HLA-A*32:01 is strongly associated with vancomycin-induced drug reaction with eosinophilia and systemic symptoms

Publication date: Available online 16 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Katherine C. Konvinse, Jason A. Trubiano, Rebecca Pavlos, Ian James, Christian M. Shaffer, Cosmin A. Bejan, Ryan J. Schutte, David A. Ostrov, Mark A. Pilkinton, Misha Rosenbach, Jeffrey P. Zwerner, Kristina B. Williams, Jack Bourke, Patricia Martinez, Francois Rwandamuriye, Abha Chopra, Mark Watson, Alec J. Redwood, Katie D. White, Simon A. Mallal

Abstract

Background

Vancomycin is a prevalent cause of the severe hypersensitivity syndrome drug reaction with eosinophilia and systemic symptoms (DRESS) which leads to significant morbidity and mortality and commonly occurs in the setting of combination antibiotic therapy which impacts future treatment choices. Variations in human leukocyte antigen (HLA) class I in particular have been associated with serious T-cell mediated adverse drug reactions which has led to preventive screening strategies for some drugs.

Objective

To determine if variation in the HLA region is associated with vancomycin-induced DRESS.

Methods

Probable vancomycin DRESS cases were matched 1:2 with tolerant controls based on sex, race, and age using BioVU, Vanderbilt's deidentified electronic health record database. Associations between DRESS and carriage of HLA class I and II alleles were assessed by conditional logistic regression. An extended sample set from BioVU was utilized to conduct a time-to-event analysis of those exposed to vancomycin with and without the identified HLA risk allele.

Results

Twenty-three individuals met inclusion criteria for vancomycin-associated DRESS. 19/23 (82.6%) cases carried HLA-A*32:01 compared to 0/46 (0%) of the matched vancomycin tolerant controls (p=1x10^-8) and 6.3% of the BioVU population (n=54,249) (p=2x10^-16). Time-to-event analysis of DRESS development during vancomycin treatment among the HLA-A*32:01 positive group indicated that 19.2% developed DRESS and did so within four weeks.

Conclusions

HLA-A*32:01 is strongly associated with vancomycin DRESS in a population of predominantly European ancestry. HLA-A*32:01 testing could improve antibiotic safety, help implicate vancomycin as the causal drug and preserve future treatment options with co-administered antibiotics.

Graphical abstract

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Treatments of Cold Urticaria: A Systematic Review

Publication date: Available online 15 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Kanokvalai Kulthanan, Saowalak Hunnangkul, Papapit Tuchinda, Leena Chularojanamontri, Puncharas Weerasubpong, Chanika Subchookul, Marcus Maurer

Abstract

Background

Several treatment options for cold urticaria (ColdU) have been studied and reported, but systematic reviews and meta-analyses are limited.

Objectives

To meta-analyze and review the efficacy and safety of ColdU treatments.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Suitable reports were identified by searching PubMed, Scopus, and Web of Science. Our systematic review included 16 studies, 9 of which met the eligibility criteria for the meta-analysis. We analyzed the effects of treatments on the critical temperature thresholds (CTTs) and critical stimulation time thresholds (CSTTs), as well as on the rates of complete response and adverse events.

Results

Our pooled meta-analyses showed that non-sedating, second-generation H₁-antihistamines (nsAHs) are effective in the treatment of ColdU, and that the updosing of nsAHs significantly reduced CTTs relative to their own standard doses and placebos. In 4 studies involving CSTT, the updosing of nsAHs also showed significantly better CSTTs than their own standard doses or placebos. Omalizumab resulted in a marked reduction of CTTs in H₁-AH-resistant patients. Of 118 adverse events in 8 studies, standard-dose nsAHs, updosed nsAHs, and omalizumab produced lower numbers of adverse events than first-generation AHs.

Conclusions

Our study showed that higher dosages of nsAHs were more effective than their own standard dosages in controlling ColdU symptoms. Increasing the dosages was not significantly associated with higher adverse event rates. Omalizumab at 150 and 300 mg every 4 weeks was shown to be effective for ColdU patients refractory to AHs.

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Refractory diet-dependent changes in neural microstructure: Implications for microstructural endophenotypes of neurologic and psychiatric disease

Publication date: Available online 15 February 2019

Source: Magnetic Resonance Imaging

Author(s): Maribel Torres-Velázquez, Emily A. Sawin, Jacqueline M. Anderson, John-Paul J. Yu

Abstract

Alterations in gut microbiome populations via dietary manipulation have been shown to induce diet-dependent changes in white matter microstructure. The purpose of this study is to examine the durability of these diet-induced microstructural alterations. We implemented a crossover experimental design where post-weaned male rats were assigned to one of four experimental diets. Following the administration of experimental diets and again following crossover and resumption of a normal diet, brains were imaged ex-vivo with diffusion tensor imaging. Following standard image preprocessing, tract-based spatial statistics and region-of-interest measurements were then calculated for all diffusion tensor indices. Voxel-wise differences in FA were identified in the high fat diet group when compared to animals receiving a control diet. Following crossover, there were new voxel-wise changes in both FA and TR that do not correspond to the regions previously identified. Animals crossed over from the high fiber diet demonstrate widespread and global changes in the diffusion tensor that stand in stark contrast to the minimal changes identified before crossover. While no significant differences between any of the diffusion metrics were identified in the high protein group before crossover, statistically significant decreased RD values were observed following resumption of a normal diet. Diet-induced changes in neural microstructure are durable changes that are unrecoverable following the resumption of a normal diet. We further show that in certain experimental diets, resumption of a normal diet can lead to further marked and unanticipated changes in white matter microstructure.

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Refractory diet-dependent changes in neural microstructure: Implications for microstructural endophenotypes of neurologic and psychiatric disease

Publication date: Available online 15 February 2019

Source: Magnetic Resonance Imaging

Author(s): Maribel Torres-Velázquez, Emily A. Sawin, Jacqueline M. Anderson, John-Paul J. Yu

Abstract

Alterations in gut microbiome populations via dietary manipulation have been shown to induce diet-dependent changes in white matter microstructure. The purpose of this study is to examine the durability of these diet-induced microstructural alterations. We implemented a crossover experimental design where post-weaned male rats were assigned to one of four experimental diets. Following the administration of experimental diets and again following crossover and resumption of a normal diet, brains were imaged ex-vivo with diffusion tensor imaging. Following standard image preprocessing, tract-based spatial statistics and region-of-interest measurements were then calculated for all diffusion tensor indices. Voxel-wise differences in FA were identified in the high fat diet group when compared to animals receiving a control diet. Following crossover, there were new voxel-wise changes in both FA and TR that do not correspond to the regions previously identified. Animals crossed over from the high fiber diet demonstrate widespread and global changes in the diffusion tensor that stand in stark contrast to the minimal changes identified before crossover. While no significant differences between any of the diffusion metrics were identified in the high protein group before crossover, statistically significant decreased RD values were observed following resumption of a normal diet. Diet-induced changes in neural microstructure are durable changes that are unrecoverable following the resumption of a normal diet. We further show that in certain experimental diets, resumption of a normal diet can lead to further marked and unanticipated changes in white matter microstructure.

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Whole-exome sequencing identification of a novel splicing mutation of RUNX2 in a Chinese family with cleidocranial dysplasia

Publication date: Available online 15 February 2019

Source: Archives of Oral Biology

Author(s): Tingting Zhang, Wu Jing, Xiaoxue Zhao, Feifei Hou, Tengfei Ma, Huijuan Wang, Xu Zhang, Xiangyu Zhang

Abstract

Objectives

Cleidocranial dysplasia (CCD) is a congenital autosomal dominant skeletal disease characterized by multiple craniofacial and dental anomalies. Here, we investigated mutation of the runt-related transcription factor 2 (RUNX2) gene, which is considered responsible for most instances of CCD in patients, in a Chinese family with CCD.

Methods

Genomic DNA was extracted from the peripheral blood lymphocytes of all participants, and mutation analysis was performed using whole-exome and Sanger sequencing. Biophysical predictions of the altered protein were analyzed using various bioinformatics tools, and direct sequencing via reverse transcription polymerase chain reaction (PCR) was performed for functional analysis of the mutation. To determine the function of the mutated protein, expression of RUNX2 and integrin-binding sialoprotein (IBSP) was investigated via quantitative PCR.

Results

We identified a novel splicing mutation (c.581–9 T > G) in all affected members, with this RUNX2 mutation incorporating in a new splice site to replace the canonical splice site, thereby resulting in insertion of an 8-bp fragment within the terminal exon 5 splice-acceptor site and premature translation termination. qPCR results confirmed attenuated RUNX2 expression and IBSP overexpression in the peripheral blood lymphocytes of patients.

Conclusions

These results suggested that the newly identified splice-site mutation (c.581–9 T > G) in RUNX2 was responsible for CCD in this family through its alteration of RUNX2 activity and upregulated IBSP levels. These findings extend the mutational spectrum of the RUNX2 gene and might contribute to genetic diagnosis and counseling of families with CCD.

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Whole-exome sequencing identification of a novel splicing mutation of RUNX2 in a Chinese family with cleidocranial dysplasia

Publication date: Available online 15 February 2019

Source: Archives of Oral Biology

Author(s): Tingting Zhang, Wu Jing, Xiaoxue Zhao, Feifei Hou, Tengfei Ma, Huijuan Wang, Xu Zhang, Xiangyu Zhang

Abstract

Objectives

Cleidocranial dysplasia (CCD) is a congenital autosomal dominant skeletal disease characterized by multiple craniofacial and dental anomalies. Here, we investigated mutation of the runt-related transcription factor 2 (RUNX2) gene, which is considered responsible for most instances of CCD in patients, in a Chinese family with CCD.

Methods

Genomic DNA was extracted from the peripheral blood lymphocytes of all participants, and mutation analysis was performed using whole-exome and Sanger sequencing. Biophysical predictions of the altered protein were analyzed using various bioinformatics tools, and direct sequencing via reverse transcription polymerase chain reaction (PCR) was performed for functional analysis of the mutation. To determine the function of the mutated protein, expression of RUNX2 and integrin-binding sialoprotein (IBSP) was investigated via quantitative PCR.

