useful to predict prognosis and treat ISSNHL in pediatric patients.

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Mucoepidermoid Carcinoma of the Head and Neck in Children

Publication date: Available online 10 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Natasha D. Dombrowski, Nikolaus E. Wolter, Alexandria L. Irace, Michael J. Cunningham, Jennifer W. Mack, Karen J. Marcus, Sara O. Vargas, Antonio R. Perez-Atayde, Caroline D. Robson, Reza Rahbar

Abstract

Introduction

Mucoepidermoid carcinoma is a rare malignant salivary gland neoplasm in the pediatric population. Few studies have discussed best practice with respect to diagnosis and treatment in children.

Objective

To present our institution's experience with the evaluation and management of pediatric mucoepidermoid carcinoma of the head and neck.

Methods

Retrospective chart review of patients under 20 years of age diagnosed with mucoepidermoid carcinoma of the head and neck between 1998 and 2017. Data assessed includes demographics, clinical presentation, imaging examinations, histopathology, treatment, complications, local recurrence, distant metastasis, and follow-up.

Results

Sixteen patients (10 female, 6 male) were identified with a median age of 12.9 (IQR: 10.9-15.0) years. Tumors were located within the parotid gland (n = 11, 68.8%), accessory lobe of the parotid gland (n = 2, 12.5%), palate (n = 2, 12.5%), and submandibular region (n = 1, 6.3%). In 9 patients (56.3%) a neoplastic etiology was suspected based on the clinical and/or radiographic findings and confirmed pathologically on biopsy or excision. All patients were treated surgically and five patients required adjuvant radiotherapy. One patient had recurrence requiring re-excision. Seven patients (43.8%) had transient facial paresis post-operatively and one had Frey syndrome. Median follow-up time was 59.7 months (IQR: 18.9-99.3).

Conclusion

The malignant nature of mucoepidermoid carcinoma requires comprehensive, multidisciplinary management. Imaging and tissue sampling by fine needle aspiration give clinicians the best insight into location and nature of the mass. Complete surgical excision with attention to preservation of facial nerve and achieving negative margins is desired.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TDTW0N

Predictive values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other prognostic factors in pediatric idiopathic sudden sensorineural hearing loss

Publication date: Available online 11 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Ryun Ha, Byeoung Woo Lim, Dong Hyun Kim, Jung Woo Park, Chang Hyun Cho, Ju Hyoung Lee

Abstract

Background and Objectives

No consensus has been reached regarding the optimum treatment or factors affecting prognosis in pediatric idiopathic sudden sensorineural hearing loss (ISSNHL) due to its rarity. In the present study, treatment outcomes and prognostic factors of ISSNHL were investigated in pediatric patients who underwent steroid therapy.

Subjects

and Methods: Forty-two patients diagnosed with ISSNHL were enrolled in this retrospective study and compared with 39 normal healthy controls with respect to demography and complete blood cell count test results. In addition, prognosis factors were sought by dividing the 42 ISSNHL patients to 3 groups according to their response to the treatment.

Results

Neutrophil-to-lymphocyte ratio (NLR) value in the ISSNHL group were significantly higher than in the control group. NLR value in the three treatment response groups differed significantly. Early treatment with steroid and accompanying tinnitus were positive prognostic factor for hearing recovery. Other characteristics were not significant.

Conclusion

The results of this study suggest that good hearing recovery in children may be associated with early time of initial treatment and accompanying tinnitus. Also, NLR value might be useful readily accessible prognostic markers in pediatric ISSNHL patients. Further studies are required to confirm prognostic factors useful to predict prognosis and treat ISSNHL in pediatric patients.

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

Mucoepidermoid Carcinoma of the Head and Neck in Children

Publication date: Available online 10 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Natasha D. Dombrowski, Nikolaus E. Wolter, Alexandria L. Irace, Michael J. Cunningham, Jennifer W. Mack, Karen J. Marcus, Sara O. Vargas, Antonio R. Perez-Atayde, Caroline D. Robson, Reza Rahbar

Abstract

Introduction

Mucoepidermoid carcinoma is a rare malignant salivary gland neoplasm in the pediatric population. Few studies have discussed best practice with respect to diagnosis and treatment in children.

Objective

To present our institution's experience with the evaluation and management of pediatric mucoepidermoid carcinoma of the head and neck.

Methods

Retrospective chart review of patients under 20 years of age diagnosed with mucoepidermoid carcinoma of the head and neck between 1998 and 2017. Data assessed includes demographics, clinical presentation, imaging examinations, histopathology, treatment, complications, local recurrence, distant metastasis, and follow-up.

Results

Sixteen patients (10 female, 6 male) were identified with a median age of 12.9 (IQR: 10.9-15.0) years. Tumors were located within the parotid gland (n = 11, 68.8%), accessory lobe of the parotid gland (n = 2, 12.5%), palate (n = 2, 12.5%), and submandibular region (n = 1, 6.3%). In 9 patients (56.3%) a neoplastic etiology was suspected based on the clinical and/or radiographic findings and confirmed pathologically on biopsy or excision. All patients were treated surgically and five patients required adjuvant radiotherapy. One patient had recurrence requiring re-excision. Seven patients (43.8%) had transient facial paresis post-operatively and one had Frey syndrome. Median follow-up time was 59.7 months (IQR: 18.9-99.3).

Conclusion

The malignant nature of mucoepidermoid carcinoma requires comprehensive, multidisciplinary management. Imaging and tissue sampling by fine needle aspiration give clinicians the best insight into location and nature of the mass. Complete surgical excision with attention to preservation of facial nerve and achieving negative margins is desired.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TDTW0N

CoreSlicer: a web toolkit for analytic morphomics

Abstract

Background

Analytic morphomics, or more simply, "morphomics," refers to the measurement of specific biomarkers of body composition from medical imaging, most commonly computed tomography (CT) images. An emerging body of literature supports the use of morphomic markers measured on single-slice CT images for risk prediction in a range of clinical populations. However, uptake by healthcare providers been limited due to the lack of clinician-friendly software to facilitate measurements. The objectives of this study were to describe the interface and functionality of CoreSlicer- a free and open-source web-based interface aiming to facilitate measurement of analytic morphomics by clinicians - and to validate muscle and fat measurements performed in CoreSlicer against reference software.

Results

Measurements of muscle and fat obtained in CoreSlicer show high agreement with established reference software. CoreSlicer features a full set of DICOM viewing tools and extensible plugin interface to facilitate rapid prototyping and validation of new morphomic markers by researchers. We present published studies illustrating the use of CoreSlicer by clinicians with no prior knowledge of medical image segmentation techniques and no formal training in radiology, where CoreSlicer was successfully used to predict operative risk in three distinct populations of cardiovascular patients.

Conclusions

CoreSlicer enables extraction of morphomic markers from CT images by non-technically skilled clinicians. Measurements were reproducible and accurate in relation to reference software.

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

CoreSlicer: a web toolkit for analytic morphomics

Abstract

Background

Analytic morphomics, or more simply, "morphomics," refers to the measurement of specific biomarkers of body composition from medical imaging, most commonly computed tomography (CT) images. An emerging body of literature supports the use of morphomic markers measured on single-slice CT images for risk prediction in a range of clinical populations. However, uptake by healthcare providers been limited due to the lack of clinician-friendly software to facilitate measurements. The objectives of this study were to describe the interface and functionality of CoreSlicer- a free and open-source web-based interface aiming to facilitate measurement of analytic morphomics by clinicians - and to validate muscle and fat measurements performed in CoreSlicer against reference software.

