F-BAR domain only protein 1 (FCHO1) deficiency is a novel cause of combined immune deficiency in humans

Publication date: Available online 26 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Enrica Calzoni, Craig D. Platt, Sevgi Keles, Hye Sun Kuehn, Sarah Beaussant-Cohen, Yu Zhang, Julia Pazmandi, Gaetana Lanzi, Francesca Pala, Azzeddine Tahiat, Hasibe Artac, Raul Jimenez Heredia, Jasmin Dmytrus, Ismail Reisli, Vedat Uygun, Dilara Uygun, Aysen Bingol, Erdem Basaran, Kamel Djenouhat, Nafissa Benhalla

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F-BAR domain only protein 1 (FCHO1) deficiency is a novel cause of combined immune deficiency in humans

Publication date: Available online 26 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Enrica Calzoni, Craig D. Platt, Sevgi Keles, Hye Sun Kuehn, Sarah Beaussant-Cohen, Yu Zhang, Julia Pazmandi, Gaetana Lanzi, Francesca Pala, Azzeddine Tahiat, Hasibe Artac, Raul Jimenez Heredia, Jasmin Dmytrus, Ismail Reisli, Vedat Uygun, Dilara Uygun, Aysen Bingol, Erdem Basaran, Kamel Djenouhat, Nafissa Benhalla

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Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis

Abstract

Objectives

Therapy of osteomyelitis and osteonecrosis very often requires surgery. Proper preoperative radiological evaluation of a lesion's localization and extent is a key in planning surgical bone resection. This study aims to assess the differences between single-photon emission computed tomography and cone beam computed tomography when detecting an osteomyelitis/osteonecrosis lesion as well as the lesion's qualitative parameters, extent, and localization.

Material and methods

Identification of candidates was performed retrospectively following a search for patients with histologically or clinically confirmed osteomyelitis or osteonecrosis. They were matched with a list of patients whose disease extent and localization had been evaluated using single-photon emission computed tomography and cone beam computed tomography in the context of clinical investigations. Subsequently, two experienced examiners for each imaging technique separately performed de novo readings. Detection rate, localization, extent, and qualitative parameters of a lesion were then compared.

Results

Twenty-one patients with mandibular osteomyelitis and osteonecrotic lesions were included. Cone beam computed tomography detected more lesions than single-photon emission computed tomography (25 vs. 23; 100% vs. 92%). Cone beam computed tomography showed significantly greater depth, area, and volume, whereas length and width did not differ statistically between the two groups.

Conclusion

Both single-photon emission computed tomography and cone beam computed tomography could sensitively detect osteomyelitis/osteonecrosis lesions. Only single-photon emission computed tomography showed metabolic changes, whereas cone beam computed tomography seemed to display anatomic morphological reactions more accurately. The selection of the most adequate three-dimensional imaging and the correct interpretation of preoperative imaging remains challenging for clinicians.

Clinical relevance

In daily clinical practice, three-dimensional imaging is an important tool for evaluation of osteomyelitis/osteonecrosis lesions. In this context, clinicians should be aware of differences between single-photon emission computed tomography and cone beam computed tomography when detecting and assessing an osteomyelitis/osteonecrosis lesion, especially if a surgical bone resection is planned.

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Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis

Abstract

Objectives

Therapy of osteomyelitis and osteonecrosis very often requires surgery. Proper preoperative radiological evaluation of a lesion's localization and extent is a key in planning surgical bone resection. This study aims to assess the differences between single-photon emission computed tomography and cone beam computed tomography when detecting an osteomyelitis/osteonecrosis lesion as well as the lesion's qualitative parameters, extent, and localization.

Material and methods

Identification of candidates was performed retrospectively following a search for patients with histologically or clinically confirmed osteomyelitis or osteonecrosis. They were matched with a list of patients whose disease extent and localization had been evaluated using single-photon emission computed tomography and cone beam computed tomography in the context of clinical investigations. Subsequently, two experienced examiners for each imaging technique separately performed de novo readings. Detection rate, localization, extent, and qualitative parameters of a lesion were then compared.

Results

Twenty-one patients with mandibular osteomyelitis and osteonecrotic lesions were included. Cone beam computed tomography detected more lesions than single-photon emission computed tomography (25 vs. 23; 100% vs. 92%). Cone beam computed tomography showed significantly greater depth, area, and volume, whereas length and width did not differ statistically between the two groups.

Conclusion

Both single-photon emission computed tomography and cone beam computed tomography could sensitively detect osteomyelitis/osteonecrosis lesions. Only single-photon emission computed tomography showed metabolic changes, whereas cone beam computed tomography seemed to display anatomic morphological reactions more accurately. The selection of the most adequate three-dimensional imaging and the correct interpretation of preoperative imaging remains challenging for clinicians.

Clinical relevance

In daily clinical practice, three-dimensional imaging is an important tool for evaluation of osteomyelitis/osteonecrosis lesions. In this context, clinicians should be aware of differences between single-photon emission computed tomography and cone beam computed tomography when detecting and assessing an osteomyelitis/osteonecrosis lesion, especially if a surgical bone resection is planned.

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Internal noise in contrast discrimination propagates forwards from early visual cortex

Publication date: Available online 26 February 2019

Source: NeuroImage

Author(s): Greta Vilidaite, Emma Marsh, Daniel H. Baker

Abstract

Human contrast discrimination performance is limited by transduction nonlinearities and variability of the neural representation (noise). Whereas the nonlinearities have been well-characterised, there is less agreement about the specifics of internal noise. Psychophysical models assume that it impacts late in sensory processing, whereas neuroimaging and intracranial electrophysiology studies suggest that the noise is much earlier. We investigated whether perceptually-relevant internal noise arises in early visual areas or later decision making areas. We recorded EEG and MEG during a two-interval-forced-choice contrast discrimination task and used multivariate pattern analysis to decode target/non-target and selected/non-selected intervals from evoked responses. We found that perceptual decisions could be decoded from both EEG and MEG signals, even when the stimuli in both intervals were physically identical. Above-chance decision classification started <100 ms after stimulus onset, suggesting that neural noise affects sensory signals early in the visual pathway. Classification accuracy increased over time, peaking at >500 ms. Applying multivariate analysis to separate anatomically-defined brain regions in MEG source space, we found that occipital regions were informative early on but then information spreads forwards across parietal and frontal regions. This is consistent with neural noise affecting sensory processing at multiple stages of perceptual decision making. We suggest how early sensory noise might be resolved with Birdsall's linearisation, in which a dominant noise source obscures subsequent nonlinearities, to allow the visual system to preserve the wide dynamic range of early areas whilst still benefitting from contrast-invariance at later stages. A preprint of this work is available at: https://doi.org/10.1101/364612.