Results

We identified a novel splicing mutation (c.581–9 T > G) in all affected members, with this RUNX2 mutation incorporating in a new splice site to replace the canonical splice site, thereby resulting in insertion of an 8-bp fragment within the terminal exon 5 splice-acceptor site and premature translation termination. qPCR results confirmed attenuated RUNX2 expression and IBSP overexpression in the peripheral blood lymphocytes of patients.

Conclusions

These results suggested that the newly identified splice-site mutation (c.581–9 T > G) in RUNX2 was responsible for CCD in this family through its alteration of RUNX2 activity and upregulated IBSP levels. These findings extend the mutational spectrum of the RUNX2 gene and might contribute to genetic diagnosis and counseling of families with CCD.

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I feel what I do: Relating interoceptive processes and reward-related behavior

Publication date: Available online 16 February 2019

Source: NeuroImage

Author(s): Amanda C. Marshall, Antje Gentsch, Anna-Lucia Blum, Christina Bröring, Simone Schütz-Bosbach

Abstract

Interoceptive signalling has been shown to contribute to action regulation and action experience. Here, we assess whether motor behaviour can be influenced by anticipated homeostatic feeling states induced through different predictable contexts. Participants performed a reward incentive paradigm in which accurate responses increased (gain) or avoided the depletion (averted loss) of a credit score. Across two types of blocks, we varied the predictability of the outcome state. In predictable blocks, a cue signalled a gain, loss or control trial (motor response did not affect the credit score). This allowed participants to anticipate the interoceptive feeling state associated with the outcome. In unpredictable blocks, the cue had no relation to the type of outcome. Thus, participants were unable to anticipate the feeling state it produced. Via EEG, we measured the Heartbeat Evoked Potential (HEP) and the Contingent Negative Variation (CNV) as indices of interoceptive and motor processing respectively. In addition, we measured feedback P3 amplitude following outcome presentation and accuracy and reaction times of the required motor response. We observed higher HEP and CNV amplitudes as well as faster and more accurate motor responses in predictable compared to unpredictable outcome blocks. Similarly, feedback-related P3 amplitudes were significantly lower for predictable relative to unpredictable outcomes. Crucially, HEP amplitudes measured prior to feedback predicted feedback-related P3 amplitudes for anticipated outcome events. Results suggest that accurate anticipation of homeostatic feeling states associated with gain, loss or control outcomes facilitates motor execution and outcome evaluation. Findings are hereby the first to empirically assess the link between interoceptive and motor domains and provide primary evidence for a joint processing structure.

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Reliability of supraspinal correlates to lower urinary tract stimulation in healthy participants – A fMRI study

Publication date: Available online 15 February 2019

Source: NeuroImage

Author(s): Matthias Walter, Lorenz Leitner, Lars Michels, Martina D. Liechti, Patrick Freund, Thomas M. Kessler, Spyros Kollias, Ulrich Mehnert

Abstract

Previous functional neuroimaging studies provided evidence for a specific supraspinal network involved in lower urinary tract (LUT) control. However, data on the reliability of blood oxygenation level-dependent (BOLD) signal changes during LUT task-related functional magnetic resonance imaging (fMRI) across separate measurements are lacking. Proof of the latter is crucial to evaluate whether fMRI can be used to assess supraspinal responses to LUT treatments.

Therefore, we prospectively assessed task-specific supraspinal responses from 20 healthy participants undergoing two fMRI measurements (test-retest) within 5–8 weeks. The fMRI measurements, conducted in a 3T magnetic resonance (MR) scanner, comprised a block design of repetitive bladder filling and drainage using an automated MR-compatible and MR-synchronized infusion-drainage device. Following transurethral catheterization and bladder pre-filling with body warm saline until participants perceived a persistent desire to void (START condition), fMRI was recorded during repetitive blocks (each 15 s) of INFUSION and WITHDRAWAL of 100 mL body warm saline into respectively from the bladder. BOLD signal changes were calculated for INFUSION minus START. In addition to whole brain analysis, we assessed BOLD signal changes within multiple 'a priori' region of interest (ROI), i.e. brain areas known to be involved in the LUT control from previous literature. To evaluate reliability of the fMRI results between visits, we applied different types of analyses: coefficient of variation (CV), intraclass correlation coefficient (ICC), Sørensen-Dice index, Bland-Altman method, and block-wise BOLD signal comparison.

All participants completed the study without adverse events. The desire to void was rated significantly higher for INFUSION compared to START or WITHDRAWAL at both measurements without any effect of visit. At whole brain level, significant (p < 0.05, cluster corrected, k ≥ 41 voxels) BOLD signal changes were found for the contrast INFUSION compared to START in several brain areas. Overlap of activation maps from both measurements were observed in the orbitofrontal cortex, insula, ventrolateral prefrontal cortex (VLPFC), and inferior parietal lobe. The two highest ICCs, based on a ROI's mean beta weight, were 0.55 (right insular cortex) and 0.47 (VLPFC). Spatial congruency (Sørensen-Dice index) of all voxels within each ROI between measurements was highest in the insular cortex (left 0.55, right 0.44). In addition, the mean beta weight of the right insula and right VLPFC demonstrated the lowest CV and narrowest Bland and Altman 95% limits of agreement.

In conclusion, the right insula and right VLPFC were revealed as the two most reliable task-specific ROIs using our automated, MR-synchronized protocol. Achieving high reliability using a viscero-sensory/interoceptive task such as repetitive bladder filling remains challenging and further endeavour is highly warranted to better understand which factors influence fMRI outcomes and finally to assess LUT treatment effects on the supraspinal level.

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I feel what I do: Relating interoceptive processes and reward-related behavior

Publication date: Available online 16 February 2019

Source: NeuroImage

Author(s): Amanda C. Marshall, Antje Gentsch, Anna-Lucia Blum, Christina Bröring, Simone Schütz-Bosbach

Abstract

Interoceptive signalling has been shown to contribute to action regulation and action experience. Here, we assess whether motor behaviour can be influenced by anticipated homeostatic feeling states induced through different predictable contexts. Participants performed a reward incentive paradigm in which accurate responses increased (gain) or avoided the depletion (averted loss) of a credit score. Across two types of blocks, we varied the predictability of the outcome state. In predictable blocks, a cue signalled a gain, loss or control trial (motor response did not affect the credit score). This allowed participants to anticipate the interoceptive feeling state associated with the outcome. In unpredictable blocks, the cue had no relation to the type of outcome. Thus, participants were unable to anticipate the feeling state it produced. Via EEG, we measured the Heartbeat Evoked Potential (HEP) and the Contingent Negative Variation (CNV) as indices of interoceptive and motor processing respectively. In addition, we measured feedback P3 amplitude following outcome presentation and accuracy and reaction times of the required motor response. We observed higher HEP and CNV amplitudes as well as faster and more accurate motor responses in predictable compared to unpredictable outcome blocks. Similarly, feedback-related P3 amplitudes were significantly lower for predictable relative to unpredictable outcomes. Crucially, HEP amplitudes measured prior to feedback predicted feedback-related P3 amplitudes for anticipated outcome events. Results suggest that accurate anticipation of homeostatic feeling states associated with gain, loss or control outcomes facilitates motor execution and outcome evaluation. Findings are hereby the first to empirically assess the link between interoceptive and motor domains and provide primary evidence for a joint processing structure.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2STYDX1

Reliability of supraspinal correlates to lower urinary tract stimulation in healthy participants – A fMRI study

Publication date: Available online 15 February 2019

Source: NeuroImage

Author(s): Matthias Walter, Lorenz Leitner, Lars Michels, Martina D. Liechti, Patrick Freund, Thomas M. Kessler, Spyros Kollias, Ulrich Mehnert

Abstract

Previous functional neuroimaging studies provided evidence for a specific supraspinal network involved in lower urinary tract (LUT) control. However, data on the reliability of blood oxygenation level-dependent (BOLD) signal changes during LUT task-related functional magnetic resonance imaging (fMRI) across separate measurements are lacking. Proof of the latter is crucial to evaluate whether fMRI can be used to assess supraspinal responses to LUT treatments.

Therefore, we prospectively assessed task-specific supraspinal responses from 20 healthy participants undergoing two fMRI measurements (test-retest) within 5–8 weeks. The fMRI measurements, conducted in a 3T magnetic resonance (MR) scanner, comprised a block design of repetitive bladder filling and drainage using an automated MR-compatible and MR-synchronized infusion-drainage device. Following transurethral catheterization and bladder pre-filling with body warm saline until participants perceived a persistent desire to void (START condition), fMRI was recorded during repetitive blocks (each 15 s) of INFUSION and WITHDRAWAL of 100 mL body warm saline into respectively from the bladder. BOLD signal changes were calculated for INFUSION minus START. In addition to whole brain analysis, we assessed BOLD signal changes within multiple 'a priori' region of interest (ROI), i.e. brain areas known to be involved in the LUT control from previous literature. To evaluate reliability of the fMRI results between visits, we applied different types of analyses: coefficient of variation (CV), intraclass correlation coefficient (ICC), Sørensen-Dice index, Bland-Altman method, and block-wise BOLD signal comparison.

All participants completed the study without adverse events. The desire to void was rated significantly higher for INFUSION compared to START or WITHDRAWAL at both measurements without any effect of visit. At whole brain level, significant (p < 0.05, cluster corrected, k ≥ 41 voxels) BOLD signal changes were found for the contrast INFUSION compared to START in several brain areas. Overlap of activation maps from both measurements were observed in the orbitofrontal cortex, insula, ventrolateral prefrontal cortex (VLPFC), and inferior parietal lobe. The two highest ICCs, based on a ROI's mean beta weight, were 0.55 (right insular cortex) and 0.47 (VLPFC). Spatial congruency (Sørensen-Dice index) of all voxels within each ROI between measurements was highest in the insular cortex (left 0.55, right 0.44). In addition, the mean beta weight of the right insula and right VLPFC demonstrated the lowest CV and narrowest Bland and Altman 95% limits of agreement.