Results

Measurements of muscle and fat obtained in CoreSlicer show high agreement with established reference software. CoreSlicer features a full set of DICOM viewing tools and extensible plugin interface to facilitate rapid prototyping and validation of new morphomic markers by researchers. We present published studies illustrating the use of CoreSlicer by clinicians with no prior knowledge of medical image segmentation techniques and no formal training in radiology, where CoreSlicer was successfully used to predict operative risk in three distinct populations of cardiovascular patients.

Conclusions

CoreSlicer enables extraction of morphomic markers from CT images by non-technically skilled clinicians. Measurements were reproducible and accurate in relation to reference software.

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Elective neck dissection in oral squamous cell carcinoma: Past, present and future

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Remco de Bree, Robert P. Takes, Jatin P. Shah, Marc Hamoir, Luiz P. Kowalski, K. Thomas Robbins, Juan P. Rodrigo, Alvaro Sanabria, Jesus E. Medina, Alessandra Rinaldo, Ashok R. Shaha, Carl Silver, Carlos Suárez, Manuel Bernal-Sprekelsen, Alfio Ferlito

Abstract

In 1994 a decision analysis, based on the literature and utility ratings for outcome by a panel of experienced head and neck physicians, was presented which showed a threshold probability of occult metastases of 20% to recommend elective treatment of the neck. It was stated that recommendations for the management of the cN0 neck are not immutable and should be reconfigured to determine the optimal management based on different sets of underlying assumptions. Although much has changed and is published in the almost 25 years after its publication, up to date this figure is still mentioned in the context of decisions on treatment of the clinically negative (cN0) neck. Therefore, we critically reviewed the developments in diagnostics and therapy and modeling approaches in the context of decisions on treatment of the cN0 neck. However, the results of studies on treatment of the cN0 neck cannot be translated to other settings due to significant differences in relevant variables such as population, culture, diagnostic work-up, follow-up, costs, institutional preferences and other factors. Moreover, patients may have personal preferences and may weigh oncologic outcomes versus morbidity and quality of life differently. Therefore, instead of trying to establish "the" best strategy for the cN0 neck or "the" optimal cut-off point for elective neck treatment, the approach to optimize the management of the cN0 neck would be to develop and implement models and decision support systems that can serve to optimize choices depending on individual, institutional, population and other relevant variables.

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Elective neck dissection in oral squamous cell carcinoma: Past, present and future

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Remco de Bree, Robert P. Takes, Jatin P. Shah, Marc Hamoir, Luiz P. Kowalski, K. Thomas Robbins, Juan P. Rodrigo, Alvaro Sanabria, Jesus E. Medina, Alessandra Rinaldo, Ashok R. Shaha, Carl Silver, Carlos Suárez, Manuel Bernal-Sprekelsen, Alfio Ferlito

Abstract

In 1994 a decision analysis, based on the literature and utility ratings for outcome by a panel of experienced head and neck physicians, was presented which showed a threshold probability of occult metastases of 20% to recommend elective treatment of the neck. It was stated that recommendations for the management of the cN0 neck are not immutable and should be reconfigured to determine the optimal management based on different sets of underlying assumptions. Although much has changed and is published in the almost 25 years after its publication, up to date this figure is still mentioned in the context of decisions on treatment of the clinically negative (cN0) neck. Therefore, we critically reviewed the developments in diagnostics and therapy and modeling approaches in the context of decisions on treatment of the cN0 neck. However, the results of studies on treatment of the cN0 neck cannot be translated to other settings due to significant differences in relevant variables such as population, culture, diagnostic work-up, follow-up, costs, institutional preferences and other factors. Moreover, patients may have personal preferences and may weigh oncologic outcomes versus morbidity and quality of life differently. Therefore, instead of trying to establish "the" best strategy for the cN0 neck or "the" optimal cut-off point for elective neck treatment, the approach to optimize the management of the cN0 neck would be to develop and implement models and decision support systems that can serve to optimize choices depending on individual, institutional, population and other relevant variables.

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Acid stimulation-induced semi-pluripotent characteristics in human somatic cells.

CONCLUSION: The human somatic cells undergoing a low pH treatment showed the similar characteristics as those of iPS cells, although the functions and therapeutic effect of these altered human somatic cells need to be further studied. PMID: 30734622 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Acid stimulation-induced semi-pluripotent characteristics in human somatic cells.

CONCLUSION: The human somatic cells undergoing a low pH treatment showed the similar characteristics as those of iPS cells, although the functions and therapeutic effect of these altered human somatic cells need to be further studied. PMID: 30734622 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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The Tooth Crossing the Confinement of Mandible: An Unique Expression of Central Variety of Dentigerous Cyst

Abstract

Dentigerous cyst (DC) is the most common developmental cyst that occurs in either jaw with a reported frequency of 18.1% (Jones et al. J Oral Pathol Med 35:500–507, 2006). DC literally means a tooth bearing cyst, and it is named due to the fact the it is almost always associated with an impacted or unerupted tooth in the jaw. The most common tooth involved by DC is mandibular third molar, since it is most common tooth to get impacted, followed by mandibular canine, maxillary third molars and mandibular premolars and less commonly maxillary central incisor. However, the association of mandibular second molar is unusual with an incidence of about 1.1%. We report a case of a 28 years old male diagnosed with an impacted mandibular third molar associated with DC and its surgical management.

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The Tooth Crossing the Confinement of Mandible: An Unique Expression of Central Variety of Dentigerous Cyst

Abstract

Dentigerous cyst (DC) is the most common developmental cyst that occurs in either jaw with a reported frequency of 18.1% (Jones et al. J Oral Pathol Med 35:500–507, 2006). DC literally means a tooth bearing cyst, and it is named due to the fact the it is almost always associated with an impacted or unerupted tooth in the jaw. The most common tooth involved by DC is mandibular third molar, since it is most common tooth to get impacted, followed by mandibular canine, maxillary third molars and mandibular premolars and less commonly maxillary central incisor. However, the association of mandibular second molar is unusual with an incidence of about 1.1%. We report a case of a 28 years old male diagnosed with an impacted mandibular third molar associated with DC and its surgical management.

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The role of energy drink consumption in the intention to initiate marijuana use among adolescents

Publication date: Available online 10 February 2019

Source: Addictive Behaviors

Author(s): Wanda Leal

Abstract

Aims

The current study aims to examine whether energy drink consumption is associated with intentions to try marijuana among adolescents who have never tried marijuana, and whether the effects of energy drink consumption on the intention to try marijuana vary between adolescents who have previously tried alcohol or cigarettes and those who have not.

Methods

This study employs a pooled cross-sectional design and uses a nationally representative sample of 8th (ages 13–14) and 10th (ages 15–16) grade adolescents from the seven most recent cohorts (2010–2016) of the Monitoring the Future (MTF) study. Logistic regression was employed to examine the association between energy drink consumption (none, light, moderate, heavy) and the odds of intending to initiate marijuana use in the next 12 months, controlling for sociodemographic factors and other health and social behaviors.

Results

The results indicate that energy drink consumers are significantly more likely to intend to initiate marijuana use relative to non-consumers of energy drinks. Specifically, youth who heavily use energy drinks have significantly higher odds of having the intention to use marijuana in the near future than youth who consume energy drinks moderately or lightly. Additionally, evidence suggests that the relationship between energy drink consumption and the intention to use marijuana is moderated by use of other substances.

Conclusions

The current study suggests that energy drink consumption (particularly heavy consumption), may be one early precursor in the escalation of substance use. It may be beneficial to include energy drinks in drug education curriculums.