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Internal noise in contrast discrimination propagates forwards from early visual cortex

Publication date: Available online 26 February 2019

Source: NeuroImage

Author(s): Greta Vilidaite, Emma Marsh, Daniel H. Baker

Abstract

Human contrast discrimination performance is limited by transduction nonlinearities and variability of the neural representation (noise). Whereas the nonlinearities have been well-characterised, there is less agreement about the specifics of internal noise. Psychophysical models assume that it impacts late in sensory processing, whereas neuroimaging and intracranial electrophysiology studies suggest that the noise is much earlier. We investigated whether perceptually-relevant internal noise arises in early visual areas or later decision making areas. We recorded EEG and MEG during a two-interval-forced-choice contrast discrimination task and used multivariate pattern analysis to decode target/non-target and selected/non-selected intervals from evoked responses. We found that perceptual decisions could be decoded from both EEG and MEG signals, even when the stimuli in both intervals were physically identical. Above-chance decision classification started <100 ms after stimulus onset, suggesting that neural noise affects sensory signals early in the visual pathway. Classification accuracy increased over time, peaking at >500 ms. Applying multivariate analysis to separate anatomically-defined brain regions in MEG source space, we found that occipital regions were informative early on but then information spreads forwards across parietal and frontal regions. This is consistent with neural noise affecting sensory processing at multiple stages of perceptual decision making. We suggest how early sensory noise might be resolved with Birdsall's linearisation, in which a dominant noise source obscures subsequent nonlinearities, to allow the visual system to preserve the wide dynamic range of early areas whilst still benefitting from contrast-invariance at later stages. A preprint of this work is available at: https://doi.org/10.1101/364612.

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Capillary dynamics, interstitial fluid and the lymphatic system

Publication date: Available online 26 February 2019

Source: Anaesthesia & Intensive Care Medicine

Author(s): Andrew Haggerty, Mahesh Nirmalan

Abstract

The regulation of small blood vessels (arterioles, venules and capillaries) and the formation of interstitial fluid at the capillary beds is an important process in the understanding of the healthy circulation. Traditionally, the Starling forces have been at the very heart of our understanding of this system. However more recent work shows that the trans-vascular fluid flux is significantly lower than what one would expect on the basis of Starling's forces alone and hence alternative explanations have been sought to understand the process of tissue fluid formation. In this context the role of the endothelial glycocalyx layer (or EGL) has drawn substantial interest. The EGL is a dynamic, active interface between the blood and the endothelial cells. It is formed by membrane-bound glycoproteins, proteoglycans and polysaccharides, producing a hydrated gel-like layer on the luminal surface of the vascular endothelium of approximately 500–2000 nm thickness. In this paper we review some of these emerging concepts and propose alternative ideas to understand some frequent clinical conditions and their treatment.

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Capillary dynamics, interstitial fluid and the lymphatic system

Publication date: Available online 26 February 2019

Source: Anaesthesia & Intensive Care Medicine

Author(s): Andrew Haggerty, Mahesh Nirmalan

Abstract

The regulation of small blood vessels (arterioles, venules and capillaries) and the formation of interstitial fluid at the capillary beds is an important process in the understanding of the healthy circulation. Traditionally, the Starling forces have been at the very heart of our understanding of this system. However more recent work shows that the trans-vascular fluid flux is significantly lower than what one would expect on the basis of Starling's forces alone and hence alternative explanations have been sought to understand the process of tissue fluid formation. In this context the role of the endothelial glycocalyx layer (or EGL) has drawn substantial interest. The EGL is a dynamic, active interface between the blood and the endothelial cells. It is formed by membrane-bound glycoproteins, proteoglycans and polysaccharides, producing a hydrated gel-like layer on the luminal surface of the vascular endothelium of approximately 500–2000 nm thickness. In this paper we review some of these emerging concepts and propose alternative ideas to understand some frequent clinical conditions and their treatment.

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Nickel release from metal tools in the German hairdressing trade – a current analysis

Background

Nickel is one of the most common contact allergens. Despite EU regulations concerning maximum permissible release of nickel from metal objects, nickel release at inappropriately high levels from metal objects was detected in various studies.

Objectives

To screen the current nickel release from metal tools in the German hairdressing trade.

Methods

Two‐hundred twenty‐nine metal tools from the German hairdressing trade were tested with the dimethylglyoxime (DMG) test for nickel release. Additionally, an employee survey was conducted to collect data about the metal tools.

Results

The DMG test showed that 21 of 229 metal tools (9.2%) released nickel. Nickel release was detected in eight of 45 hair clips (17.8%), two of 27 tail combs (7.4%) and eleven of 17 tweezers (64.7%).

Conclusion

It must be assumed that hairdressers in Germany have prolonged skin contact with nickel releasing metal tools. This should prompt further testing for nickel release from metal tools as well as the development of regulation to eliminate nickel releasing metal tools in the (German) hairdressing trade.

This article is protected by copyright. All rights reserved.

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SWI processing using a local phase difference modulated venous enhancement filter with noise compensation

Publication date: Available online 26 February 2019

Source: Magnetic Resonance Imaging

Author(s): Sreekanth Madhusoodhanan, Chandrasekharan Kesavadas, Joseph Suresh Paul

Abstract

Susceptibility weighted imaging (SWI) involves post-processing of gradient echo images which are sensitive to the spatial variations in magnetic susceptibility. The aim of this study is to develop an automated filtering scheme to enhance the contrast-to-noise ratio (CNR) and blooming on SWI. Here, the high-pass filtering for SWI processing is designed by applying a weighting function to the neighboring phase differences to enhance the susceptibility-related (SuR) contrast. This is accomplished by summing the neighboring phase differences, weighted with a scaled and shifted error function of the phase difference. Besides using the filter weights of this weighted high-pass (WHP) filter to minimize the filtering artefacts using a filter scale parameter, the CNR is further increased by introduction of the neighborhood-based noise compensation weights into the filtering process. These weights are deduced from the channel phase distribution, conditioned on the channel magnitude and noise variance. Using in vivo SWI data acquired at 1.5 T (16 nos.) and 3.0 T (30 nos.), the magnitude SWI processed using the noise compensated WHP (WHPC) filter is shown to provide an average CNR improvement of 68.40% over that of a homodyne high-pass (HHP) filter. Two tailed t-tests performed separately for different field strengths, show significant differences (p < 0.001) between mean separations of phase masks generated from the WHPC and HHP filtered phase images. In conclusion, the WHPC filter, tuned by the mean separation of the phase mask, enhances the SuR contrast of magnitude SWI for evaluation of mild cognitive impairments, brain tumor and hemorrhagic stroke.

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Nickel release from metal tools in the German hairdressing trade – a current analysis

Background

Nickel is one of the most common contact allergens. Despite EU regulations concerning maximum permissible release of nickel from metal objects, nickel release at inappropriately high levels from metal objects was detected in various studies.

Objectives

To screen the current nickel release from metal tools in the German hairdressing trade.

Methods

Two‐hundred twenty‐nine metal tools from the German hairdressing trade were tested with the dimethylglyoxime (DMG) test for nickel release. Additionally, an employee survey was conducted to collect data about the metal tools.

Results

The DMG test showed that 21 of 229 metal tools (9.2%) released nickel. Nickel release was detected in eight of 45 hair clips (17.8%), two of 27 tail combs (7.4%) and eleven of 17 tweezers (64.7%).