In conclusion, the right insula and right VLPFC were revealed as the two most reliable task-specific ROIs using our automated, MR-synchronized protocol. Achieving high reliability using a viscero-sensory/interoceptive task such as repetitive bladder filling remains challenging and further endeavour is highly warranted to better understand which factors influence fMRI outcomes and finally to assess LUT treatment effects on the supraspinal level.

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Binaural advantages in using a cochlear implant for adults with profound unilateral hearing loss.

CONCLUSION AND SIGNIFICANCE: Patients with a postlingual onset of a profound hearing loss in one ear and normal hearing or only a moderate loss in the other ear are able to make the effective use of a CI in the profound-loss ear in conjunction with acoustic stimulation of the other ear. PMID: 30762466 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Development of vestibular ocular reflex and gross motor function in infants with common cavity deformity as a type of inner ear malformation.

CONCLUSIONS AND SIGNIFICANCE: In the eight infants with common cavity deformity, vestibular ocular reflex was not present around the first year of life, but appeared after three or four years probably because of some vestibular sensory cells. Head control and independent walking were delayed but eventually acquired by the central vestibular compensation. PMID: 30762456 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Efficacy of combination therapy in adolescent and adult patients with total-deafness sudden sensorineural hearing loss.

CONCLUSION: Compared with adult patients, adolescent patients with total-deafness SSNHL undergoing combination therapy may be less likely to have hearing recovery and the improvement of tinnitus. PMID: 30762471 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Analysis between phenotypes and genotypes of inner ear malformation.

CONCLUSIONS: 1. EVA patients with severe sensorineural hearing loss were always diagnosed in childhood and Cochlear implantation was feasible for these patients with the bilateral hearing loss. 2. SLC26A4 gene was closely related to EVA. 3. GJB2 and mtDNA genes were not responsible for EVA. SIGNIFICANCE: The relationship between genotype and clinical phenotype provides a theoretical basis for future gene diagnosis and prevention and treatment of LVAS. PMID: 30762457 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Identification of causative variants in patients with non-syndromic hearing loss in the Minnan region, China by targeted next-generation sequencing.

CONCLUSIONS AND SIGNIFICANCE: Our targeted NGS analysis added supports for the application of NGS in routine diagnosis and provided an overview of genetic variants with allele frequencies in the deaf population from the Minnan region. PMID: 30762455 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Intravascular large B-cell lymphoma presenting with hearing loss and dizziness: A case report

Rationale: Intravascular large B-cell lymphoma (IVLBCL) is a type of malignant lymphoma in which neoplastic B cells proliferate selectively within the lumina of small- and medium-sized vessels. Patients with IVLBCL frequently develop neurological manifestations during their disease course. Patients are known to often develop various neurological manifestations, but there are only a few reports of IVLBCL whose initial symptoms are deafness and/or disequilibrium. Patient concerns: A 66-year-old Japanese man was provisionally diagnosed with sudden sensorineural hearing loss. Administration of prednisolone did not improve his symptoms, and then he experienced amaurosis fugax. Magnetic resonance imaging (MRI) showed multiple brain infarcts, so he was administered antithrombotic drugs. Neve...

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Untreated allergic rhinitis is a major risk factor contributing to motorcar accidents - Church MK, Zuberbier T.

[Abstract unavailable] Language: en... (Source: SafetyLit)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2N83D56

Binaural advantages in using a cochlear implant for adults with profound unilateral hearing loss.

CONCLUSION AND SIGNIFICANCE: Patients with a postlingual onset of a profound hearing loss in one ear and normal hearing or only a moderate loss in the other ear are able to make the effective use of a CI in the profound-loss ear in conjunction with acoustic stimulation of the other ear. PMID: 30762466 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2N6M3P5

Development of vestibular ocular reflex and gross motor function in infants with common cavity deformity as a type of inner ear malformation.

CONCLUSIONS AND SIGNIFICANCE: In the eight infants with common cavity deformity, vestibular ocular reflex was not present around the first year of life, but appeared after three or four years probably because of some vestibular sensory cells. Head control and independent walking were delayed but eventually acquired by the central vestibular compensation. PMID: 30762456 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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

Efficacy of combination therapy in adolescent and adult patients with total-deafness sudden sensorineural hearing loss.

CONCLUSION: Compared with adult patients, adolescent patients with total-deafness SSNHL undergoing combination therapy may be less likely to have hearing recovery and the improvement of tinnitus. PMID: 30762471 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Nb1vd4

Analysis between phenotypes and genotypes of inner ear malformation.

CONCLUSIONS: 1. EVA patients with severe sensorineural hearing loss were always diagnosed in childhood and Cochlear implantation was feasible for these patients with the bilateral hearing loss. 2. SLC26A4 gene was closely related to EVA. 3. GJB2 and mtDNA genes were not responsible for EVA. SIGNIFICANCE: The relationship between genotype and clinical phenotype provides a theoretical basis for future gene diagnosis and prevention and treatment of LVAS. PMID: 30762457 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SVe94V

Identification of causative variants in patients with non-syndromic hearing loss in the Minnan region, China by targeted next-generation sequencing.

CONCLUSIONS AND SIGNIFICANCE: Our targeted NGS analysis added supports for the application of NGS in routine diagnosis and provided an overview of genetic variants with allele frequencies in the deaf population from the Minnan region. PMID: 30762455 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2N8mxc5

Intravascular large B-cell lymphoma presenting with hearing loss and dizziness: A case report

Rationale: Intravascular large B-cell lymphoma (IVLBCL) is a type of malignant lymphoma in which neoplastic B cells proliferate selectively within the lumina of small- and medium-sized vessels. Patients with IVLBCL frequently develop neurological manifestations during their disease course. Patients are known to often develop various neurological manifestations, but there are only a few reports of IVLBCL whose initial symptoms are deafness and/or disequilibrium. Patient concerns: A 66-year-old Japanese man was provisionally diagnosed with sudden sensorineural hearing loss. Administration of prednisolone did not improve his symptoms, and then he experienced amaurosis fugax. Magnetic resonance imaging (MRI) showed multiple brain infarcts, so he was administered antithrombotic drugs. Neve...

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Untreated allergic rhinitis is a major risk factor contributing to motorcar accidents - Church MK, Zuberbier T.

[Abstract unavailable] Language: en... (Source: SafetyLit)

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Repeat hepatectomy with systemic chemotherapy might improve survival of recurrent liver metastasis from colorectal cancer—a retrospective observational study

Although hepatectomy for metastatic colorectal cancer (mCRC) prolongs survival in up to 40% of people, recurrence rates approach 70%. We used a multidisciplinary approach to treat recurrent liver metastases, i...

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Repeat hepatectomy with systemic chemotherapy might improve survival of recurrent liver metastasis from colorectal cancer—a retrospective observational study

Although hepatectomy for metastatic colorectal cancer (mCRC) prolongs survival in up to 40% of people, recurrence rates approach 70%. We used a multidisciplinary approach to treat recurrent liver metastases, i...

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Untreated allergic rhinitis is a major risk factor contributing to motorcar accidents - Church MK, Zuberbier T.

[Abstract unavailable] Language: en... (Source: SafetyLit)

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Untreated allergic rhinitis is a major risk factor contributing to motorcar accidents - Church MK, Zuberbier T.

[Abstract unavailable] Language: en... (Source: SafetyLit)

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Influence of speaking style adaptations and semantic context on the time course of word recognition in quiet and in noise

This study examines the effects of different listener-oriented speaking styles and semantic contexts on online spoken word recognition using eyetracking. In Experiment 1, different groups of listeners participated in a word-identification-in-noise and in a pleasantness-rating task. Listeners heard sentences with high- versus low-predictability semantic contexts produced in infant-directed speech, Clear Speech, and Conversational Speech. Experiment 2 (in silence) and 3 (in noise) investigated the time course of visual fixations to target objects when participants were listening to different speaking styles and contexts. Results from all experiments show that relative to conversational speech, both infant-directed speech and Clear Speech improved word recognition for high-predictability sent...

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Eco-friendly walnut shell powder based facile fabrication of biogenic Ag-nanodisks, and their interaction with bovine serum albumin

Publication date: Available online 15 February 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Zoya ZaheerAbstractWalnut shell biomass was used for the extraction of juglone by water as a solvent at room temperature. Upon addition of AgNO3 to a dye solution, prefect transparent pale brown color develops within the reaction time. UV–visible spectroscopy revealed the appearance of surface plasmon absorption (SRP) peak at 410 nm for spherical silver nanoparticles (AgNPs). Transmission electron microscopy suggested the formation of spherical and truncated triangular nano-plate geometry of AgNPs with average diameter 25 nm. Juglone-surfactant interactions (micellization and incorporation) have been studied spectrophotometrically by using cationic cetyltrimethyl...

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Influence of within-category tonal information in the recognition of Mandarin-Chinese words by native and non-native listeners: An eye-tracking study

This study investigates how within-category tonal information influences native and non-native Mandarin listeners' spoken word recognition. Previous eye-tracking research has shown that the within-category phonetic details of consonants and vowels constrain lexical activation. However, given the highly dynamic and variable nature of lexical tones, it is unclear whether the within-category phonetic details of lexical tones would similarly modulate lexical activation. Native Mandarin listeners and proficient adult English-speaking Mandarin learners were tested in a visual-world eye-tracking experiment. The target word contained a level tone and the competitor word contained a high-rising tone, or vice versa. The auditory stimuli were manipulated such that the target tone was either canonic...

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Effects of Motor Imagery and Visual Neurofeedback on Activation in the Swallowing Network: A Real-Time fMRI Study

AbstractMotor imagery of movements is used as mental strategy in neurofeedback applications to gain voluntary control over activity in motor areas of the brain. In the present functional magnetic resonance imaging (fMRI) study, we first addressed the question whether motor imagery and execution of swallowing activate comparable brain areas, which has been already proven for hand and foot movements. Prior near-infrared spectroscopy (NIRS) studies provide evidence that this is the case in the outer layer of the cortex. With the present fMRI study, we want to expand these prior NIRS findings to the whole brain. Second, we used motor imagery of swallowing as mental strategy during visual neurofeedback to investigate whether one can learn to modulate voluntarily activity in brain regions, which...