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The role of energy drink consumption in the intention to initiate marijuana use among adolescents

Publication date: Available online 10 February 2019

Source: Addictive Behaviors

Author(s): Wanda Leal

Abstract

Aims

The current study aims to examine whether energy drink consumption is associated with intentions to try marijuana among adolescents who have never tried marijuana, and whether the effects of energy drink consumption on the intention to try marijuana vary between adolescents who have previously tried alcohol or cigarettes and those who have not.

Methods

This study employs a pooled cross-sectional design and uses a nationally representative sample of 8th (ages 13–14) and 10th (ages 15–16) grade adolescents from the seven most recent cohorts (2010–2016) of the Monitoring the Future (MTF) study. Logistic regression was employed to examine the association between energy drink consumption (none, light, moderate, heavy) and the odds of intending to initiate marijuana use in the next 12 months, controlling for sociodemographic factors and other health and social behaviors.

Results

The results indicate that energy drink consumers are significantly more likely to intend to initiate marijuana use relative to non-consumers of energy drinks. Specifically, youth who heavily use energy drinks have significantly higher odds of having the intention to use marijuana in the near future than youth who consume energy drinks moderately or lightly. Additionally, evidence suggests that the relationship between energy drink consumption and the intention to use marijuana is moderated by use of other substances.

Conclusions

The current study suggests that energy drink consumption (particularly heavy consumption), may be one early precursor in the escalation of substance use. It may be beneficial to include energy drinks in drug education curriculums.

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Diagnostic Accuracy of Shear Wave Elastography – Virtual TouchTM Imaging Quantification in the evaluation of breast masses: Impact on Ultrasonography’s Specificity and its Ultimate Clinical Benefit

Publication date: Available online 10 February 2019

Source: European Journal of Radiology

Author(s): Maíra Teixeira Dória, Rodrigo Menezes Jales, Livia Conz, Sophie Françoise Mauricette Derchain, Luís Otávio Zanatta Sarian

Abstract

Objectives

To evaluate the diagnostic performance and the clinical benefit of Shear-Wave Elastography - Virtual Touch^TM Imaging Quantification (SWE-VTIQ) as a complement to ultrasonography (US).

Methods

From October 2016 through Jun 2017, B-mode US and SWE-VTIQ were prospectively performed in 396 breast masses in 357 women who consented to undergo this study. Quantitative elastography values were recorded: V_max (maximum elasticity), V_mean (median elasticity), V_ratio(max) (ratio of V_max and surrounding parenchyma) and V_ratio(mean) (ratio of V_mean and surrounding parenchyma). The histopathology of the lesions was considered the reference standard for benign or malignant definition. The performance of the four elastographic parameters was evaluated trough sensitivity, specificity and AUC. The parameter with the best performance was tested in six different diagnostic approaches defined based on clinical practice.

Results

Of the 396 masses, 122 (30.8%) were benign and 274 (69.2%) were malignant. All SWE parameters were significantly higher in malignant masses (all p < 0.01). V_max and V_ratio(max) performed significantly better then V_ratio(mean) (p = 0.01 and p = 0.03, respectively). SWE-VTIQ improved US specificity in all diagnostic approaches, except when applied to BI-RADS 3 lesions. SWE-VTIQ reduced the false positive rate in 25% if applied only to BI-RADS 4A masses, maintaining a high sensitivity (98.9%, 95% confidence interval 97.1-100%) and a negative predictive value of 95.5%. When applied to BI-RADS 4A and 4B masses, SWE-VTIQ reduced the false positive rate in 54.4%. However, 13 malignant cases would be missed in this approach (4.7% of all malignant cases).

Conclusions

SWE-VTIQ increases US specificity when applied to BI-RADS 4 A lesions, significantly reducing unnecessary interventions and preserving the diagnosis of malignant lesions. When applied also to BI-RADS® 4B lesions, SWE-VTIQ increases the number of false negative cases, which should be evaluated with caution.

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First-year radiology residents teaching anatomy to first-year medical students: A symbiotic relationship: Brief Communication for The Education Corner

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Preya Shah, Samantha P. Zuckerman, Cole Thompson, Austin R. Pantel, Neal A. Rubinstein, Maya Galperin-Aizenberg, Mary H. Scanlon, Arun C. Nachiappan

Abstract

Rationale and Objectives

: Our institution has developed an educational program in which first-year radiology residents teach first-year medical students during gross anatomy laboratory sessions. The purpose of this study is to assess the impact of this program on medical student knowledge and perceptions of radiology, and on resident attitudes toward teaching.

Materials and Methods

: First-year resident pairs taught small groups of medical students during weekly 15-minute interactive sessions, and were evaluated on teaching skills by senior residents. A survey about attitudes toward radiology and a knowledge quiz were sent to the medical students, and a survey about attitudes toward teaching was sent to the first-year radiology residents, both pre-course and post-course.

Results

: Students' radiology knowledge significantly increased between the pre-course and post-course survey across all categories tested (p < 0.001). Additionally, there were significant improvements in terms of students' confidence in radiological anatomy skills, perceived importance of radiology for medical training, familiarity with the field of radiology, and perception that radiologists are friendly (p < 0.001). Radiology residents felt more confident in their teaching proficiency (p < 0.001) by the conclusion of the course.

Conclusion

: Resident-led small-group teaching sessions during anatomy laboratory are mutually beneficial for medical students and radiology residents. The program also allows radiology residents to be exposed early on in residency to teaching and academic medicine.

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Preoperative MRI for the Multiligament Knee Injury: What the Surgeon Needs to Know

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Jack Porrino, Annie Wang, Kimia Kani, Christopher Y Kweon, Albert Gee

Abstract

The multiligament knee injury is devastating and potentially limb threatening. Preoperative MRI for the evaluation of the multiligament knee injury is an invaluable clinical tool, and when the radiologist is familiar with how certain injury patterns influence management, optimal outcomes can be achieved. We provide a detailed description of the relationship between salient imaging features of the multiligament knee injury, focusing on the preoperative MRI, and their influence on clinical decision-making.

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The Role and Pitfall of F18-FDG PET/CT in Surveillance of High Grade Pulmonary Lymphomatoid Granulomatosis

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Ming Yang, Allison C. Rosenthal, Jonathan B. Ashman, Fiona E. Craig

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Diagnostic Accuracy of Shear Wave Elastography – Virtual TouchTM Imaging Quantification in the evaluation of breast masses: Impact on Ultrasonography’s Specificity and its Ultimate Clinical Benefit

Publication date: Available online 10 February 2019

Source: European Journal of Radiology

Author(s): Maíra Teixeira Dória, Rodrigo Menezes Jales, Livia Conz, Sophie Françoise Mauricette Derchain, Luís Otávio Zanatta Sarian

Abstract

Objectives

To evaluate the diagnostic performance and the clinical benefit of Shear-Wave Elastography - Virtual Touch^TM Imaging Quantification (SWE-VTIQ) as a complement to ultrasonography (US).

Methods

From October 2016 through Jun 2017, B-mode US and SWE-VTIQ were prospectively performed in 396 breast masses in 357 women who consented to undergo this study. Quantitative elastography values were recorded: V_max (maximum elasticity), V_mean (median elasticity), V_ratio(max) (ratio of V_max and surrounding parenchyma) and V_ratio(mean) (ratio of V_mean and surrounding parenchyma). The histopathology of the lesions was considered the reference standard for benign or malignant definition. The performance of the four elastographic parameters was evaluated trough sensitivity, specificity and AUC. The parameter with the best performance was tested in six different diagnostic approaches defined based on clinical practice.