Conclusion

It must be assumed that hairdressers in Germany have prolonged skin contact with nickel releasing metal tools. This should prompt further testing for nickel release from metal tools as well as the development of regulation to eliminate nickel releasing metal tools in the (German) hairdressing trade.

This article is protected by copyright. All rights reserved.

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SWI processing using a local phase difference modulated venous enhancement filter with noise compensation

Publication date: Available online 26 February 2019

Source: Magnetic Resonance Imaging

Author(s): Sreekanth Madhusoodhanan, Chandrasekharan Kesavadas, Joseph Suresh Paul

Abstract

Susceptibility weighted imaging (SWI) involves post-processing of gradient echo images which are sensitive to the spatial variations in magnetic susceptibility. The aim of this study is to develop an automated filtering scheme to enhance the contrast-to-noise ratio (CNR) and blooming on SWI. Here, the high-pass filtering for SWI processing is designed by applying a weighting function to the neighboring phase differences to enhance the susceptibility-related (SuR) contrast. This is accomplished by summing the neighboring phase differences, weighted with a scaled and shifted error function of the phase difference. Besides using the filter weights of this weighted high-pass (WHP) filter to minimize the filtering artefacts using a filter scale parameter, the CNR is further increased by introduction of the neighborhood-based noise compensation weights into the filtering process. These weights are deduced from the channel phase distribution, conditioned on the channel magnitude and noise variance. Using in vivo SWI data acquired at 1.5 T (16 nos.) and 3.0 T (30 nos.), the magnitude SWI processed using the noise compensated WHP (WHPC) filter is shown to provide an average CNR improvement of 68.40% over that of a homodyne high-pass (HHP) filter. Two tailed t-tests performed separately for different field strengths, show significant differences (p < 0.001) between mean separations of phase masks generated from the WHPC and HHP filtered phase images. In conclusion, the WHPC filter, tuned by the mean separation of the phase mask, enhances the SuR contrast of magnitude SWI for evaluation of mild cognitive impairments, brain tumor and hemorrhagic stroke.

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Influence of timing on the horizontal stability of connective tissue grafts for buccal soft tissue augmentation at single implants: a prospective controlled pilot study

Publication date: Available online 26 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Pier Paolo Poli, Paolo Carlo Maridati, Enrico Stoffella, Mario Beretta, Carlo Maiorana

Abstract

Purpose

The influence of different timing for soft tissue augmentation during implant therapy is still debated. Therefore, the present study aimed to evaluate clinically whether immediate versus delayed soft tissue augmentation procedures had an impact on the stability of peri-implant mucosal thickness.

Methods

Subjects requiring a single implant posterior to the canines in association with soft tissue augmentation procedures at the buccal aspect of single implants by means of connective tissue graft (CTG) were enrolled. Patients were randomly allocated to two different timing protocols: implant placement and simultaneous CTG (test group) or implant placement and CTG after 3 months (control group). PMT was measured clinically at the mid-buccal aspect of the implant site by bone sounding with an endodontic K-file using customized acrylic stents. PMT measurements were recorded before and after implant placement, and at 1, 2, 3, 4, 6, 9, and 12 months following implant insertion. Parametric statistical tests were used to compare the PMT between test and control groups at each study period and to evaluate the changes in PMT over time. The level of significance was set at P < .05.

Results

A total of 14 implants placed in 14 patients were available for the statistical comparison.

At 12 months, the difference in PMT between test and control groups was 0.12 ± 0.51 mm. This difference was not statistically significant (P = .54). A significant increase in PMT was observed from baseline to 12 months post-implantation in both test (P = .004) and control (P < .001) groups.

Conclusions

The present study indicated that changes in PMT following CTG were not influenced by the timing of soft tissue augmentation, and remained stable up to one year after implant insertion.

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Intraoperative Findings Of Extraocular Muscle Necrosis In Linear Orbital Trapdoor Fractures

Publication date: Available online 26 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Ramakrishnan Karthik, Scott Cynthia, Narayanan Vivek, Chandran Saravanan, Gurram Prashanthi

Abstract

Purpose

Orbital trapdoor fractures may constitute a relative surgical emergency. The reason for poor surgical outcomes in ocular motility disturbances and diplopia is not apparent in these fractures. The purpose of this retrospective study was to analyze the possibility of ischemic necrosis of the orbital contents in linear trapdoor fracture of the orbital floor and to evaluate the recovery period of trapdoor fractures.

Patients And Methods

The study included 11 patients with linear trapdoor fracture of the orbital floor in five years with a minimum of one year follow up. Patients with associated facial bone fractures were excluded. The demographic, etiologic, radiologic, interval between trauma and surgery and surgical techniques were recorded.

Results

The age range was 9 to 29 years with the mean being 16.3 years. The mean time to surgical intervention from the time of injury was 3.9 days (range 0-11). Intraoperatively we observed macroscopic segmental necrosis of the entrapped inferior rectus muscle in 3 patients. Post operative review was conducted for a minimum of 12 months at the interval of 1st week, one month, 3 months, 6 months and 12 months. At the end of the follow-up period, incomplete recovery was observed in five patients which included all the three patients with intraoperative necrosed muscle and the other two patients were operated at 7th day and 8th day from the time of injury.

Conclusion

From our study, we observed that segmental necrosis of the entrapped inferior rectus muscle is possible in linear trapdoor fracture of the orbital floor. We also noted that incomplete recovery correlates with clinical evidence of inferior rectus muscle necrosis and late surgical intervention.

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Quality of Life after oral cancer resection and free flap reconstruction

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Shuai Wang, Shoucheng Yin, Ze-liang Zhang, Xingzhou Su, Zhong-fei Xu

Abstract

Purpose

This study focused on quality of life for patients in northeast China who underwent oral cancer resection directly before flap reconstruction. Additionally, this study compared differences between the radial forearm free flap (RFFF), ulnar forearm free flap (UFFF), and anterolateral thigh flap (ALTF) for defect reconstruction.

Methods

To assess the patients' quality of life, the UW-QOL (University of Washington Quality of Life) and OHIP-14 (14-Item Oral Health Impact Profile) questionnaires were given six months after reconstruction.

Results

The flap size of the ALTF group was much larger than that of the UFFF and RFFF groups. Meanwhile, the appearance score in the ALTF group was significantly higher than that in the UFFF and RFFF groups, while these groups had a much higher swallowing score than the ALTF group did. Furthermore, the ALTF group had much lower social disability OHIP-14 scores than the RFFF group did.

Conclusion

The results indicate that all three reconstruction methods are similar, but ALTF has a slight advantage over UFFF and RFFF.

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Tapered Vs Cylindrical Implant: Which Shape Inflicts Less Pain after Dental Implant Surgery? A Clinical Trial

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sahand Samieirad, Vajiheh Mianbandi, Farid Shiezadeh, Majid Hosseini-Abrishami, Elahe Tohidi

Abstract

Objective

Since no study has evaluated the post-operative pain caused by dental implants shape up to now, the aim of this study was to compare the amount of postoperative pain between tapered and cylindrical implants inserted in the posterior region of the maxilla.