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Learning Phonology from Surface Distributions, Considering Dutch and English Vowel Duration

. (Source: Language Learning and Development)

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Towards Abstract Syntax at 24 Months: Evidence from Subject-Verb Agreement with Conjoined Subjects

. (Source: Language Learning and Development)

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Annual hearing screening in girls with Turner Syndrome: results from the first three years in Glasgow

Publication date: Available online 15 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Haytham Kubba, Kerrie McAllister, Karen Hunter, Avril Mason

Abstract

Background

Hearing loss is prevalent in girls with Turner Syndrome (TS). A number of cross-sectional studies have confirmed that conductive hearing loss due to middle ear disease and permanent, progressive sensorineural hearing loss are both very common and often unrecognised in TS. Hearing screening has been suggested by many authors and is recommended in some recent national audiology guidelines (every 3-5 years in an international consensus statement, every 1-2 years in the USA and every year in the UK). The effectiveness of such regular hearing screening has not been assessed before.

Study aims and methods

In January 2016 we began a programme of annual hearing screening for all girls attending the West of Scotland TS clinic. We have collected data on age, karyotype, ear and hearing symptoms, otoscopy findings, audiometric test results and subsequent outcomes for the first three years of our programme. Our aim is to assess whether this screening programme is an effective use of resources, with a worthwhile rate of detecting new otological problems and without an excessive additional workload for the audiology department.

Results

Twenty-six girls participated in the screening programme and 8 of these had no hearing issues or ear abnormalities at any time over the 3 years. Two girls had cholesteatoma, 4 had tympanic membrane retractions and/or perforations, and 9 had OME (of which 6 were transient and 3 persistent, with 2 of these requiring treatment). One cholesteatoma, one perforation and one persistent OME were already known about but all other diagnoses were new as a result of the screening programme. Five girls have persistent conductive hearing loss (plus another 6 who had a transient episode of conductive loss due to middle ear fluid) and 6 have some degree of sensorineural hearing loss (3 purely sensorineural, 3 mixed). At the time that a hearing loss was diagnosed, the parents had concerns about the hearing in 4 cases and no concerns in 12. Six girls have been fitted with hearing aids since we started the screening programme, each for different indications (sensorineural hearing loss in two cases, and one case each of persistent OME, post cholesteatoma surgery, tympanic membrane perforation and unilateral tympanic membrane retraction respectively). Two girls have had ear surgery as a result of referral from the programme (one for ventilation tubes, one for cholesteatoma).

Conclusions

The screening programme has picked up ear disease in 69% of girls with TS with only a small additional workload for the audiology department. The ongoing detection of new problems in the second and third years of the programme attests to the value of continued regular hearing screening for girls with TS.

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

Influence of speaking style adaptations and semantic context on the time course of word recognition in quiet and in noise

This study examines the effects of different listener-oriented speaking styles and semantic contexts on online spoken word recognition using eyetracking. In Experiment 1, different groups of listeners participated in a word-identification-in-noise and in a pleasantness-rating task. Listeners heard sentences with high- versus low-predictability semantic contexts produced in infant-directed speech, Clear Speech, and Conversational Speech. Experiment 2 (in silence) and 3 (in noise) investigated the time course of visual fixations to target objects when participants were listening to different speaking styles and contexts. Results from all experiments show that relative to conversational speech, both infant-directed speech and Clear Speech improved word recognition for high-predictability sent...

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

Eco-friendly walnut shell powder based facile fabrication of biogenic Ag-nanodisks, and their interaction with bovine serum albumin

Publication date: Available online 15 February 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Zoya ZaheerAbstractWalnut shell biomass was used for the extraction of juglone by water as a solvent at room temperature. Upon addition of AgNO3 to a dye solution, prefect transparent pale brown color develops within the reaction time. UV–visible spectroscopy revealed the appearance of surface plasmon absorption (SRP) peak at 410 nm for spherical silver nanoparticles (AgNPs). Transmission electron microscopy suggested the formation of spherical and truncated triangular nano-plate geometry of AgNPs with average diameter 25 nm. Juglone-surfactant interactions (micellization and incorporation) have been studied spectrophotometrically by using cationic cetyltrimethyl...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BG5tFM

Effects of Motor Imagery and Visual Neurofeedback on Activation in the Swallowing Network: A Real-Time fMRI Study

AbstractMotor imagery of movements is used as mental strategy in neurofeedback applications to gain voluntary control over activity in motor areas of the brain. In the present functional magnetic resonance imaging (fMRI) study, we first addressed the question whether motor imagery and execution of swallowing activate comparable brain areas, which has been already proven for hand and foot movements. Prior near-infrared spectroscopy (NIRS) studies provide evidence that this is the case in the outer layer of the cortex. With the present fMRI study, we want to expand these prior NIRS findings to the whole brain. Second, we used motor imagery of swallowing as mental strategy during visual neurofeedback to investigate whether one can learn to modulate voluntarily activity in brain regions, which...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SDbeP1

Learning Phonology from Surface Distributions, Considering Dutch and English Vowel Duration

. (Source: Language Learning and Development)

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

Towards Abstract Syntax at 24 Months: Evidence from Subject-Verb Agreement with Conjoined Subjects

. (Source: Language Learning and Development)

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Home environment of infants with risk indicators for hearing loss tends to be less stimulating

Publication date: Available online 16 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Danielle Mendonça Araujo, Denise Castilho Cabrera Santos, Maria Cecília Marconi Pinheiro Lima

Abstract

Objective

To verify the home opportunities to the motor development offered to infants with and without risk indicators for hearing loss (RIHL).

Methods

Observational transversal study was done with infants between 8 and 10 months, being 77 with RIHL (Study Group-SG) and 77 without RIHL (Control Group-CG) The instrument used to characterize the sample and obtain information about the home affordances was the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The results of the AHEMD-IS between the groups were compared using the Mann-Whitney and Chi-Squared tests. The significance test adopted for the study was 5%.

Results

Absolute values in the frequency of homes considered "moderately adequate" and "less than adequate" were greater in the SG in the most part of the categories, except the item Toys for Fine Motricity. It was possible to observe a statistically significant difference in the Total Score of the groups (p-value = 0.01346). Even with better results when compared with the SG, the number of homes of the CG group with affordances below expected is more than half of the sample.

Conclusions

It was possible to verify that home of infants with risk indicators for hearing loss have statistically less affordances when compared to the homes of infants without the indicators. The results alert us to the need of orientation to the infant's responsible/caretakers regarding to the importance of a favorable environment with stimulation of the infant motor development.

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Annual hearing screening in girls with Turner Syndrome: results from the first three years in Glasgow

Publication date: Available online 15 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Haytham Kubba, Kerrie McAllister, Karen Hunter, Avril Mason

Abstract

Background

Hearing loss is prevalent in girls with Turner Syndrome (TS). A number of cross-sectional studies have confirmed that conductive hearing loss due to middle ear disease and permanent, progressive sensorineural hearing loss are both very common and often unrecognised in TS. Hearing screening has been suggested by many authors and is recommended in some recent national audiology guidelines (every 3-5 years in an international consensus statement, every 1-2 years in the USA and every year in the UK). The effectiveness of such regular hearing screening has not been assessed before.

Study aims and methods

In January 2016 we began a programme of annual hearing screening for all girls attending the West of Scotland TS clinic. We have collected data on age, karyotype, ear and hearing symptoms, otoscopy findings, audiometric test results and subsequent outcomes for the first three years of our programme. Our aim is to assess whether this screening programme is an effective use of resources, with a worthwhile rate of detecting new otological problems and without an excessive additional workload for the audiology department.

Results

Twenty-six girls participated in the screening programme and 8 of these had no hearing issues or ear abnormalities at any time over the 3 years. Two girls had cholesteatoma, 4 had tympanic membrane retractions and/or perforations, and 9 had OME (of which 6 were transient and 3 persistent, with 2 of these requiring treatment). One cholesteatoma, one perforation and one persistent OME were already known about but all other diagnoses were new as a result of the screening programme. Five girls have persistent conductive hearing loss (plus another 6 who had a transient episode of conductive loss due to middle ear fluid) and 6 have some degree of sensorineural hearing loss (3 purely sensorineural, 3 mixed). At the time that a hearing loss was diagnosed, the parents had concerns about the hearing in 4 cases and no concerns in 12. Six girls have been fitted with hearing aids since we started the screening programme, each for different indications (sensorineural hearing loss in two cases, and one case each of persistent OME, post cholesteatoma surgery, tympanic membrane perforation and unilateral tympanic membrane retraction respectively). Two girls have had ear surgery as a result of referral from the programme (one for ventilation tubes, one for cholesteatoma).

Conclusions

The screening programme has picked up ear disease in 69% of girls with TS with only a small additional workload for the audiology department. The ongoing detection of new problems in the second and third years of the programme attests to the value of continued regular hearing screening for girls with TS.

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Childhood hearing loss: Impact on parents and family life

Publication date: Available online 15 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Jesper Dammeyer, Anja Toft Hansen, Kathryn Crowe, Marc Marschark

Abstract

Background

Studies investigating the impact of having a child with hearing loss on the lives of parents and families have shown divergent results. Where some studies have reported that childhood hearing loss is associated with parental mental health problems, such as depression and stress, other studies report no impact on parental mental health and/or wellbeing.

Objective

The aim of this study was to examine the association between child-related variables—degree of hearing loss, additional disabilities, sign language abilities, cochlear implants (CI), externalizing and internalizing emotional and behavioral difficulties measured by the Strength and Difficulties Questionnaire (SDQ)—and parent-related variables—parents living together, parents' mental health, spouse activities without children, and parents' experience of the child as being a burden for the family.

Method

Data of 257 parents of children with hearing loss from a national survey were included.