Results

Of the 396 masses, 122 (30.8%) were benign and 274 (69.2%) were malignant. All SWE parameters were significantly higher in malignant masses (all p < 0.01). V_max and V_ratio(max) performed significantly better then V_ratio(mean) (p = 0.01 and p = 0.03, respectively). SWE-VTIQ improved US specificity in all diagnostic approaches, except when applied to BI-RADS 3 lesions. SWE-VTIQ reduced the false positive rate in 25% if applied only to BI-RADS 4A masses, maintaining a high sensitivity (98.9%, 95% confidence interval 97.1-100%) and a negative predictive value of 95.5%. When applied to BI-RADS 4A and 4B masses, SWE-VTIQ reduced the false positive rate in 54.4%. However, 13 malignant cases would be missed in this approach (4.7% of all malignant cases).

Conclusions

SWE-VTIQ increases US specificity when applied to BI-RADS 4 A lesions, significantly reducing unnecessary interventions and preserving the diagnosis of malignant lesions. When applied also to BI-RADS® 4B lesions, SWE-VTIQ increases the number of false negative cases, which should be evaluated with caution.

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First-year radiology residents teaching anatomy to first-year medical students: A symbiotic relationship: Brief Communication for The Education Corner

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Preya Shah, Samantha P. Zuckerman, Cole Thompson, Austin R. Pantel, Neal A. Rubinstein, Maya Galperin-Aizenberg, Mary H. Scanlon, Arun C. Nachiappan

Abstract

Rationale and Objectives

: Our institution has developed an educational program in which first-year radiology residents teach first-year medical students during gross anatomy laboratory sessions. The purpose of this study is to assess the impact of this program on medical student knowledge and perceptions of radiology, and on resident attitudes toward teaching.

Materials and Methods

: First-year resident pairs taught small groups of medical students during weekly 15-minute interactive sessions, and were evaluated on teaching skills by senior residents. A survey about attitudes toward radiology and a knowledge quiz were sent to the medical students, and a survey about attitudes toward teaching was sent to the first-year radiology residents, both pre-course and post-course.

Results

: Students' radiology knowledge significantly increased between the pre-course and post-course survey across all categories tested (p < 0.001). Additionally, there were significant improvements in terms of students' confidence in radiological anatomy skills, perceived importance of radiology for medical training, familiarity with the field of radiology, and perception that radiologists are friendly (p < 0.001). Radiology residents felt more confident in their teaching proficiency (p < 0.001) by the conclusion of the course.

Conclusion

: Resident-led small-group teaching sessions during anatomy laboratory are mutually beneficial for medical students and radiology residents. The program also allows radiology residents to be exposed early on in residency to teaching and academic medicine.

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

Preoperative MRI for the Multiligament Knee Injury: What the Surgeon Needs to Know

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Jack Porrino, Annie Wang, Kimia Kani, Christopher Y Kweon, Albert Gee

Abstract

The multiligament knee injury is devastating and potentially limb threatening. Preoperative MRI for the evaluation of the multiligament knee injury is an invaluable clinical tool, and when the radiologist is familiar with how certain injury patterns influence management, optimal outcomes can be achieved. We provide a detailed description of the relationship between salient imaging features of the multiligament knee injury, focusing on the preoperative MRI, and their influence on clinical decision-making.

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The Role and Pitfall of F18-FDG PET/CT in Surveillance of High Grade Pulmonary Lymphomatoid Granulomatosis

Publication date: Available online 10 February 2019

Source: Current Problems in Diagnostic Radiology

Author(s): Ming Yang, Allison C. Rosenthal, Jonathan B. Ashman, Fiona E. Craig

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Can f 5 as a suitable marker of dog allergy: Assess male dog exposure before banning it

Publication date: Available online 10 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Gennaro Liccardi, Luigino Calzetta, Manlio Milanese, Giovanni Passalacqua, Paola Rogliani

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Reply

Publication date: Available online 10 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Ulrika Käck, Anna Asarnoj, Hans Grönlund, Magnus P. Borres, Marianne van Hage, Gunnar Lilja, Jon R. Konradsen

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Can f 5 as a suitable marker of dog allergy: Assess male dog exposure before banning it

Publication date: Available online 10 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Gennaro Liccardi, Luigino Calzetta, Manlio Milanese, Giovanni Passalacqua, Paola Rogliani

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Reply

Publication date: Available online 10 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Ulrika Käck, Anna Asarnoj, Hans Grönlund, Magnus P. Borres, Marianne van Hage, Gunnar Lilja, Jon R. Konradsen

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Emerging Triggers of FPIES: Lessons from a Pediatric Cohort of 74 Children in the US

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Andrea C. Blackman, Sara Anvari, Carla M. Davis, Aikaterini Anagnostou

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Eliminating health disparities in asthma: are we at the end of the beginning?

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Christian Rosas-Salazar, Juan C. Celedón

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Characteristics of Inner City Children with Life-Threatening Asthma

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Mary Elizabeth Bollinger, Arlene Butz, Mona Tsoukleris, Cassia Lewis-Land, Shawna Mudd, Tricia Morphew

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Emerging Triggers of FPIES: Lessons from a Pediatric Cohort of 74 Children in the US

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Andrea C. Blackman, Sara Anvari, Carla M. Davis, Aikaterini Anagnostou

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Eliminating health disparities in asthma: are we at the end of the beginning?

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Christian Rosas-Salazar, Juan C. Celedón

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Characteristics of Inner City Children with Life-Threatening Asthma

Publication date: Available online 10 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Mary Elizabeth Bollinger, Arlene Butz, Mona Tsoukleris, Cassia Lewis-Land, Shawna Mudd, Tricia Morphew

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Improved state change estimation in dynamic functional connectivity using hidden semi-Markov models

Publication date: Available online 10 February 2019

Source: NeuroImage

Author(s): Heather Shappell, Brian S. Caffo, James J. Pekar, Martin A. Lindquist

Abstract

The study of functional brain networks has grown rapidly over the past decade. While most functional connectivity (FC) analyses estimate one static network structure for the entire length of the functional magnetic resonance imaging (fMRI) time series, recently there has been increased interest in studying time-varying changes in FC. Hidden Markov models (HMMs) have proven to be a useful modeling approach for discovering repeating graphs of interacting brain regions (brain states). However, a limitation lies in HMMs assuming that the sojourn time, the number of consecutive time points in a state, is geometrically distributed. This may encourage inaccurate estimation of the time spent in a state before switching to another state. We propose a hidden semi-Markov model (HSMM) approach for inferring time-varying brain networks from fMRI data, which explicitly models the sojourn distribution. Specifically, we propose using HSMMs to find each subject's most probable series of network states and the graphs associated with each state, while properly estimating and modeling the sojourn distribution for each state. We perform a simulation study, as well as an analysis on both task-based fMRI data from an anxiety-inducing experiment and resting-state fMRI data from the Human Connectome Project. Our results demonstrate the importance of model choice when estimating sojourn times and reveal their potential for understanding healthy and diseased brain mechanisms.

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Improved state change estimation in dynamic functional connectivity using hidden semi-Markov models

Publication date: Available online 10 February 2019

Source: NeuroImage

Author(s): Heather Shappell, Brian S. Caffo, James J. Pekar, Martin A. Lindquist

Abstract

The study of functional brain networks has grown rapidly over the past decade. While most functional connectivity (FC) analyses estimate one static network structure for the entire length of the functional magnetic resonance imaging (fMRI) time series, recently there has been increased interest in studying time-varying changes in FC. Hidden Markov models (HMMs) have proven to be a useful modeling approach for discovering repeating graphs of interacting brain regions (brain states). However, a limitation lies in HMMs assuming that the sojourn time, the number of consecutive time points in a state, is geometrically distributed. This may encourage inaccurate estimation of the time spent in a state before switching to another state. We propose a hidden semi-Markov model (HSMM) approach for inferring time-varying brain networks from fMRI data, which explicitly models the sojourn distribution. Specifically, we propose using HSMMs to find each subject's most probable series of network states and the graphs associated with each state, while properly estimating and modeling the sojourn distribution for each state. We perform a simulation study, as well as an analysis on both task-based fMRI data from an anxiety-inducing experiment and resting-state fMRI data from the Human Connectome Project. Our results demonstrate the importance of model choice when estimating sojourn times and reveal their potential for understanding healthy and diseased brain mechanisms.