Method and materials

The study was designed as a double-blind randomized clinical trial. It was implemented on 50 healthy patients with the age range of 20-60 years who were edentulous in the posterior maxilla and were candidates for single implantation. All of the patients had the same surgical difficulty with appropriate bone width and height. The BioHorizons implants (tapered or cylindrical) with 4.5 mm platform diameter were randomly selected for each group. In order to evaluate the amount of pain, "Visual Analog Scale" (VAS) was used. Pain severity in each group was measured at 30-minutes, 3-h, 6-h, 12-h and 24-h as well as 2-day, 3-day and 1-week intervals. The predictor variable was the implant shape and the outcome was postoperative pain severity. Finally, the data were statistically analyzed with SPPS 16 at the significance level of p < 0.05.

Results

50 patients (2 groups of 25 cases) with the mean age of 43.7 ± 10.9 were included in this study. It was considerable that the pain level in both groups reached its maximum at 6-h postoperative interval. The pain severity decreased significantly over time in both implant groups (P<0.001).

It was observed that the postoperative pain severity amounts in the tapered implant group at 3-, 6-, 12-h and 24-h intervals were statistically lower than those in the cylindrical group (P<0.05).

Conclusion

The implant shape had an impact on the postoperative pain. It can be concluded that the tapered implants lead to less post-operative pain compared to cylindrical ones.

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Does sleep quality affect temporomandibular joint with degenerative joint changes?

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Tran Duy Thuy Duong, Min-Chi Chen, Ellen Wen-Ching Ko, Yu-Ray Chen, Chiung Shing Huang

Abstract

Objectives

The purpose of this study was to answer the following question: among female patients who have skeletal Class III malocclusion, does poor sleep quality increase the prevalence of degenerative joint changes in temporomandibular joints (DJC-TMJ)?

Materials and Methods

The authors designed a prospective cohort study and enrolled female patients who required orthognathic surgery (OGS) to correct skeletal Class III malocclusion from January 2014 to December 2017. This is the first serial study to identify the relationship between sleep quality and DJC-TMJ before OGS. The predictor variable was sleep quality documented as poor sleep, indicated by a Pittsburgh Sleep Quality Index (PSQI) score of ≥5, or good sleep, indicated by a PSQI score of <5. The primary outcome variable was the presence of ≥5 or <5 DJC-TMJ signs. Other associated variables were grouped into the following categories: demographic variables (age and body mass index [BMI]) and cephalometric data. Descriptive bivariate statistics were computed and univariate and multiple logistic regression analyses were conducted to identify factors associated with DJC-TMJ.

Results

The sample was composed of 52 patients grouped as follows: a good sleep group (n = 25, PSQI < 5) and poor sleep group (n = 27, PSQI ≥ 5). Poor sleep quality was significantly associated (P = 0.027) with an increase in DJC-TMJ signs. In the multiple regression model, a PSQI score of ≥5 (adjusted odds ratio: 5.806; 95% confidence interval: 1.406–23.974) and greater SNA (adjusted odds ratio: 1.453; 95% confidence interval: 1.127–1.871) were significantly associated (P < 0.05) with an increased prevalence of DJC-TMJ.

Conclusion

The results of this study suggest that in female patients with skeletal Class III malocclusion, poor sleep quality could increase the prevalence of DJC-TMJ. Future cohort studies are required to support that sleep disturbance can increase DJC-TMJ in the general population.

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Conservative treatment of ameloblastoma in a paediatric patient: A case report

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Risimati Ephraim Rikhotso, Vinayagie Premviyasa

Abstract

Purpose

Ameloblastomas typically occur in adults but is considered a rarity in the paediatric patient population. We report on the treatment outcome of a paediatric patient who presented with a unicystic ameloblastoma in the mandible

Material and Methods

A 15-year old boy presented with a large, expansile lesion in the ramus angle region of the mandible. Incisional biopsy confirmed the lesion as a Type II unicystic ameloblastoma. Treatment consisted of unroofing of the bone overlying the lesion followed by enucleation with peripheral ostectomy. A 10 mL disposable Luer-Lock syringe was cut and modified to fit into the window of the lesion to facilitate irrigation with saline. The disposable syringe was held in position with 0.18 mm stainless steel wire for 3 months.

Conclusion

Modification of the conservative treatment using the syringe allowed for complete regeneration of bone in the large cavity without the need for bone graft or resection of the lesion. At the 3-year follow-up there was no sign of recurrence.

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Is Noise from Suctioning Harmful to Surgeon’s Hearing?

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mira Prabhakar, Yasmine Abdallah, Dennis Hanseman, Deepak Krishnan

Abstract

Purpose

A growing concern in the community of oral and maxillofacial surgeons (OMSs) is the progressive hearing loss that has become more evident in older surgeons. Very few studies have focused on the effects on a surgeon's hearing based on their environment. The purpose of this study was to investigate whether or not the noise produced by suction, compared to federal guidelines, could have a damaging effect on the hearing of OMSs.

Materials and Methods

A CEM DT-8851 industrial high-accuracy digital sound noise level meter data logger was used to capture the sound intensities in various procedures. The sound meter was used to record the intensities of sound produced in decibels in the clinics and operating rooms. The analysis was divided into different variables: non-drilling/suction, suction, drilling, suction and drilling, suction and irrigation, and Yankauer suction.

Results

50 clinic and 50 operating room procedures were recorded, focusing on suction. The noise intensities captured were analyzed based on federal workplace standards. Compared to non-drilling/suction, all other noise exposures on average were greater in intensity and found to be statistically significant with p>0.0001. Both the maximum and minimum intensity recorded occurred during non-drilling/suction periods. It was found that noise intensities exceeded 85 dB only 0.04% of the time.

Conclusion

The hypothesis that suction noise intensity exceeded federal guidelines was not supported and therefore was not accepted. However, it cannot conclusively be said that surgeons are not experiencing hearing loss due to their work-related noise exposure. The extent to which OMSs are exposed to this type of setting could be the cause of their progressive hearing loss since federal guidelines are based on 8 hour workdays and 16 hours of being in a quiet environment. A longitudinal study following specific surgeons through a substantial period of time would perhaps be able to give more definitive results.

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Estrogen-mediated miRNA101-3p expression represses HAS2 in synovial fibroblasts from idiopathic condylar resorption patients

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Chi Feng, Ping Ji, Ping Luo, Jie Xu

Abstract

Purpose

Idiopathic condylar resorption (ICR) is an aggressive form of osteoarthritis that is frequently observed in adolescent females. We hypothesize that an estrogen-mediated pathway may contribute to ICR development.

Methods

Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of estradiol (E2) and hyaluronan (HA) in synovial fluid. Immunohistochemistry, real-time polymerase chain reaction (PCR), and western blotting were used to detect the expression of miRNAs and related genes after transfecting miRNA101-3p mimics, inhibitor, or siRNA into synovial fibroblasts. Dual luciferase activity was determined to identify the direct effect of miRNA101-3p on HAS2. Linear regression analysis, nonparametric Mann–Whitney U test, Student's t-test, and one-way analysis of variance were carried out to analyze the results of each group.