Results

Only 18% of the children with hearing loss did not live with both parents, a figure significantly lower than that of the general population. The child variables of degree of hearing loss, having a CI or not, and sign language ability were not significantly associated with any of the parent variables investigated. The child having a disability in addition to hearing loss was found to be significantly associated with the frequency of spouses engaging in activities without children and reports that the child was a burden for the family. Both higher externalizing and internalizing scores on the SDQ were significantly associated with parental mental health problems, frequency of spouse activities without children, and the degree to which the child's difficulties were experienced as a burden for the family.

Conclusion

Children's hearing loss, per se, was found not to be significantly related to several key parent and family variables. However, children having additional disabilities and behavioral and emotional difficulties were significant with parent and family variables. This study thus underlines the need for further studies concerning relationships among factors related to childhood hearing loss and various family factors in order to better understand their impact on child development and family life.

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Survival outcomes after treatment of cancer of the oral cavity (1985–2015)

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Daniella Karassawa Zanoni, Pablo H. Montero, Jocelyn C. Migliacci, Jatin P. Shah, Richard J. Wong, Ian Ganly, Snehal G. Patel

Abstract

Objectives

To present treatment results of oral squamous cell carcinoma (OSCC) at a tertiary cancer care center from 1985 to 2015.

Materials and methods

A total of 2082 patients were eligible for this study. Main outcomes measured were overall survival (OS) and disease specific survival (DSS). Prognostic variables were identified with bivariate analyses using Kaplan-Meier curves and log-rank testing for comparison. A p-value < 0.05 was considered statistically significant and significant factors were entered into multivariate analysis. Median age was 62 years (16–100), 56% were men, 66% reported a history of tobacco use and 71% of alcohol consumption. The most common subsite was tongue (51%). Seventy-three percent of patients had cT1-2 and 71% had clinically negative necks (cN0). Surgery alone was performed in 1348 patients (65%), adjuvant postoperative radiotherapy in 608 patients (29%) and postoperative chemoradiation in 126 patients (6%). Neck dissection was performed in 920 patients with cN0, and in 585 patients with a clinically involved neck. The median follow-up was 37.6 months (range 1–382).

Results

The 5-year OS and DSS were 64.4% and 79.3%, respectively. Age, comorbidities, margin status, vascular invasion, perineural invasion, AJCC 8th edition pT, and pN were independent prognostic factors of OS (p < 0.05). History of alcohol consumption, margin status, vascular invasion, perineural invasion, pT, and pN were independent prognostic factors of DSS (p < 0.05).

Conclusion

pN stage is the most powerful and consistent predictor of outcome in patients with OSCC treated with primary surgery and appropriate adjuvant therapy.

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Can topical 5-fluorouracil be used as a viable treatment option for oral premalignant lesions and tumors?

Publication date: Available online 15 February 2019

Source: Oral Oncology

Author(s): Samapika Routray, Punit S. Dikhit, B.C. Rajani, Mohd. Musab Khan

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Survival outcomes after treatment of cancer of the oral cavity (1985–2015)

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Daniella Karassawa Zanoni, Pablo H. Montero, Jocelyn C. Migliacci, Jatin P. Shah, Richard J. Wong, Ian Ganly, Snehal G. Patel

Abstract

Objectives

To present treatment results of oral squamous cell carcinoma (OSCC) at a tertiary cancer care center from 1985 to 2015.

Materials and methods

A total of 2082 patients were eligible for this study. Main outcomes measured were overall survival (OS) and disease specific survival (DSS). Prognostic variables were identified with bivariate analyses using Kaplan-Meier curves and log-rank testing for comparison. A p-value < 0.05 was considered statistically significant and significant factors were entered into multivariate analysis. Median age was 62 years (16–100), 56% were men, 66% reported a history of tobacco use and 71% of alcohol consumption. The most common subsite was tongue (51%). Seventy-three percent of patients had cT1-2 and 71% had clinically negative necks (cN0). Surgery alone was performed in 1348 patients (65%), adjuvant postoperative radiotherapy in 608 patients (29%) and postoperative chemoradiation in 126 patients (6%). Neck dissection was performed in 920 patients with cN0, and in 585 patients with a clinically involved neck. The median follow-up was 37.6 months (range 1–382).

Results

The 5-year OS and DSS were 64.4% and 79.3%, respectively. Age, comorbidities, margin status, vascular invasion, perineural invasion, AJCC 8th edition pT, and pN were independent prognostic factors of OS (p < 0.05). History of alcohol consumption, margin status, vascular invasion, perineural invasion, pT, and pN were independent prognostic factors of DSS (p < 0.05).

Conclusion

pN stage is the most powerful and consistent predictor of outcome in patients with OSCC treated with primary surgery and appropriate adjuvant therapy.

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Can topical 5-fluorouracil be used as a viable treatment option for oral premalignant lesions and tumors?

Publication date: Available online 15 February 2019

Source: Oral Oncology

Author(s): Samapika Routray, Punit S. Dikhit, B.C. Rajani, Mohd. Musab Khan

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Impact of MEditerranean Diet, Inflammation and Microbiome After an Acute Coronary Syndrome

Condition:   Acute Coronary Syndrome Interventions:   Other: Microbiota analysis;   Other: Immunological analysis;   Other: Proteome analysis;   Other: Metabolome analysis;   Other: Clinical evaluation;   Other: Diet evaluation;   Other: MedDiet Sponsors:   Consorcio Centro de Investigación Biomédica en Red, M.P.;   Hospital General Universitario Gregorio Marañon;   Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana;   University of Navarra;   Institut National de la Santé Et de la Recher che Médicale, France;   Tel Aviv University;   Göteborg University Not yet recruiting (Source: ClinicalTrials.gov)

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Experimental Human Infection With Neisseria Gonorrhoeae

Condition:   Gonococcal Infection Interventions:   Drug: Cefixime;   Drug: Ceftriaxone;   Drug: Ciprofloxacin;   Biological: Neisseria gonorrhoeae strain FA1090 A26;   Biological: Neisseria gonorrhoeae strain FA7537 Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Point of care ultrasonography in the allergy and immunology clinic

Publication date: Available online 16 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Samira Jeimy, Andrew Wong-Pack, Shafaz Veetil, Harold Kim

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Impact of MEditerranean Diet, Inflammation and Microbiome After an Acute Coronary Syndrome

Condition:   Acute Coronary Syndrome Interventions:   Other: Microbiota analysis;   Other: Immunological analysis;   Other: Proteome analysis;   Other: Metabolome analysis;   Other: Clinical evaluation;   Other: Diet evaluation;   Other: MedDiet Sponsors:   Consorcio Centro de Investigación Biomédica en Red, M.P.;   Hospital General Universitario Gregorio Marañon;   Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana;   University of Navarra;   Institut National de la Santé Et de la Recher che Médicale, France;   Tel Aviv University;   Göteborg University Not yet recruiting (Source: ClinicalTrials.gov)

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Experimental Human Infection With Neisseria Gonorrhoeae

Condition:   Gonococcal Infection Interventions:   Drug: Cefixime;   Drug: Ceftriaxone;   Drug: Ciprofloxacin;   Biological: Neisseria gonorrhoeae strain FA1090 A26;   Biological: Neisseria gonorrhoeae strain FA7537 Sponsor:   National Institute of Allergy and Infectious Diseases (NIAID) Recruiting (Source: ClinicalTrials.gov)

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Point of care ultrasonography in the allergy and immunology clinic

Publication date: Available online 16 February 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Samira Jeimy, Andrew Wong-Pack, Shafaz Veetil, Harold Kim

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Regional variation of ankle and hindfoot cartilage T2 mapping values at 3 T: A feasibility study

Publication date: Available online 16 February 2019

Source: European Journal of Radiology

Author(s): Carly A. Lockard, Angela Chang, Richard C. Shin, Thomas O. Clanton, Charles P. Ho

Abstract

Objective

To develop a method for T2 mapping of the entire tibiotalar/hindfoot articular surfaces and to examine regional T2 variation in asymptomatic volunteers, establishing necessary methods for future T2 mapping work in patients with ankle/hindfoot injury.

Materials and Methods

Twenty-six asymptomatic volunteers (11 female/13 male, aged 23 to 64 years in final analysis) underwent sagittal T2 mapping. Tibiotalar and hindfoot cartilage surfaces were segmented by two raters. The tibiotalar joint cartilage was divided into subregions to assess T2 variation across the joint. The articular surface and subregion mean T2 values were compared using Tukey post hoc pairwise comparisons to test for statistical significance.

Results and Conclusion

Mean ankle/hindfoot cartilage T2 ranged from 37 ± 3 to 47 ± 7 ms. Tibial plafond mean T2 was significantly different from the middle and posterior subtalar cartilage T2 (both articular surface comparisons resulted in P <  .05). Talar dome mean T2 was significantly different from the posterior calcaneal-side and talar-side subtalar cartilage, and middle calcaneal-side subtalar cartilage (P <  .05 for all comparisons). Tibial plafond middle versus lateral, anterior versus middle, middle versus posterior, and anterior versus posterior subregion T2 values were significantly different (P <  .05 for all comparisons). Talar dome medial versus middle, middle versus lateral, anterior versus middle, and middle versus posterior subregion T2 values were significantly different (P <  .05 for all comparisons). Ankle/hindfoot joint cartilage T2 mapping and segmentation was found to be feasible for all cartilage surfaces except the anterior subtalar joint facet. Mean T2 differed significantly between ankle/hindfoot joint and subregion cartilage in asymptomatic volunteers.

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Comparative analysis of radiation dose and low contrast detail detectability using routine paediatric chest radiography protocols

Publication date: Available online 15 February 2019

Source: European Journal of Radiology

Author(s): Sadeq Al-Murshedi, Peter Hogg, Annemieke Meijer, Hendrik Erenstein, Andrew England

Abstract

Objectives

To compare low contrast detail (LCD) detectability and radiation dose for routine paediatric chest X-ray (CXR) imaging protocols among various hospitals.

Methods

CDRAD 2.0 phantom and medical grade polymethyl methacrylate (PMMA) slabs were used to simulate the chest region of four different paediatric age groups. Radiographic acquisitions were undertaken on 17 X-ray machines located in eight hospitals using their existing CXR protocols. LCD detectability represented by image quality figure inverse (IQF_inv) was measured physically using the CDRAD analyser software. Incident air kerma (IAK) measurements were obtained using a solid-state dosimeter.