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Three-dimensional skeletal changes after early proportional condylectomy for condylar hyperplasia

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): R. Fariña, E. Moreno, J. Lolas, F. Silva, B. Martínez

Abstract

The purpose of this study was to evaluate volumetric and dentoskeletal changes in 21 patients with active unilateral condylar hyperplasia (AUCH) after proportional condylectomy. A split-mouth design was used: control group healthy joints (HS, healthy side) and test group affected joints (AS, affected side) (21 per group). Cone beam tomography scans were obtained at T0 (preoperative), T1 (10 days after the intervention), and T2 (approximately 12 months post-surgery). The condylar unit volume (CUV), articular cavity volume (ACV), and dentoalveolar units (DAUs) were measured. CUV showed a difference of 1.12 cm³ between T0 and T1, increasing 0.4 cm³ between T1 and T2 on AS. There was no difference between T0 and T2 on HS. ACV increased 0.65 cm³ between T0 and T1 on AS, after which it decreased by 0.36 cm³ at T2 (0.30 cm³ larger than the initial articular cavity at T0). ACV showed no post-surgery differences on HS. Midline DAU showed extrusion of 0.20 mm for maxilla and 0.52 mm for mandible, while in the lateral area, maxilla was extruded by 0.3 mm on HS and was intruded 0.12 mm on AS. For the mandible, both sides showed extrusion (0.4–0.6 mm). In the distal to canine and molar areas, intrusion of 0.2 mm and 0.9 mm, respectively, was observed on AS; there was extrusion of 0.6 mm distal to the canine on HS. At the mandibular level, AS distal to the canine showed extrusion of 1 mm, while intrusion of 0.2 mm was observed in the molars. For HS, only extrusion at the molar level (0.2 mm) was observed. In conclusion, after proportional condylectomy, a neocondyle forms within 12 months to equal the healthy contralateral side. The articular cavity, which is reduced in the initial stage, increases in size after surgery and the volume gradually approaches that of the healthy side. Dentoalveolar changes occur at the anterior and posterior levels, causing intrusion and extrusion of the interdental crests. An early proportional condylectomy as the sole surgical treatment for patients with AUCH allows normalization of the maxillomandibular relationship.

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Management of velopharyngeal insufficiency by modified Furlow palatoplasty with pharyngeal flap: a retrospective outcome review

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): L.S. Wong, E. Lim, T.C. Lu, P.K.T. Chen

Abstract

The surgical approach for the correction of residual velopharyngeal insufficiency requiring secondary surgery at Chang Gung Memorial Hospital is the modified Furlow palatoplasty with pharyngeal flap (mFP-PF). The aim of this study was to describe the mFP-PF technique and to determine the results obtained with regard to improvements in velopharyngeal function in patients undergoing this surgery. This retrospective analysis included 58 non-syndromic patients treated during the period 1992–2015 who complained of hypernasal speech after primary cleft palate repair and failed postoperative speech therapy. All of them underwent mFP-PF surgery. Preoperative and postoperative perceptual speech assessment results were obtained. The male to female ratio in the study group was 1.2:1, and the mean patient age at the time of surgery was 8.27 years. The patients underwent nasoendoscopic examination and the velar closing ratio was categorized as 0.1–0.4 in 53.4% and 0.5–0.7 in 46.6%. The assessment of speech after mFP-PF showed statistically significant changes for all perceptual speech outcomes. The incidence of repeat surgery was 3.4%. This study revealed that 96.6% of patients did not require second surgery for velopharyngeal insufficiency. Further studies on obstructive sleep apnoea in post-mFP-PF patients and improvements to the surgical technique should be considered.

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Learning condyle repositioning during orthognathic surgery with a surgical navigation system

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): R. Lartizien, I. Zaccaria, C. Savoldelli, L. Noyelles, E. Chamorey, J.L. Cracowski, G. Bettega

Abstract

Condyle repositioning during bilateral sagittal splint osteotomy (BSSO) is a challenging step for the inexperienced surgeon. We aimed to demonstrate the benefit of navigation for learning the condyle repositioning. We treated 100 patients who underwent a BSSO. A trainee performed the condyle repositioning of one side in two phases. In the first one, the trainee positioned without watching the screen of the Orthopilot Navigation system (ONS). In the second one, the trainee could use the ONS to replace the condyle. Heuristic, anatomical and functional scores of each phase were recorded. Heuristic (17% vs. 75%; p < 0.0001), anatomical (35% vs. 86%; p < 0.0001) and functional (14% vs. 56%; p < 0.0001) scores were significantly greater with the ONS. The ONS is a promising and original intraoperative learning tool for the repositioning of the condyle during BSSO.

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Three-dimensional skeletal changes after early proportional condylectomy for condylar hyperplasia

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): R. Fariña, E. Moreno, J. Lolas, F. Silva, B. Martínez

Abstract

The purpose of this study was to evaluate volumetric and dentoskeletal changes in 21 patients with active unilateral condylar hyperplasia (AUCH) after proportional condylectomy. A split-mouth design was used: control group healthy joints (HS, healthy side) and test group affected joints (AS, affected side) (21 per group). Cone beam tomography scans were obtained at T0 (preoperative), T1 (10 days after the intervention), and T2 (approximately 12 months post-surgery). The condylar unit volume (CUV), articular cavity volume (ACV), and dentoalveolar units (DAUs) were measured. CUV showed a difference of 1.12 cm³ between T0 and T1, increasing 0.4 cm³ between T1 and T2 on AS. There was no difference between T0 and T2 on HS. ACV increased 0.65 cm³ between T0 and T1 on AS, after which it decreased by 0.36 cm³ at T2 (0.30 cm³ larger than the initial articular cavity at T0). ACV showed no post-surgery differences on HS. Midline DAU showed extrusion of 0.20 mm for maxilla and 0.52 mm for mandible, while in the lateral area, maxilla was extruded by 0.3 mm on HS and was intruded 0.12 mm on AS. For the mandible, both sides showed extrusion (0.4–0.6 mm). In the distal to canine and molar areas, intrusion of 0.2 mm and 0.9 mm, respectively, was observed on AS; there was extrusion of 0.6 mm distal to the canine on HS. At the mandibular level, AS distal to the canine showed extrusion of 1 mm, while intrusion of 0.2 mm was observed in the molars. For HS, only extrusion at the molar level (0.2 mm) was observed. In conclusion, after proportional condylectomy, a neocondyle forms within 12 months to equal the healthy contralateral side. The articular cavity, which is reduced in the initial stage, increases in size after surgery and the volume gradually approaches that of the healthy side. Dentoalveolar changes occur at the anterior and posterior levels, causing intrusion and extrusion of the interdental crests. An early proportional condylectomy as the sole surgical treatment for patients with AUCH allows normalization of the maxillomandibular relationship.