Results

The relationship between HA and E2 was negatively correlated in synovial fluid (Pearson r=-0.3179, p=0.0230). Among the screened miRNAs, miRNA101-3p was the most overexpressed in ICR. E2 mostly upregulated the expression of miRNA101-3p at a dose of 10 nM 12 h after transfection in synovial fibroblasts of patients with ICR. However, E2 induction of miRNA101-3p expression was significantly repressed by ERα interference. The dual luciferase assay demonstrated that miRNA101-3p regulated the expression of HAS2 by directly targeting its 3' UTR.

Conclusions

We speculate that E2 regulates HAS2 expression by targeting miRNA101-3p in synovial fibroblasts of patients with ICR. Thus, the E2/miRNA101-3p/HAS2 pathway might play an important role in the pathogenesis of ICR.

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Influence of timing on the horizontal stability of connective tissue grafts for buccal soft tissue augmentation at single implants: a prospective controlled pilot study

Publication date: Available online 26 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Pier Paolo Poli, Paolo Carlo Maridati, Enrico Stoffella, Mario Beretta, Carlo Maiorana

Abstract

Purpose

The influence of different timing for soft tissue augmentation during implant therapy is still debated. Therefore, the present study aimed to evaluate clinically whether immediate versus delayed soft tissue augmentation procedures had an impact on the stability of peri-implant mucosal thickness.

Methods

Subjects requiring a single implant posterior to the canines in association with soft tissue augmentation procedures at the buccal aspect of single implants by means of connective tissue graft (CTG) were enrolled. Patients were randomly allocated to two different timing protocols: implant placement and simultaneous CTG (test group) or implant placement and CTG after 3 months (control group). PMT was measured clinically at the mid-buccal aspect of the implant site by bone sounding with an endodontic K-file using customized acrylic stents. PMT measurements were recorded before and after implant placement, and at 1, 2, 3, 4, 6, 9, and 12 months following implant insertion. Parametric statistical tests were used to compare the PMT between test and control groups at each study period and to evaluate the changes in PMT over time. The level of significance was set at P < .05.

Results

A total of 14 implants placed in 14 patients were available for the statistical comparison.

At 12 months, the difference in PMT between test and control groups was 0.12 ± 0.51 mm. This difference was not statistically significant (P = .54). A significant increase in PMT was observed from baseline to 12 months post-implantation in both test (P = .004) and control (P < .001) groups.

Conclusions

The present study indicated that changes in PMT following CTG were not influenced by the timing of soft tissue augmentation, and remained stable up to one year after implant insertion.

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Intraoperative Findings Of Extraocular Muscle Necrosis In Linear Orbital Trapdoor Fractures

Publication date: Available online 26 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Ramakrishnan Karthik, Scott Cynthia, Narayanan Vivek, Chandran Saravanan, Gurram Prashanthi

Abstract

Purpose

Orbital trapdoor fractures may constitute a relative surgical emergency. The reason for poor surgical outcomes in ocular motility disturbances and diplopia is not apparent in these fractures. The purpose of this retrospective study was to analyze the possibility of ischemic necrosis of the orbital contents in linear trapdoor fracture of the orbital floor and to evaluate the recovery period of trapdoor fractures.

Patients And Methods

The study included 11 patients with linear trapdoor fracture of the orbital floor in five years with a minimum of one year follow up. Patients with associated facial bone fractures were excluded. The demographic, etiologic, radiologic, interval between trauma and surgery and surgical techniques were recorded.

Results

The age range was 9 to 29 years with the mean being 16.3 years. The mean time to surgical intervention from the time of injury was 3.9 days (range 0-11). Intraoperatively we observed macroscopic segmental necrosis of the entrapped inferior rectus muscle in 3 patients. Post operative review was conducted for a minimum of 12 months at the interval of 1st week, one month, 3 months, 6 months and 12 months. At the end of the follow-up period, incomplete recovery was observed in five patients which included all the three patients with intraoperative necrosed muscle and the other two patients were operated at 7th day and 8th day from the time of injury.

Conclusion

From our study, we observed that segmental necrosis of the entrapped inferior rectus muscle is possible in linear trapdoor fracture of the orbital floor. We also noted that incomplete recovery correlates with clinical evidence of inferior rectus muscle necrosis and late surgical intervention.

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Quality of Life after oral cancer resection and free flap reconstruction

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Shuai Wang, Shoucheng Yin, Ze-liang Zhang, Xingzhou Su, Zhong-fei Xu

Abstract

Purpose

This study focused on quality of life for patients in northeast China who underwent oral cancer resection directly before flap reconstruction. Additionally, this study compared differences between the radial forearm free flap (RFFF), ulnar forearm free flap (UFFF), and anterolateral thigh flap (ALTF) for defect reconstruction.

Methods

To assess the patients' quality of life, the UW-QOL (University of Washington Quality of Life) and OHIP-14 (14-Item Oral Health Impact Profile) questionnaires were given six months after reconstruction.

Results

The flap size of the ALTF group was much larger than that of the UFFF and RFFF groups. Meanwhile, the appearance score in the ALTF group was significantly higher than that in the UFFF and RFFF groups, while these groups had a much higher swallowing score than the ALTF group did. Furthermore, the ALTF group had much lower social disability OHIP-14 scores than the RFFF group did.

Conclusion

The results indicate that all three reconstruction methods are similar, but ALTF has a slight advantage over UFFF and RFFF.

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Tapered Vs Cylindrical Implant: Which Shape Inflicts Less Pain after Dental Implant Surgery? A Clinical Trial

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sahand Samieirad, Vajiheh Mianbandi, Farid Shiezadeh, Majid Hosseini-Abrishami, Elahe Tohidi

Abstract

Objective

Since no study has evaluated the post-operative pain caused by dental implants shape up to now, the aim of this study was to compare the amount of postoperative pain between tapered and cylindrical implants inserted in the posterior region of the maxilla.

Method and materials

The study was designed as a double-blind randomized clinical trial. It was implemented on 50 healthy patients with the age range of 20-60 years who were edentulous in the posterior maxilla and were candidates for single implantation. All of the patients had the same surgical difficulty with appropriate bone width and height. The BioHorizons implants (tapered or cylindrical) with 4.5 mm platform diameter were randomly selected for each group. In order to evaluate the amount of pain, "Visual Analog Scale" (VAS) was used. Pain severity in each group was measured at 30-minutes, 3-h, 6-h, 12-h and 24-h as well as 2-day, 3-day and 1-week intervals. The predictor variable was the implant shape and the outcome was postoperative pain severity. Finally, the data were statistically analyzed with SPPS 16 at the significance level of p < 0.05.

Results

50 patients (2 groups of 25 cases) with the mean age of 43.7 ± 10.9 were included in this study. It was considerable that the pain level in both groups reached its maximum at 6-h postoperative interval. The pain severity decreased significantly over time in both implant groups (P<0.001).