Results

The range of IQF_inv, between and within the hospitals, was 1.40-4.44 and 1.52-2.18, respectively for neonates; 0.96-4.73 and 2.33-4.73 for a 1-year old; 0.87-1.81 and 0.98-1.46 for a 5-year old and 0.90-2.39 and 1.27-2.39 for a 10-year old.

The range of IAK, between and within the hospitals, was 8.56-52.62 µGy and 21.79-52.62 µGy, respectively for neonates; 5.44-82.82 µGy and 36.78-82.82 µGy for a 1-year old; 10.97-59.22 µGy and 11.75-52.94 µGy for a 5-year old and 13.97-100.77 µGy and 35.72-100.77 µGy for a 10-year old.

Conclusions

Results show considerable variation, between and within hospitals, in the LCD detectability and IAK. Further radiation dose optimisation for the four paediatric age groups, especially in hospitals /X-ray rooms with low LCD detectability and high IAK, are required.

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Editorial Board

Publication date: March 2019

Source: European Journal of Radiology, Volume 112

Author(s):

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Regional variation of ankle and hindfoot cartilage T2 mapping values at 3 T: A feasibility study

Publication date: Available online 16 February 2019

Source: European Journal of Radiology

Author(s): Carly A. Lockard, Angela Chang, Richard C. Shin, Thomas O. Clanton, Charles P. Ho

Abstract

Objective

To develop a method for T2 mapping of the entire tibiotalar/hindfoot articular surfaces and to examine regional T2 variation in asymptomatic volunteers, establishing necessary methods for future T2 mapping work in patients with ankle/hindfoot injury.

Materials and Methods

Twenty-six asymptomatic volunteers (11 female/13 male, aged 23 to 64 years in final analysis) underwent sagittal T2 mapping. Tibiotalar and hindfoot cartilage surfaces were segmented by two raters. The tibiotalar joint cartilage was divided into subregions to assess T2 variation across the joint. The articular surface and subregion mean T2 values were compared using Tukey post hoc pairwise comparisons to test for statistical significance.

Results and Conclusion

Mean ankle/hindfoot cartilage T2 ranged from 37 ± 3 to 47 ± 7 ms. Tibial plafond mean T2 was significantly different from the middle and posterior subtalar cartilage T2 (both articular surface comparisons resulted in P <  .05). Talar dome mean T2 was significantly different from the posterior calcaneal-side and talar-side subtalar cartilage, and middle calcaneal-side subtalar cartilage (P <  .05 for all comparisons). Tibial plafond middle versus lateral, anterior versus middle, middle versus posterior, and anterior versus posterior subregion T2 values were significantly different (P <  .05 for all comparisons). Talar dome medial versus middle, middle versus lateral, anterior versus middle, and middle versus posterior subregion T2 values were significantly different (P <  .05 for all comparisons). Ankle/hindfoot joint cartilage T2 mapping and segmentation was found to be feasible for all cartilage surfaces except the anterior subtalar joint facet. Mean T2 differed significantly between ankle/hindfoot joint and subregion cartilage in asymptomatic volunteers.

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Comparative analysis of radiation dose and low contrast detail detectability using routine paediatric chest radiography protocols

Publication date: Available online 15 February 2019

Source: European Journal of Radiology

Author(s): Sadeq Al-Murshedi, Peter Hogg, Annemieke Meijer, Hendrik Erenstein, Andrew England

Abstract

Objectives

To compare low contrast detail (LCD) detectability and radiation dose for routine paediatric chest X-ray (CXR) imaging protocols among various hospitals.

Methods

CDRAD 2.0 phantom and medical grade polymethyl methacrylate (PMMA) slabs were used to simulate the chest region of four different paediatric age groups. Radiographic acquisitions were undertaken on 17 X-ray machines located in eight hospitals using their existing CXR protocols. LCD detectability represented by image quality figure inverse (IQF_inv) was measured physically using the CDRAD analyser software. Incident air kerma (IAK) measurements were obtained using a solid-state dosimeter.

Results

The range of IQF_inv, between and within the hospitals, was 1.40-4.44 and 1.52-2.18, respectively for neonates; 0.96-4.73 and 2.33-4.73 for a 1-year old; 0.87-1.81 and 0.98-1.46 for a 5-year old and 0.90-2.39 and 1.27-2.39 for a 10-year old.

The range of IAK, between and within the hospitals, was 8.56-52.62 µGy and 21.79-52.62 µGy, respectively for neonates; 5.44-82.82 µGy and 36.78-82.82 µGy for a 1-year old; 10.97-59.22 µGy and 11.75-52.94 µGy for a 5-year old and 13.97-100.77 µGy and 35.72-100.77 µGy for a 10-year old.

Conclusions

Results show considerable variation, between and within hospitals, in the LCD detectability and IAK. Further radiation dose optimisation for the four paediatric age groups, especially in hospitals /X-ray rooms with low LCD detectability and high IAK, are required.

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Brazilian Scale of Hearing and Language Development: Normality Curve for Infants and Children from 0 to 24 Months Old with Normal Hearing

Conclusion The normal curve for EDAL-1 was successfully established. The averages can be considered as the standard protocol for normality, serving as a reference for comparison with other populations. [...] Thieme Revinter Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: International Archives of Otorhinolaryngology)

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Brazilian Scale of Hearing and Language Development: Normality Curve for Infants and Children from 0 to 24 Months Old with Normal Hearing

Conclusion The normal curve for EDAL-1 was successfully established. The averages can be considered as the standard protocol for normality, serving as a reference for comparison with other populations. [...] Thieme Revinter Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: International Archives of Otorhinolaryngology)

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Radiology's Role in Public Health Education About Obesity

Publication date: Available online 16 February 2019

Source: Academic Radiology

Author(s): Evan M Rush, Richard B Gunderman

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Comparison of 2D BLADE Turbo Gradient- and Spin-Echo and 2D Spin-Echo Echo-Planar Diffusion-Weighted Brain MRI at 3 T: Preliminary Experience in Children

Publication date: Available online 15 February 2019

Source: Academic Radiology

Author(s): Houchun H. Hu, Aaron S. McAllister, Ning Jin, Lacey J. Lubeley, Bhavani Selvaraj, Mark Smith, Ramkumar Krishnamurthy, Kun Zhou

Rationale and Objectives

We describe our preliminary experience using a 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with non-Cartesian BLADE trajectory at 3 T in pediatric patients. We compared the TGSE BLADE to conventional DW spin-echo echo-planar imaging (SE-EPI) in pediatric brain imaging, assessing the presence of artifacts from signal pile-ups, geometric distortion, motion, susceptibility from air-tissue interface, shunts and orthodontia, and diagnostic image quality.

Materials and Methods

Data were acquired in 53 patients (10.4 ± 7.9 years). All DW imaging data were acquired precontrast, with SE-EPI first. A four-point scale for rating was used—1 (best) and 4 (worst). A neuroradiologist scored the two sequences and further noted whether the TGSE BLADE approach or SE-EPI was preferred in each case. Apparent diffusion coefficients were compared quantitatively between the two sequences in a subset of 16 patients, in 41 separate regions of interests including caudate nucleus, putamen, globus pallidus, thalamus, and pathological areas.

Results

In 43.4% of the cases, TGSE BLADE was preferred; in 49.1% of the cases, both sequences were preferred equally. Average scores for SE-EPI were 2.2 ± 0.8 versus TGSE's 1.2 ± 0.4 in assessing diagnostic quality (p < 0.05). Motion artifacts were minimal on both sequences in 92.5% of the cases. In the TGSE BLADE scores, no case received a "4" for significant artifacts with marginally acceptable image quality. Apparent diffusion coefficients values between the two sequences were statistically similar, with a linear regression slope of 0.92 (r² = 0.97).

Conclusion

TGSE BLADE DW imaging exhibited less geometric distortion in the brain and reduced signal pile-ups in areas of high susceptibility than conventional SE-EPI.

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Radiology's Role in Public Health Education About Obesity

Publication date: Available online 16 February 2019

Source: Academic Radiology

Author(s): Evan M Rush, Richard B Gunderman

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Comparison of 2D BLADE Turbo Gradient- and Spin-Echo and 2D Spin-Echo Echo-Planar Diffusion-Weighted Brain MRI at 3 T: Preliminary Experience in Children

Publication date: Available online 15 February 2019

Source: Academic Radiology

Author(s): Houchun H. Hu, Aaron S. McAllister, Ning Jin, Lacey J. Lubeley, Bhavani Selvaraj, Mark Smith, Ramkumar Krishnamurthy, Kun Zhou

Rationale and Objectives

We describe our preliminary experience using a 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with non-Cartesian BLADE trajectory at 3 T in pediatric patients. We compared the TGSE BLADE to conventional DW spin-echo echo-planar imaging (SE-EPI) in pediatric brain imaging, assessing the presence of artifacts from signal pile-ups, geometric distortion, motion, susceptibility from air-tissue interface, shunts and orthodontia, and diagnostic image quality.

Materials and Methods

Data were acquired in 53 patients (10.4 ± 7.9 years). All DW imaging data were acquired precontrast, with SE-EPI first. A four-point scale for rating was used—1 (best) and 4 (worst). A neuroradiologist scored the two sequences and further noted whether the TGSE BLADE approach or SE-EPI was preferred in each case. Apparent diffusion coefficients were compared quantitatively between the two sequences in a subset of 16 patients, in 41 separate regions of interests including caudate nucleus, putamen, globus pallidus, thalamus, and pathological areas.

Results

In 43.4% of the cases, TGSE BLADE was preferred; in 49.1% of the cases, both sequences were preferred equally. Average scores for SE-EPI were 2.2 ± 0.8 versus TGSE's 1.2 ± 0.4 in assessing diagnostic quality (p < 0.05). Motion artifacts were minimal on both sequences in 92.5% of the cases. In the TGSE BLADE scores, no case received a "4" for significant artifacts with marginally acceptable image quality. Apparent diffusion coefficients values between the two sequences were statistically similar, with a linear regression slope of 0.92 (r² = 0.97).