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Management of velopharyngeal insufficiency by modified Furlow palatoplasty with pharyngeal flap: a retrospective outcome review

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): L.S. Wong, E. Lim, T.C. Lu, P.K.T. Chen

Abstract

The surgical approach for the correction of residual velopharyngeal insufficiency requiring secondary surgery at Chang Gung Memorial Hospital is the modified Furlow palatoplasty with pharyngeal flap (mFP-PF). The aim of this study was to describe the mFP-PF technique and to determine the results obtained with regard to improvements in velopharyngeal function in patients undergoing this surgery. This retrospective analysis included 58 non-syndromic patients treated during the period 1992–2015 who complained of hypernasal speech after primary cleft palate repair and failed postoperative speech therapy. All of them underwent mFP-PF surgery. Preoperative and postoperative perceptual speech assessment results were obtained. The male to female ratio in the study group was 1.2:1, and the mean patient age at the time of surgery was 8.27 years. The patients underwent nasoendoscopic examination and the velar closing ratio was categorized as 0.1–0.4 in 53.4% and 0.5–0.7 in 46.6%. The assessment of speech after mFP-PF showed statistically significant changes for all perceptual speech outcomes. The incidence of repeat surgery was 3.4%. This study revealed that 96.6% of patients did not require second surgery for velopharyngeal insufficiency. Further studies on obstructive sleep apnoea in post-mFP-PF patients and improvements to the surgical technique should be considered.

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

Learning condyle repositioning during orthognathic surgery with a surgical navigation system

Publication date: Available online 10 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): R. Lartizien, I. Zaccaria, C. Savoldelli, L. Noyelles, E. Chamorey, J.L. Cracowski, G. Bettega

Abstract

Condyle repositioning during bilateral sagittal splint osteotomy (BSSO) is a challenging step for the inexperienced surgeon. We aimed to demonstrate the benefit of navigation for learning the condyle repositioning. We treated 100 patients who underwent a BSSO. A trainee performed the condyle repositioning of one side in two phases. In the first one, the trainee positioned without watching the screen of the Orthopilot Navigation system (ONS). In the second one, the trainee could use the ONS to replace the condyle. Heuristic, anatomical and functional scores of each phase were recorded. Heuristic (17% vs. 75%; p < 0.0001), anatomical (35% vs. 86%; p < 0.0001) and functional (14% vs. 56%; p < 0.0001) scores were significantly greater with the ONS. The ONS is a promising and original intraoperative learning tool for the repositioning of the condyle during BSSO.

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Gestalt Theory in Education and Practice

Publication date: Available online 11 February 2019

Source: Academic Radiology

Author(s): Mert Sirakaya

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Coronary CT Angiography in Challenging Patients: High Heart Rate and Atrial Fibrillation. A Review

Publication date: Available online 10 February 2019

Source: Academic Radiology

Author(s): Saima Mushtaq, Edoardo Conte, Eleonora Melotti, Daniele Andreini

Despite several strategies have been developed by different vendors to improve image quality and diagnostic accuracy of coronary CT angiography performed at high heart rate (HR) and HR variability, as in patients with atrial fibrillation (AF), some concerns and small clinical experience characterize these subsets of challenging patients. However, patients with AF have been reported to have higher risk of cardiovascular events and noninvasive evaluation of suspected coronary artery disease in this setting may be of extreme clinical interest. The goal of this review is to provide to the reader an overview on the use of cardiac CT in patients with AF and high HR and to outline the technological improvements recently introduced in the clinical field that may enable to definitively overcome the limitations of cardiac CT in this challenging scenario.

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Gestalt Theory in Education and Practice

Publication date: Available online 11 February 2019

Source: Academic Radiology

Author(s): Mert Sirakaya

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Coronary CT Angiography in Challenging Patients: High Heart Rate and Atrial Fibrillation. A Review

Publication date: Available online 10 February 2019

Source: Academic Radiology

Author(s): Saima Mushtaq, Edoardo Conte, Eleonora Melotti, Daniele Andreini

Despite several strategies have been developed by different vendors to improve image quality and diagnostic accuracy of coronary CT angiography performed at high heart rate (HR) and HR variability, as in patients with atrial fibrillation (AF), some concerns and small clinical experience characterize these subsets of challenging patients. However, patients with AF have been reported to have higher risk of cardiovascular events and noninvasive evaluation of suspected coronary artery disease in this setting may be of extreme clinical interest. The goal of this review is to provide to the reader an overview on the use of cardiac CT in patients with AF and high HR and to outline the technological improvements recently introduced in the clinical field that may enable to definitively overcome the limitations of cardiac CT in this challenging scenario.

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Impact of patient characteristics on edentulous subjects’ preferences for prosthodontic rehabilitation with implants

Abstract

Objective

The aim of this study was to assess the influence of patient characteristics on edentulous subjects' preferences for different prosthodontic treatments with implants.

Materials and Methods

A cross‐sectional study was carried out with 131 edentulous subjects referred for treatment at a university clinic. Participants received detailed information about available treatment options, and were asked to rank their preferences among three alternatives for rehabilitation of the maxilla and mandible: conventional dentures (CD), 2‐implant retained overdentures (IOD) or 4‐implant fixed dentures (IFD). Individual data and prosthodontic‐related variables were assessed through interviews. Oral health‐related quality of life impacts were measured using the Brazilian version of the Oral Health Impact Profile for edentulous subjects (OHIP‐Edent). Descriptive statistics, bivariate tests, and binary and multinomial logistic regressions were used for data analysis.

Results

The majority of participants chose CD as their most preferred treatment for the maxilla (45.8%), while IFD was the most prevalent choice for the mandible (38.9%). Regression analysis showed that the OHIP‐Edent "oral pain and dysfunction" (OPD) domain scores were positively associated with IOD preference for the maxilla (OR=1.31; p=0.010) and mandible (OR=1.46; p=0.002), and with IFD preference for the mandible (OR=1.20; p=0.031). Subjects with lower levels of formal education and those with lower income levels were less likely to choose IFD.

Conclusion

Level of education, income and perceived quality of life impacts are potentially predictive variables of edentulous patients' preference for rehabilitation with implants. These factors may constitute important aspects to be considered by clinicians when treatment planning for edentulous patients.

This article is protected by copyright. All rights reserved.

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Impact of patient characteristics on edentulous subjects’ preferences for prosthodontic rehabilitation with implants

Abstract

Objective

The aim of this study was to assess the influence of patient characteristics on edentulous subjects' preferences for different prosthodontic treatments with implants.

Materials and Methods

A cross‐sectional study was carried out with 131 edentulous subjects referred for treatment at a university clinic. Participants received detailed information about available treatment options, and were asked to rank their preferences among three alternatives for rehabilitation of the maxilla and mandible: conventional dentures (CD), 2‐implant retained overdentures (IOD) or 4‐implant fixed dentures (IFD). Individual data and prosthodontic‐related variables were assessed through interviews. Oral health‐related quality of life impacts were measured using the Brazilian version of the Oral Health Impact Profile for edentulous subjects (OHIP‐Edent). Descriptive statistics, bivariate tests, and binary and multinomial logistic regressions were used for data analysis.

Results

The majority of participants chose CD as their most preferred treatment for the maxilla (45.8%), while IFD was the most prevalent choice for the mandible (38.9%). Regression analysis showed that the OHIP‐Edent "oral pain and dysfunction" (OPD) domain scores were positively associated with IOD preference for the maxilla (OR=1.31; p=0.010) and mandible (OR=1.46; p=0.002), and with IFD preference for the mandible (OR=1.20; p=0.031). Subjects with lower levels of formal education and those with lower income levels were less likely to choose IFD.