It was observed that the postoperative pain severity amounts in the tapered implant group at 3-, 6-, 12-h and 24-h intervals were statistically lower than those in the cylindrical group (P<0.05).

Conclusion

The implant shape had an impact on the postoperative pain. It can be concluded that the tapered implants lead to less post-operative pain compared to cylindrical ones.

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Does sleep quality affect temporomandibular joint with degenerative joint changes?

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Tran Duy Thuy Duong, Min-Chi Chen, Ellen Wen-Ching Ko, Yu-Ray Chen, Chiung Shing Huang

Abstract

Objectives

The purpose of this study was to answer the following question: among female patients who have skeletal Class III malocclusion, does poor sleep quality increase the prevalence of degenerative joint changes in temporomandibular joints (DJC-TMJ)?

Materials and Methods

The authors designed a prospective cohort study and enrolled female patients who required orthognathic surgery (OGS) to correct skeletal Class III malocclusion from January 2014 to December 2017. This is the first serial study to identify the relationship between sleep quality and DJC-TMJ before OGS. The predictor variable was sleep quality documented as poor sleep, indicated by a Pittsburgh Sleep Quality Index (PSQI) score of ≥5, or good sleep, indicated by a PSQI score of <5. The primary outcome variable was the presence of ≥5 or <5 DJC-TMJ signs. Other associated variables were grouped into the following categories: demographic variables (age and body mass index [BMI]) and cephalometric data. Descriptive bivariate statistics were computed and univariate and multiple logistic regression analyses were conducted to identify factors associated with DJC-TMJ.

Results

The sample was composed of 52 patients grouped as follows: a good sleep group (n = 25, PSQI < 5) and poor sleep group (n = 27, PSQI ≥ 5). Poor sleep quality was significantly associated (P = 0.027) with an increase in DJC-TMJ signs. In the multiple regression model, a PSQI score of ≥5 (adjusted odds ratio: 5.806; 95% confidence interval: 1.406–23.974) and greater SNA (adjusted odds ratio: 1.453; 95% confidence interval: 1.127–1.871) were significantly associated (P < 0.05) with an increased prevalence of DJC-TMJ.

Conclusion

The results of this study suggest that in female patients with skeletal Class III malocclusion, poor sleep quality could increase the prevalence of DJC-TMJ. Future cohort studies are required to support that sleep disturbance can increase DJC-TMJ in the general population.

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Conservative treatment of ameloblastoma in a paediatric patient: A case report

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Risimati Ephraim Rikhotso, Vinayagie Premviyasa

Abstract

Purpose

Ameloblastomas typically occur in adults but is considered a rarity in the paediatric patient population. We report on the treatment outcome of a paediatric patient who presented with a unicystic ameloblastoma in the mandible

Material and Methods

A 15-year old boy presented with a large, expansile lesion in the ramus angle region of the mandible. Incisional biopsy confirmed the lesion as a Type II unicystic ameloblastoma. Treatment consisted of unroofing of the bone overlying the lesion followed by enucleation with peripheral ostectomy. A 10 mL disposable Luer-Lock syringe was cut and modified to fit into the window of the lesion to facilitate irrigation with saline. The disposable syringe was held in position with 0.18 mm stainless steel wire for 3 months.

Conclusion

Modification of the conservative treatment using the syringe allowed for complete regeneration of bone in the large cavity without the need for bone graft or resection of the lesion. At the 3-year follow-up there was no sign of recurrence.

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Is Noise from Suctioning Harmful to Surgeon’s Hearing?

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mira Prabhakar, Yasmine Abdallah, Dennis Hanseman, Deepak Krishnan

Abstract

Purpose

A growing concern in the community of oral and maxillofacial surgeons (OMSs) is the progressive hearing loss that has become more evident in older surgeons. Very few studies have focused on the effects on a surgeon's hearing based on their environment. The purpose of this study was to investigate whether or not the noise produced by suction, compared to federal guidelines, could have a damaging effect on the hearing of OMSs.

Materials and Methods

A CEM DT-8851 industrial high-accuracy digital sound noise level meter data logger was used to capture the sound intensities in various procedures. The sound meter was used to record the intensities of sound produced in decibels in the clinics and operating rooms. The analysis was divided into different variables: non-drilling/suction, suction, drilling, suction and drilling, suction and irrigation, and Yankauer suction.

Results

50 clinic and 50 operating room procedures were recorded, focusing on suction. The noise intensities captured were analyzed based on federal workplace standards. Compared to non-drilling/suction, all other noise exposures on average were greater in intensity and found to be statistically significant with p>0.0001. Both the maximum and minimum intensity recorded occurred during non-drilling/suction periods. It was found that noise intensities exceeded 85 dB only 0.04% of the time.

Conclusion

The hypothesis that suction noise intensity exceeded federal guidelines was not supported and therefore was not accepted. However, it cannot conclusively be said that surgeons are not experiencing hearing loss due to their work-related noise exposure. The extent to which OMSs are exposed to this type of setting could be the cause of their progressive hearing loss since federal guidelines are based on 8 hour workdays and 16 hours of being in a quiet environment. A longitudinal study following specific surgeons through a substantial period of time would perhaps be able to give more definitive results.

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Estrogen-mediated miRNA101-3p expression represses HAS2 in synovial fibroblasts from idiopathic condylar resorption patients

Publication date: Available online 25 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Chi Feng, Ping Ji, Ping Luo, Jie Xu

Abstract

Purpose

Idiopathic condylar resorption (ICR) is an aggressive form of osteoarthritis that is frequently observed in adolescent females. We hypothesize that an estrogen-mediated pathway may contribute to ICR development.

Methods

Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of estradiol (E2) and hyaluronan (HA) in synovial fluid. Immunohistochemistry, real-time polymerase chain reaction (PCR), and western blotting were used to detect the expression of miRNAs and related genes after transfecting miRNA101-3p mimics, inhibitor, or siRNA into synovial fibroblasts. Dual luciferase activity was determined to identify the direct effect of miRNA101-3p on HAS2. Linear regression analysis, nonparametric Mann–Whitney U test, Student's t-test, and one-way analysis of variance were carried out to analyze the results of each group.

Results

The relationship between HA and E2 was negatively correlated in synovial fluid (Pearson r=-0.3179, p=0.0230). Among the screened miRNAs, miRNA101-3p was the most overexpressed in ICR. E2 mostly upregulated the expression of miRNA101-3p at a dose of 10 nM 12 h after transfection in synovial fibroblasts of patients with ICR. However, E2 induction of miRNA101-3p expression was significantly repressed by ERα interference. The dual luciferase assay demonstrated that miRNA101-3p regulated the expression of HAS2 by directly targeting its 3' UTR.

Conclusions

We speculate that E2 regulates HAS2 expression by targeting miRNA101-3p in synovial fibroblasts of patients with ICR. Thus, the E2/miRNA101-3p/HAS2 pathway might play an important role in the pathogenesis of ICR.