Conclusion

TGSE BLADE DW imaging exhibited less geometric distortion in the brain and reduced signal pile-ups in areas of high susceptibility than conventional SE-EPI.

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Altered Expression of miR-326 in T Cell-Derived Exosomes of Patients with Relapsing-Remitting Multiple Sclerosis

Background/Aim: Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of central nervous system (CNS). Invasion of autoreactive CD4⁺ T cells into CNS is believed to be an underlying pathogenic mechanism in MS. CD4+ T cells release exosomes which are highly enriched in microRNAs, reflective of physiological or pathological condition. Exosomal microRNAs are transferred between cells and affect the physiology of target cells. Thus exosomes could be potent agents to provide quantitative and qualitative information about immune cells involved in MS. We investigated the expression of pathogenic microRNAs in T cells-derived exosomes of MS patients or healthy controls.

Methods:  Conventional T cells (Tconv) derived from relapsing-remitting (RR) MS patients or healthy controls were cultured for 3 days by soluble anti-CD3/CD28. Exosomes were purified from supernatants. After RNA extraction from exosomes pellet, the expression levels of miR-146a, miR-29a, miR-155, and miR-326 were quantified by real-time PCR.

Result: A statistically significant increased expression of miR-326 in  Tconv- derived exosomes was observed in RRMS patients as compared with controls (7.5±1.88vs 2.51±0.9 P=0.03), On the contrary, no differences were found in the expression levels of miR-155, miR-146a, and miR-29a, in Tconv-derived exosomes of  patients as compared with controls (P>0.05). 

Conclusion: Our results point to an altered expression in exosome-derived microRNAs. MiR-326 was previously shown to play a role in the immunopathogenesis of MS by inducing TH17 differentiation and maturation. Therefore, miR-326 containing exosomes might also be a potential clinical target in course of MS. Moreover, the deregulation of this miRNA in exosomes may serve as a diagnostic and prognostic biomarker.

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Altered Expression of miR-326 in T Cell-Derived Exosomes of Patients with Relapsing-Remitting Multiple Sclerosis

Background/Aim: Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of central nervous system (CNS). Invasion of autoreactive CD4⁺ T cells into CNS is believed to be an underlying pathogenic mechanism in MS. CD4+ T cells release exosomes which are highly enriched in microRNAs, reflective of physiological or pathological condition. Exosomal microRNAs are transferred between cells and affect the physiology of target cells. Thus exosomes could be potent agents to provide quantitative and qualitative information about immune cells involved in MS. We investigated the expression of pathogenic microRNAs in T cells-derived exosomes of MS patients or healthy controls.

Methods:  Conventional T cells (Tconv) derived from relapsing-remitting (RR) MS patients or healthy controls were cultured for 3 days by soluble anti-CD3/CD28. Exosomes were purified from supernatants. After RNA extraction from exosomes pellet, the expression levels of miR-146a, miR-29a, miR-155, and miR-326 were quantified by real-time PCR.

Result: A statistically significant increased expression of miR-326 in  Tconv- derived exosomes was observed in RRMS patients as compared with controls (7.5±1.88vs 2.51±0.9 P=0.03), On the contrary, no differences were found in the expression levels of miR-155, miR-146a, and miR-29a, in Tconv-derived exosomes of  patients as compared with controls (P>0.05). 

Conclusion: Our results point to an altered expression in exosome-derived microRNAs. MiR-326 was previously shown to play a role in the immunopathogenesis of MS by inducing TH17 differentiation and maturation. Therefore, miR-326 containing exosomes might also be a potential clinical target in course of MS. Moreover, the deregulation of this miRNA in exosomes may serve as a diagnostic and prognostic biomarker.

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In reference to management and follow‐up results of salivary fistulas treated with botulinum toxin

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Surgery versus radiation for T1 glottic carcinoma: Second primary considerations

Although early glottic carcinoma is managed with radiation therapy (RT) or surgery, there is limited data on differences in second primary cancers of the larynx. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to query T1 glottic carcinomas and assess the incidence of second primary laryngeal malignancies. Cumulative hazard for second primary laryngeal malignancies was compared with the log‐rank method. Among 844 surgical and 2,272 RT cases, observed‐to‐expected incidence ratios of laryngeal second primaries were 10.19 (5.89–16.55) and 6.87 (4.64–9.81) per 10 thousand person‐years, respectively. Mean person‐years at risk were comparable at 8.16 years (surgery) and 8.01 years (RT), and relative increased risk of laryngeal second primary was 20.95 (surgery) versus 14.09 (RT) per 10 thousand person‐years. Mean times to development of a second primary were also comparable (304 vs. 305 months, P = 0.898). Thus, second laryngeal primary development is analogous between cases treated with surgery alone versus RT. Continued discussion and investigation of surgery versus RT for early glottic squamous cell carcinoma will need to leverage these findings, along with ongoing investigation of voice and survival outcomes, to develop more well‐informed treatment algorithms. Laryngoscope, 2019

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Optimization and Repeatability of Multipool Chemical Exchange Saturation Transfer MRI of the Prostate at 3.0 T

Background

Chemical exchange saturation transfer (CEST) can potentially support cancer imaging with metabolically derived information. Multiparametric prostate MRI has improved diagnosis but may benefit from additional information to reduce the need for biopsies.

Purpose

To optimize an acquisition and postprocessing protocol for 3.0 T multipool CEST analysis of prostate data and evaluate the repeatability of the technique.

Study Type

Prospective.

Subjects

Five healthy volunteers (age range: 24–47 years; median age: 28 years) underwent two sessions (interval range: 7–27 days; median interval: 20 days) and two biopsy‐proven prostate cancer patients were evaluated once. Patient 1 (71 years) had a Gleason 3 + 4 transition zone (TZ) tumor and patient 2 (55 years) had a Gleason 4 + 3 peripheral zone (PZ) tumor.

Field Strength

3.0 T. Sequences run: T₂‐weighted turbo‐spin‐echo (TSE); diffusion‐weighted imaging; CEST; WASABI (for B₀ determination).

Assessment

Saturation, readout, and fit‐model parameters were optimized to maximize in vivo amide and nuclear Overhauser effect (NOE) signals. Repeatability (intrasession and intersession) was evaluated in healthy volunteers. Subsequently, preliminary evaluation of signal differences was made in patients. Regions of interest were drawn by two post‐FRCR board‐certified readers, both with over 5 years of experience in multiparametric prostate MRI.

Statistical Tests

Repeatability was assessed using Bland–Altman analysis, coefficient of variation (CV), and 95% limits of agreement (LOA). Statistical significance of CEST contrast was calculated using a nonparametric Mann–Whitney U‐test.

Results

The optimized saturation scheme was found to be 60 sinc‐Gaussian pulses with 40 msec pulse duration, at 50% duty‐cycle with continuous‐wave pulse equivalent B1 power (B1_CWPE) of 0.92 μT. The magnetization transfer (MT) contribution to the fit‐model was centered at –1.27 ppm. Intersession coefficients of variation (CVs) of the amide, NOE, and magnetization transfer (MT) and asymmetric magnetization transfer ratio (MTR_asym) signals of 25%, 23%, 18%, and 200%, respectively, were observed. Fit‐metric and MTR_asym CVs agreed between readers to within 4 and 10 percentage points, respectively.

Data Conclusion

Signal differences of 0.03–0.10 (17–43%) detectable depending upon pool, with MT the most repeatable (signal difference of 17–22% detectable).

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019.

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Regarding clinical implications of magnetic resonance imaging in temporomandibular disorder patients presenting ear fullness

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In reference to management and follow‐up results of salivary fistulas treated with botulinum toxin

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Surgery versus radiation for T1 glottic carcinoma: Second primary considerations

Although early glottic carcinoma is managed with radiation therapy (RT) or surgery, there is limited data on differences in second primary cancers of the larynx. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to query T1 glottic carcinomas and assess the incidence of second primary laryngeal malignancies. Cumulative hazard for second primary laryngeal malignancies was compared with the log‐rank method. Among 844 surgical and 2,272 RT cases, observed‐to‐expected incidence ratios of laryngeal second primaries were 10.19 (5.89–16.55) and 6.87 (4.64–9.81) per 10 thousand person‐years, respectively. Mean person‐years at risk were comparable at 8.16 years (surgery) and 8.01 years (RT), and relative increased risk of laryngeal second primary was 20.95 (surgery) versus 14.09 (RT) per 10 thousand person‐years. Mean times to development of a second primary were also comparable (304 vs. 305 months, P = 0.898). Thus, second laryngeal primary development is analogous between cases treated with surgery alone versus RT. Continued discussion and investigation of surgery versus RT for early glottic squamous cell carcinoma will need to leverage these findings, along with ongoing investigation of voice and survival outcomes, to develop more well‐informed treatment algorithms. Laryngoscope, 2019

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Investigating the Nasal Cycle Using Unilateral Peak Nasal Inspiratory Flow and Acoustic Rhinometry Minimal Cross‐Sectional Area Measurements

Abstract

Objective

To plot the nasal cycle using unilateral peak nasal inspiratory flow (UPNIF) and unilateral minimal cross‐sectional area (UMCA) readings demonstrating a linear relationship in normal nasal function. Additionally, to determine how this changes in abnormal nasal function.

Design

A cross‐sectional study measuring UPNIF and UMCA in controls demonstrating normal nasal function and in patients with nasal obstruction.

Setting

Royal National Throat Nose and Ear Hospital, London.

Participants

39 participants, 26 controls and 13 patients, were recruited. Controls exhibited normal nasal function with SNOT‐22 <5. Patients nasal obstruction symptoms secondary to inflammation or structural abnormality with SNOT‐22 >9.