Conclusion

Level of education, income and perceived quality of life impacts are potentially predictive variables of edentulous patients' preference for rehabilitation with implants. These factors may constitute important aspects to be considered by clinicians when treatment planning for edentulous patients.

This article is protected by copyright. All rights reserved.

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A Case‐control Study of the Association between Sialolithiasis and Osteoporosis

Abstract

Objective

The purpose of this study was to evaluate the association between osteoporosis and salivary gland stone using a population‐based claims database.

Design

A case‐control design.

Setting

Taiwan.

Participants

We retrieved the sample for this case‐control study from the Taiwan "Longitudinal Health Insurance Database 2005". All 557 patients aged 40 years or older with a diagnosis of sialolithiasis were cases and 1671 matched controls (without sialolithiasis) were selected.

Subjects and Methods

We used the chi‐square test to explore differences between cases and controls on socio‐demographic characteristics. Furthermore, conditional logistic regressions were used to examine the association of sialolithiasis with previously diagnosed osteoporosis.

Results

Of 2228 sampled patients, 171 (7.68%) had ever been previously diagnosed with osteoporosis; 58 (10.41%) among cases and 113 (6.76%) among controls (p=0.005). Conditional logistic regression analysis found that the odds ratio (OR) of prior osteoporosis for cases was 1.79 (95% confidence interval [CI]: 1.24‐2.59, p=0.002) relative to controls after adjusting for urbanization, and the selected medical co‐morbidities. Furthermore, we found that among patients aged ≥65 years, the adjusted OR of prior osteoporosis for cases was 1.89 (95% CI=1.02‐3.51).No significant relationship was observed among patients aged <65 years old.

Conclusion

This study demonstrates an association between sialolithiasis and osteoporosis. Although the finding warrants further investigation, the results call for more awareness of the possible concurrence of osteoporosis among physicians and patients with salivary gland stones.

This article is protected by copyright. All rights reserved.

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A Case‐control Study of the Association between Sialolithiasis and Osteoporosis

Abstract

Objective

The purpose of this study was to evaluate the association between osteoporosis and salivary gland stone using a population‐based claims database.

Design

A case‐control design.

Setting

Taiwan.

Participants

We retrieved the sample for this case‐control study from the Taiwan "Longitudinal Health Insurance Database 2005". All 557 patients aged 40 years or older with a diagnosis of sialolithiasis were cases and 1671 matched controls (without sialolithiasis) were selected.

Subjects and Methods

We used the chi‐square test to explore differences between cases and controls on socio‐demographic characteristics. Furthermore, conditional logistic regressions were used to examine the association of sialolithiasis with previously diagnosed osteoporosis.

Results

Of 2228 sampled patients, 171 (7.68%) had ever been previously diagnosed with osteoporosis; 58 (10.41%) among cases and 113 (6.76%) among controls (p=0.005). Conditional logistic regression analysis found that the odds ratio (OR) of prior osteoporosis for cases was 1.79 (95% confidence interval [CI]: 1.24‐2.59, p=0.002) relative to controls after adjusting for urbanization, and the selected medical co‐morbidities. Furthermore, we found that among patients aged ≥65 years, the adjusted OR of prior osteoporosis for cases was 1.89 (95% CI=1.02‐3.51).No significant relationship was observed among patients aged <65 years old.

Conclusion

This study demonstrates an association between sialolithiasis and osteoporosis. Although the finding warrants further investigation, the results call for more awareness of the possible concurrence of osteoporosis among physicians and patients with salivary gland stones.

This article is protected by copyright. All rights reserved.

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Optimising Radiation Therapy Dose to the Swallowing Organs at Risk: An In Silico Study of feasibility for Patients with Oropharyngeal Tumours

Abstract

Recent evidence suggests that reducing radiotherapy dose delivered to specific anatomical swallowing structures [Swallowing Organs at Risk (SWOARs)] may improve swallowing outcomes post-treatment for patients with head and neck cancer. However, for those patients with tumours of the oropharynx, which typically directly overlap the SWOARs, reducing dose to these structures may be unachievable without compromising on the treatment of the disease. To assess the feasibility of dose reduction in this cohort, standard IMRT plans (ST-IMRT) and plans with reduced dose to the SWOARs (SW-IMRT) were generated for 25 oropharyngeal cancer patients (Brouwer et al. in Radiother Oncol 117(1):83–90, http://bit.ly/2I5RkHK, 2015; Christianen et al. in Radiother Oncol 101(3):394–402, http://bit.ly/2GkW3Uo, 2011). ST-IMRT and SW-IMRT plans were compared for: mean dose to the SWOARs, volume of pharynx and larynx receiving 50 Gy and 60 Gy (V50 and V60 respectively) and overlap between the tumour volume and the SWOARs. Additionally, two different SWOARs delineation guidelines (Brouwer et al. in Radiother Oncol 117(1):83–90, http://bit.ly/2I5RkHK, 2015; Christianen et al. in Radiother Oncol 101(3):394–402, http://bit.ly/2GkW3Uo, 2011) were used to highlight differences in calculated volumes between existing contouring guidelines. Agreement in SWOARs volumes between the two guidelines was calculated using a concordance index (CI). Despite a large overlap between the tumour and SWOARs, significant (p < 0.05) reductions in mean dose to 4 of the 5 SWOARs, and V50/V60 for the pharynx and larynx were achieved with SW-IMRT plans. Low CIs per structure (0.15–0.45) were found between the two guidelines highlighting issues comparing data between studies when different guidelines have been used (Hawkins et al. in Semin Radiat Oncol 28(1):46–52, http://bit.ly/2I8RcqW, 2018; Brodin et al. in Int J Radiat Oncol Biol Phys 100(2):391–407, http://bit.ly/2GjtUwJ, 2018). This study found reducing dose to the SWOARs is a feasible practice for patients with oropharyngeal cancer. However, future prospective research is needed to determine if the extent of dose reduction achieved equates to clinical benefits.

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Optimising Radiation Therapy Dose to the Swallowing Organs at Risk: An In Silico Study of feasibility for Patients with Oropharyngeal Tumours

Abstract

Recent evidence suggests that reducing radiotherapy dose delivered to specific anatomical swallowing structures [Swallowing Organs at Risk (SWOARs)] may improve swallowing outcomes post-treatment for patients with head and neck cancer. However, for those patients with tumours of the oropharynx, which typically directly overlap the SWOARs, reducing dose to these structures may be unachievable without compromising on the treatment of the disease. To assess the feasibility of dose reduction in this cohort, standard IMRT plans (ST-IMRT) and plans with reduced dose to the SWOARs (SW-IMRT) were generated for 25 oropharyngeal cancer patients (Brouwer et al. in Radiother Oncol 117(1):83–90, http://bit.ly/2I5RkHK, 2015; Christianen et al. in Radiother Oncol 101(3):394–402, http://bit.ly/2GkW3Uo, 2011). ST-IMRT and SW-IMRT plans were compared for: mean dose to the SWOARs, volume of pharynx and larynx receiving 50 Gy and 60 Gy (V50 and V60 respectively) and overlap between the tumour volume and the SWOARs. Additionally, two different SWOARs delineation guidelines (Brouwer et al. in Radiother Oncol 117(1):83–90, http://bit.ly/2I5RkHK, 2015; Christianen et al. in Radiother Oncol 101(3):394–402, http://bit.ly/2GkW3Uo, 2011) were used to highlight differences in calculated volumes between existing contouring guidelines. Agreement in SWOARs volumes between the two guidelines was calculated using a concordance index (CI). Despite a large overlap between the tumour and SWOARs, significant (p < 0.05) reductions in mean dose to 4 of the 5 SWOARs, and V50/V60 for the pharynx and larynx were achieved with SW-IMRT plans. Low CIs per structure (0.15–0.45) were found between the two guidelines highlighting issues comparing data between studies when different guidelines have been used (Hawkins et al. in Semin Radiat Oncol 28(1):46–52, http://bit.ly/2I8RcqW, 2018; Brodin et al. in Int J Radiat Oncol Biol Phys 100(2):391–407, http://bit.ly/2GjtUwJ, 2018). This study found reducing dose to the SWOARs is a feasible practice for patients with oropharyngeal cancer. However, future prospective research is needed to determine if the extent of dose reduction achieved equates to clinical benefits.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2I5RmPS

Lessons from times of shortage: interchangeability of venom preparations and dosing protocols

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Computed tomography texture features can discriminate benign from malignant lymphadenopathy in pediatric patients: a preliminary study

Abstract

Background

Differentiation of benign from malignant lymphadenopathy remains challenging in pediatric radiology. Textural analysis (TA) quantitates heterogeneity of tissue signal intensities and has been applied to analysis of CT images.