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Erkrankungen und Diagnostik der Gallenwege

Zusammenfassung

Klinisches Problem

Gallenwegerkrankungen erfordern eine schnelle Diagnostik und den rationalen Einsatz apparativer Verfahren durch den Gastroenterologen und den Radiologen.

Diagnostische Standardverfahren

Als diagnostische Standardverfahren kommen die transabdominelle Sonographie, die endoskopisch-retrograde Cholangiographie (ERC), Endosonographie, direkte Cholangioskopie, Magnetresonanz-Cholangiopankreatikographie (MRT/MRCP) sowie die Computertomographie (CT) zum Einsatz.

Neue Diagnoseverfahren

Bei der modularen Cholangioskopie handelt es sich um ein neues diagnostisches Verfahren.

Diagnostik

Ziel der diagnostischen Untersuchung ist die Bestimmung der Lokalisation von Abflussbehinderungen und die Abgrenzung von malignen und benignen Läsionen.

Leistungsfähigkeit

Die transabdominelle Sonographie ist risikolos und stellt insbesondere die Gallenblase in hoher Auflösung dar. Sie bietet in den meisten Fällen eine hohe diagnostische Sicherheit. Endosonographie, ERC und/oder Cholangioskopie stellen die großen Gallenwege dar und erlauben die Entnahme von Biopsien, sind aber mit einem prozeduralen Risiko verbunden.

Empfehlung für die Praxis

Gallenblasenerkrankungen können häufig durch die transabdominelle Sonographie allein abgeklärt werden. Erkrankungen der großen Gallenwege erfordern meist den Einsatz von Endosonographie, ERC und/oder Cholangioskopie.

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Was bringt die neue Strahlenschutzverordnung?

Zusammenfassung

Die seit 31.12.2018 gültige Strahlenschutzverordnung (StrlSchV) und das Strahlenschutzgesetz (StrlSchG) haben viele Neuerungen gebracht: Ein System zur Erfassung und Bearbeitung von Vorkommnissen muss aufgebaut werden, und bedeutsame unbeabsichtigte Ereignisse werden meldepflichtig. Medizinphysik-Experten sind zukünftig bei Hochdosisarbeitsplätzen heranzuziehen. Es können weitere Früherkennungsuntersuchungen vom Bundesamt für Strahlenschutz (BfS) geprüft und genehmigt werden. Änderungen gibt es z. B. für Arbeitsanweisungen, Teleradiologie, Aufgaben der ärztlichen Stellen und bei Dosisgrenzwerten. Die erweiterten Anforderungen zu Dokumentationen und Auswertungen machen in größeren radiologischen Abteilungen oder Praxen Funktionen wie in einem Dosismanagementsystem praktisch erforderlich. An mehreren Stellen im Regelwerk besteht noch Interpretationsspielraum oder Nachbearbeitungsbedarf. Die bisherigen Richtlinien sollen inhaltlich bis auf Weiteres verwendet werden.

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Perkutane Intervention der Gallenwege und der Gallenblase

Zusammenfassung

Klinisches Problem

Perkutane Interventionen der Gallenwege und der Gallenblase sind fester Bestandteil in der Diagnostik und Therapie von Gallenwegerkrankungen.

Leistungsfähigkeit

Sie zeigen mit technischen Erfolgsraten von bis zu 99 % sowie Komplikationsraten von max. 26 % gute Ergebnisse. Die Indikationen reichen dabei von der Darstellung der Gallenwege bis hin zu therapeutischen Eingriffen wie Drainagen und Stents.

Bewertung

Angewendet werden perkutane Interventionen, wenn endoskopische Verfahren nicht möglich oder ausgeschöpft sind. Dieser Übersichtsartikel gibt einen Überblick über den aktuellen Stand sowie die Bandbreite perkutaner Interventionen der Gallenwege/Gallenblase und beschreibt die technische Durchführung der grundlegenden Gallenweginterventionen.

Empfehlung für die Praxis

Interventionen der Gallenwege und der Gallenblase sind sichere und effektive Verfahren in der Behandlung von benignen und malignen Gallenwegstrikturen, postoperativen Komplikationen sowie Risikopatienten mit Cholezystitis.

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Altered topological connectivity of internet addiction in resting-state EEG through network analysis

Publication date: Available online 26 February 2019

Source: Addictive Behaviors

Author(s): Yan Sun, Hongxia Wang, Siyu Bo

Abstract

The results of some neuroimaging studies have revealed that people with internet addiction (IA) exhibit structural and functional changes in specific brain areas and connections. However, the understanding about global topological organization of IA may also require a more integrative and holistic view of brain function. In the present study, we used synchronization likelihood combined with graph theory analysis to investigate the functional connectivity (FC) and topological differences between 25 participants with IA and 27 healthy controls (HCs) based on their spontaneous EEG activities in the eye-closed resting state. There were no significant differences in FC (total network or sub-networks) between groups (p > .05 for all). Graph analysis showed significantly lower characteristic path length and clustering coefficient in the IA group than in the HC group in the beta and gamma bands, respectively. Altered nodal centralities of the frontal (FP₁, FPz) and parietal (CP₁, CP₅, PO₃, PO₇, P₅, P_6, TP₈) lobes in the IA group were also observed. Correlation analysis demonstrated that the observed regional alterations were significantly correlated with the severity of IA. Collectively, our findings showed that IA group demonstrated altered topological organization, shifting towards a more random state. Moreover, this study revealed the important role of altered brain areas in the neuropathological mechanism of IA and provides further supportive evidence for the diagnosis of IA.

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Erkrankungen und Diagnostik der Gallenwege

Zusammenfassung

Klinisches Problem

Gallenwegerkrankungen erfordern eine schnelle Diagnostik und den rationalen Einsatz apparativer Verfahren durch den Gastroenterologen und den Radiologen.

Diagnostische Standardverfahren

Als diagnostische Standardverfahren kommen die transabdominelle Sonographie, die endoskopisch-retrograde Cholangiographie (ERC), Endosonographie, direkte Cholangioskopie, Magnetresonanz-Cholangiopankreatikographie (MRT/MRCP) sowie die Computertomographie (CT) zum Einsatz.

Neue Diagnoseverfahren

Bei der modularen Cholangioskopie handelt es sich um ein neues diagnostisches Verfahren.

Diagnostik

Ziel der diagnostischen Untersuchung ist die Bestimmung der Lokalisation von Abflussbehinderungen und die Abgrenzung von malignen und benignen Läsionen.

Leistungsfähigkeit

Die transabdominelle Sonographie ist risikolos und stellt insbesondere die Gallenblase in hoher Auflösung dar. Sie bietet in den meisten Fällen eine hohe diagnostische Sicherheit. Endosonographie, ERC und/oder Cholangioskopie stellen die großen Gallenwege dar und erlauben die Entnahme von Biopsien, sind aber mit einem prozeduralen Risiko verbunden.

Empfehlung für die Praxis

Gallenblasenerkrankungen können häufig durch die transabdominelle Sonographie allein abgeklärt werden. Erkrankungen der großen Gallenwege erfordern meist den Einsatz von Endosonographie, ERC und/oder Cholangioskopie.