Main Outcome Measures and Results

Airflow rates and resistance values were derived from UPNIF and UMCA measurements respectively based on Poiseuille's laws. Ratios between right and left UPNIF and UMCA values were taken to adjust for confounding factors. The relationship of 1/Resistance Ratio and Airflow Rate Ratio demonstrated a linear of direct proportionality of strong correlation and statistical significance (correlation coefficient =0.76, p<<0.01). This suggests that data points from controls with a normal nasal cycle lie closely along the regressed line, while those lying significantly away were shown to belong to patients with nasal dysfunction. Olfactory dysfunction appears to be a sensitive discriminator in predicting this.

Conclusion

This study demonstrates the directly proportional relationship of 1/Resistance Ratio and Airflow Rate Ratio in normal nasal function. Furthermore, nasal pathology can be predicted if data points lie significantly outside these normal limits. Further studies are needed to validate exact normal and abnormal thresholds.

This article is protected by copyright. All rights reserved.

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The fibroblast of radicular cyst facilitate osteoclastogenesis via the autocrine of Fibronectin containing extra domain A

Abstract

Objective

To investigate the alternative spliced isoforms of Fibronectin (FN) in the stroma of radicular cysts; and analyze the associations between these isoforms and the osteoclastogenic effects of fibroblasts.

Methods and materials

The specimens of radicular cysts were stained with immunohistochemistry, and the associations between each FN isoform and clinical parameters were assessed. The fibroblasts isolated from cysts or jaw bone were cultured to induce the Trap+MNCs. In the conditioned medium, the Fibronectin containing extra domain A (EDA+FN) were neutralized by antibody IST‐9, and the EDA exon of fibroblasts were knockout by CRISPR/Cas system, for assessing the osteolastogenic effects. The mRNA level of FN isoforms and the osteoclastogenesis related genes were analyzed by quantitive PCR.

Results

EDA+FN staining was positively associate with the size of the lesions (P<0.05). In contrast with the controls, the ratio of EDA+FN/total FN in the fibroblasts from radicular cysts was significantly higher (P<0.05), and positively associate with Trap+MNCs counting, it was consistent with increased expression of COX‐2, IL‐6, IL‐17 and the RANKL/OPG (P<0.05). The Trap+MNCs counting and osteoclastogenesis related genes were decreased by IST‐9 blocking and EDA exon knockout in fibroblasts, but the blockage of the interaction between EDA+FN and pre‐osteoclasts exhibited little effects on Trap+MNCs formation.

Conclusion

The microenvironment of the fibrous capsule of radicular cysts facilitate the splicing of EDA exon, it endues EDA+FN with autocrine effects on fibroblast itself, and increases the expression of osteoclastogenesis related genes, by which the osteoclastogenesis in radicular cysts could be initiated.

This article is protected by copyright. All rights reserved.

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Issue Information

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The fibroblast of radicular cyst facilitate osteoclastogenesis via the autocrine of Fibronectin containing extra domain A

Abstract

Objective

To investigate the alternative spliced isoforms of Fibronectin (FN) in the stroma of radicular cysts; and analyze the associations between these isoforms and the osteoclastogenic effects of fibroblasts.

Methods and materials

The specimens of radicular cysts were stained with immunohistochemistry, and the associations between each FN isoform and clinical parameters were assessed. The fibroblasts isolated from cysts or jaw bone were cultured to induce the Trap+MNCs. In the conditioned medium, the Fibronectin containing extra domain A (EDA+FN) were neutralized by antibody IST‐9, and the EDA exon of fibroblasts were knockout by CRISPR/Cas system, for assessing the osteolastogenic effects. The mRNA level of FN isoforms and the osteoclastogenesis related genes were analyzed by quantitive PCR.

Results

EDA+FN staining was positively associate with the size of the lesions (P<0.05). In contrast with the controls, the ratio of EDA+FN/total FN in the fibroblasts from radicular cysts was significantly higher (P<0.05), and positively associate with Trap+MNCs counting, it was consistent with increased expression of COX‐2, IL‐6, IL‐17 and the RANKL/OPG (P<0.05). The Trap+MNCs counting and osteoclastogenesis related genes were decreased by IST‐9 blocking and EDA exon knockout in fibroblasts, but the blockage of the interaction between EDA+FN and pre‐osteoclasts exhibited little effects on Trap+MNCs formation.

Conclusion

The microenvironment of the fibrous capsule of radicular cysts facilitate the splicing of EDA exon, it endues EDA+FN with autocrine effects on fibroblast itself, and increases the expression of osteoclastogenesis related genes, by which the osteoclastogenesis in radicular cysts could be initiated.

This article is protected by copyright. All rights reserved.

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Issue Information

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“Cold turkey” or pharmacotherapy: Examination of tobacco cessation methods tried among smokers prior to developing head and neck cancer

Abstract

Background

Tobacco cessation methods employed by patients with head and neck cancer (HNSCC) are previously unstudied and have the potential to inform choice of cessation method and necessary abstinence support.

Methods

A total of 130 current smokers with HNSCC were queried regarding prior unsuccessful tobacco cessation techniques, product used (cold turkey, varenicline, and nicotine patch/gum), and maximum time abstained from smoking.

Results

One hundred six smokers retrospectively reported using one of the four main quit methods. Unassisted cessation ("cold turkey") was the most commonly used method (P < .001). A multiple ordinal logistic general estimating equation analysis revealed that cold turkey had increased odds [5.2 (95% confidence interval [CI]: 2.2, 11.8) and 4.3 (95% CI: 1.5, 12.9)] of achieving a longer quit duration than the nicotine patch or varenicline, respectively.

Conclusions

Among smokers developing HNSCC, previous cessation attempts were most commonly unassisted. This method was associated with longest abstinence periods. These data suggest insufficient support and education regarding behavioral and pharmacologic cessation therapies.

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“Cold turkey” or pharmacotherapy: Examination of tobacco cessation methods tried among smokers prior to developing head and neck cancer

Abstract

Background

Tobacco cessation methods employed by patients with head and neck cancer (HNSCC) are previously unstudied and have the potential to inform choice of cessation method and necessary abstinence support.

Methods

A total of 130 current smokers with HNSCC were queried regarding prior unsuccessful tobacco cessation techniques, product used (cold turkey, varenicline, and nicotine patch/gum), and maximum time abstained from smoking.

Results

One hundred six smokers retrospectively reported using one of the four main quit methods. Unassisted cessation ("cold turkey") was the most commonly used method (P < .001). A multiple ordinal logistic general estimating equation analysis revealed that cold turkey had increased odds [5.2 (95% confidence interval [CI]: 2.2, 11.8) and 4.3 (95% CI: 1.5, 12.9)] of achieving a longer quit duration than the nicotine patch or varenicline, respectively.

Conclusions

Among smokers developing HNSCC, previous cessation attempts were most commonly unassisted. This method was associated with longest abstinence periods. These data suggest insufficient support and education regarding behavioral and pharmacologic cessation therapies.

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Rates of symptomatology are lower in recurrent sinonasal malignancy than in other recurrent cancers of the head and neck: a multi‐institutional study

Background

Sinonasal malignancies are a rare subset of head and neck tumors, and surveillance strategies after definitive tumor treatment are often generalized from those for overall head and neck cancer outcomes data. However, recent literature suggests that the posttreatment period in sinonasal cancer is fundamentally different and a more tailored surveillance approach may be beneficial. Although rates of symptomatology are high in head and neck cancer recurrence and patient‐driven follow‐up is common, rates of symptomatology are unknown in sinonasal cancer specifically.

Methods

Patients with recurrence of sinonasal malignancy were identified at 3 academic rhinology and skull base surgery centers. Demographic, tumor, and treatment data were collected. Rates of symptomatology at presentation were tabulated and examined in the context of several other variables.

Results

Fifty‐five patients had recurrence of sinonasal malignancy after definitive treatment. Fifty‐one percent of patients had no suspicious symptoms at the time of tumor recurrence, with an average time to recurrence of 33 months. Male patients and patients with stage IVA or lower disease were significantly more likely to be asymptomatic at the time of recurrence (p < 0.05).

Conclusion

Patients with sinonasal malignancy have a much lower rate of symptomatology during tumor recurrence than that observed in head and neck cancer overall. Furthermore, time to recurrence is substantially longer, as a majority of head and neck cancer recurrences occur in the first 12 months after treatment. These differences highlight the need for more tailored surveillance paradigms in asymptomatic patients with a history of a definitively treated sinonasal neoplasm.

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Rates of symptomatology are lower in recurrent sinonasal malignancy than in other recurrent cancers of the head and neck: a multi‐institutional study

Background

Sinonasal malignancies are a rare subset of head and neck tumors, and surveillance strategies after definitive tumor treatment are often generalized from those for overall head and neck cancer outcomes data. However, recent literature suggests that the posttreatment period in sinonasal cancer is fundamentally different and a more tailored surveillance approach may be beneficial. Although rates of symptomatology are high in head and neck cancer recurrence and patient‐driven follow‐up is common, rates of symptomatology are unknown in sinonasal cancer specifically.

Methods

Patients with recurrence of sinonasal malignancy were identified at 3 academic rhinology and skull base surgery centers. Demographic, tumor, and treatment data were collected. Rates of symptomatology at presentation were tabulated and examined in the context of several other variables.

Results

Fifty‐five patients had recurrence of sinonasal malignancy after definitive treatment. Fifty‐one percent of patients had no suspicious symptoms at the time of tumor recurrence, with an average time to recurrence of 33 months. Male patients and patients with stage IVA or lower disease were significantly more likely to be asymptomatic at the time of recurrence (p < 0.05).

Conclusion

Patients with sinonasal malignancy have a much lower rate of symptomatology during tumor recurrence than that observed in head and neck cancer overall. Furthermore, time to recurrence is substantially longer, as a majority of head and neck cancer recurrences occur in the first 12 months after treatment. These differences highlight the need for more tailored surveillance paradigms in asymptomatic patients with a history of a definitively treated sinonasal neoplasm.

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Audiological outcome for hearing preservation surgery in acoustic neuroma: the need of agreement in reporting results

. (Source: Hearing, Balance and Communication)

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Audiological outcome for hearing preservation surgery in acoustic neuroma: the need of agreement in reporting results

. (Source: Hearing, Balance and Communication)

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