Objective

The purpose of this study was to establish whether CT textural analysis of enlarged lymph nodes visualized on pediatric CT can distinguish benign from malignant lymphadenopathy.

Materials and methods

We retrospectively identified enlarged lymph nodes measuring 10–20 mm on contrast-enhanced CTs of patients age 18 years and younger that had been categorized as benign or malignant based on the known diagnoses. We placed regions of interest (ROIs) over lymph nodes of interest and performed textural analysis with and without feature size filtration. We then calculated test performance characteristics for TA features, along with multivariate logistic regression modeling using Akaike Information Criterion (AIC) minimization, to determine the optimal thresholds for distinguishing benign from malignant lymphadenopathy.

Results

We identified 34 enlarged malignant nodes and 29 benign nodes from 63 patients within the 10- to 20-mm size range. Filtered image TA exhibited 82.4% sensitivity, 86.2% specificity and 84.1% accuracy for detecting malignant lymph nodes using mean and entropy parameters, whereas unfiltered TA exhibited 88.2% sensitivity, 72.4% specificity and 81.0% accuracy using mean and mean value of positive pixels parameters.

Conclusion

This preliminary study demonstrates that the use of TA features improves the utility of pediatric CT to distinguish benign from malignant lymphadenopathy. The addition of TA to pediatric CT protocols has great potential to aid the characterization of indeterminate lymph nodes. If definitive differentiation between benign and malignant lymphadenopathy is possible by TA, it has the potential to reduce the need for follow-up imaging and tissue sampling, with reduced associated radiation exposure. However future studies are needed to confirm the clinical applicability of TA in distinguishing benign from malignant lymphadenopathy.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2E3wNzi

Lessons from times of shortage: interchangeability of venom preparations and dosing protocols

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GCR9RF

Computed tomography texture features can discriminate benign from malignant lymphadenopathy in pediatric patients: a preliminary study

Abstract

Background

Differentiation of benign from malignant lymphadenopathy remains challenging in pediatric radiology. Textural analysis (TA) quantitates heterogeneity of tissue signal intensities and has been applied to analysis of CT images.

Objective

The purpose of this study was to establish whether CT textural analysis of enlarged lymph nodes visualized on pediatric CT can distinguish benign from malignant lymphadenopathy.

Materials and methods

We retrospectively identified enlarged lymph nodes measuring 10–20 mm on contrast-enhanced CTs of patients age 18 years and younger that had been categorized as benign or malignant based on the known diagnoses. We placed regions of interest (ROIs) over lymph nodes of interest and performed textural analysis with and without feature size filtration. We then calculated test performance characteristics for TA features, along with multivariate logistic regression modeling using Akaike Information Criterion (AIC) minimization, to determine the optimal thresholds for distinguishing benign from malignant lymphadenopathy.

Results

We identified 34 enlarged malignant nodes and 29 benign nodes from 63 patients within the 10- to 20-mm size range. Filtered image TA exhibited 82.4% sensitivity, 86.2% specificity and 84.1% accuracy for detecting malignant lymph nodes using mean and entropy parameters, whereas unfiltered TA exhibited 88.2% sensitivity, 72.4% specificity and 81.0% accuracy using mean and mean value of positive pixels parameters.

Conclusion

This preliminary study demonstrates that the use of TA features improves the utility of pediatric CT to distinguish benign from malignant lymphadenopathy. The addition of TA to pediatric CT protocols has great potential to aid the characterization of indeterminate lymph nodes. If definitive differentiation between benign and malignant lymphadenopathy is possible by TA, it has the potential to reduce the need for follow-up imaging and tissue sampling, with reduced associated radiation exposure. However future studies are needed to confirm the clinical applicability of TA in distinguishing benign from malignant lymphadenopathy.

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Water-dispersible glycosylated poly(2,5'-thienylene)porphyrin-based nanoparticles for antibacterial photodynamic therapy

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00470F, Paper

Donus Tuncel, REHAN KHAN, Aisan khaligh, Melis Özkan
Here we report the preparation of water-dispersible glycosylated poly(2,5'-thienylene)porphyrin based nanoparticles by a nanoprecipitation method and demonstrate the application of these nanoparticles in the antibacterial photodynamic therapy. The size of...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Water-dispersible glycosylated poly(2,5'-thienylene)porphyrin-based nanoparticles for antibacterial photodynamic therapy

Photochem. Photobiol. Sci., 2019, Accepted Manuscript
DOI: 10.1039/C8PP00470F, Paper

Donus Tuncel, REHAN KHAN, Aisan khaligh, Melis Özkan
Here we report the preparation of water-dispersible glycosylated poly(2,5'-thienylene)porphyrin based nanoparticles by a nanoprecipitation method and demonstrate the application of these nanoparticles in the antibacterial photodynamic therapy. The size of...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Bullous irritant contact dermatitis due to alcoholic extract from Juglans regia leaves

Phytotherapeutic remedies can be responsible for allergic and irritant contact dermatitis and even chemical burns (1). We report a case of irritant contact dermatitis due to alcoholic extract from Juglans regia leaves.

This article is protected by copyright. All rights reserved.

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Bullous irritant contact dermatitis due to alcoholic extract from Juglans regia leaves

Phytotherapeutic remedies can be responsible for allergic and irritant contact dermatitis and even chemical burns (1). We report a case of irritant contact dermatitis due to alcoholic extract from Juglans regia leaves.

This article is protected by copyright. All rights reserved.

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Combination Therapy With VRC-HIVMAB060-00-AB (VRC01) and 10-1074 in HIV-Infected Individuals Undergoing Sequential Treatment Interruptions

Condition:   HIV Interventions:   Biological: VRC-HIVMAB060-00-AB (VRC01);   Biological: 10-1074;   Biological: Normal Saline Placebo Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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The Influence of ANS-6637 on Midazolam Pharmacokinetics in Healthy Volunteers

Condition:   Opioid Addiction Interventions:   Drug: MDZ;   Drug: ANS-6637 Sponsors:   National Institutes of Health Clinical Center (CC);   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Healthy Meals: A Restaurant-based Study to Promote Healthy and Allergy Adapted Diet

Conditions:   Intervention;   Food Allergy;   Food Preferences;   Food Intolerance;   Diet Habit;   Diet Modification Intervention:   Behavioral: Multicomponent intervention Sponsors:   University Rovira i Virgili;   Diputació de Tarragona Not yet recruiting (Source: ClinicalTrials.gov)

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Retrospective Chart Review of Candida Fungemia

Condition:   Candida Intervention:   Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Active, not recruiting (Source: ClinicalTrials.gov)

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