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Was bringt die neue Strahlenschutzverordnung?

Zusammenfassung

Die seit 31.12.2018 gültige Strahlenschutzverordnung (StrlSchV) und das Strahlenschutzgesetz (StrlSchG) haben viele Neuerungen gebracht: Ein System zur Erfassung und Bearbeitung von Vorkommnissen muss aufgebaut werden, und bedeutsame unbeabsichtigte Ereignisse werden meldepflichtig. Medizinphysik-Experten sind zukünftig bei Hochdosisarbeitsplätzen heranzuziehen. Es können weitere Früherkennungsuntersuchungen vom Bundesamt für Strahlenschutz (BfS) geprüft und genehmigt werden. Änderungen gibt es z. B. für Arbeitsanweisungen, Teleradiologie, Aufgaben der ärztlichen Stellen und bei Dosisgrenzwerten. Die erweiterten Anforderungen zu Dokumentationen und Auswertungen machen in größeren radiologischen Abteilungen oder Praxen Funktionen wie in einem Dosismanagementsystem praktisch erforderlich. An mehreren Stellen im Regelwerk besteht noch Interpretationsspielraum oder Nachbearbeitungsbedarf. Die bisherigen Richtlinien sollen inhaltlich bis auf Weiteres verwendet werden.

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Perkutane Intervention der Gallenwege und der Gallenblase

Zusammenfassung

Klinisches Problem

Perkutane Interventionen der Gallenwege und der Gallenblase sind fester Bestandteil in der Diagnostik und Therapie von Gallenwegerkrankungen.

Leistungsfähigkeit

Sie zeigen mit technischen Erfolgsraten von bis zu 99 % sowie Komplikationsraten von max. 26 % gute Ergebnisse. Die Indikationen reichen dabei von der Darstellung der Gallenwege bis hin zu therapeutischen Eingriffen wie Drainagen und Stents.

Bewertung

Angewendet werden perkutane Interventionen, wenn endoskopische Verfahren nicht möglich oder ausgeschöpft sind. Dieser Übersichtsartikel gibt einen Überblick über den aktuellen Stand sowie die Bandbreite perkutaner Interventionen der Gallenwege/Gallenblase und beschreibt die technische Durchführung der grundlegenden Gallenweginterventionen.

Empfehlung für die Praxis

Interventionen der Gallenwege und der Gallenblase sind sichere und effektive Verfahren in der Behandlung von benignen und malignen Gallenwegstrikturen, postoperativen Komplikationen sowie Risikopatienten mit Cholezystitis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T6JBOU

Altered topological connectivity of internet addiction in resting-state EEG through network analysis

Publication date: Available online 26 February 2019

Source: Addictive Behaviors

Author(s): Yan Sun, Hongxia Wang, Siyu Bo

Abstract

The results of some neuroimaging studies have revealed that people with internet addiction (IA) exhibit structural and functional changes in specific brain areas and connections. However, the understanding about global topological organization of IA may also require a more integrative and holistic view of brain function. In the present study, we used synchronization likelihood combined with graph theory analysis to investigate the functional connectivity (FC) and topological differences between 25 participants with IA and 27 healthy controls (HCs) based on their spontaneous EEG activities in the eye-closed resting state. There were no significant differences in FC (total network or sub-networks) between groups (p > .05 for all). Graph analysis showed significantly lower characteristic path length and clustering coefficient in the IA group than in the HC group in the beta and gamma bands, respectively. Altered nodal centralities of the frontal (FP₁, FPz) and parietal (CP₁, CP₅, PO₃, PO₇, P₅, P_6, TP₈) lobes in the IA group were also observed. Correlation analysis demonstrated that the observed regional alterations were significantly correlated with the severity of IA. Collectively, our findings showed that IA group demonstrated altered topological organization, shifting towards a more random state. Moreover, this study revealed the important role of altered brain areas in the neuropathological mechanism of IA and provides further supportive evidence for the diagnosis of IA.

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ECR 2019: Book of Abstracts

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ECR 2019: Book of Abstracts

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Influence of residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone

Abstract

Objective

To evaluate the influence of the posterior residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone.

Material and Methods

Bilateral sinus bone augmentation was performed using anorganic bovine bone in twenty patients with residual bone height <2 mm in at least one site on each side. Trephine samples were removed at the implant insertion site eight months after the grafting procedure, and histological and histomorphometric analyses were performed to examine the relative amount (%) of new bone, anorganic bovine bone, and soft tissue in the grafted area. Based on CBCT evaluation, the sites of implant insertion were classified according to sinus width into narrow, average, and wide, and according to residual bone height into ≤2 mm and >2 mm.

Results

A total of 146 implants were installed and 103 biopsies were evaluated. New bone formation in sites classified as narrow (69 sites), average (19 sites), and wide (15 sites) was 28.5%±9.24, 28.9%±8.61, and 30.3%±7.80, respectively. The mean posterior maxillary residual bone height was 4.0±2.43 mm, and 26 and 77 sites were classified as ≤2 mm and >2 mm, respectively. New bone formation was 26.2%±9.10 and 29.8%±8.67 for residual bone height ≤2 mm and >2 mm, respectively. The differences were non‐significant.

Conclusions

Within the limitations of the present study, posterior residual bone height and sinus width were not factors with influence on new bone formation in sinuses grafted exclusively with anorganic bovine bone after eight months of healing.

This article is protected by copyright. All rights reserved.

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Changes in alveolar process dimensions following extraction of molars with advanced periodontal disease: a clinical pilot study

Abstract

Objective

To use cone beam computed tomography (CBCT) to assess the alterations of socket dimensions after a 6‐month healing period following molar extraction.

Material and methods

Seventeen molars were extracted due to advanced periodontitis. CBCT scans were taken immediately after extraction and once more 6 months later. Superimposition of CBCT images were used to measure: horizontal changes at extraction sites at three corono‐apical levels (‐1, ‐3, ‐5 mm) below the bone crest, three mesio‐distal levels (mesial, central, and distal), vertical changes at nine regions of the alveolar crest, and alveolar bone volume.

Results

The width of the central crests at ‐1 mm decreased by 0.59 and 0.72 mm in the buccal and 0.27 and 0.02 mm in the lingual, in the maxilla and mandible, respectively. No statistically significant decreases in the ridge height were observed except in the disto‐palatal region with a 1.11 mm decrease in the maxilla (P<0.05). Heights of the buccal and lingual bone plates decreased significantly and ranged from 0.56 mm to 1.38 mm in the mandible after 6 months of healing (P<0.05). Overall ridge height changes were not significantly different between the maxilla and mandible (P>0.05) and no significant volumetric bone loss occurred in either maxillary or mandibular sockets after 6 months of healing.

Conclusions

Socket dimensions of molars with advanced periodontal disease showed a significant increase at the middle‐central portion, although there were no significant changes of horizontal width 6 months following the procedures.

This article is protected by copyright. All rights reserved.

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Influence of residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone

Abstract

Objective

To evaluate the influence of the posterior residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone.

Material and Methods

Bilateral sinus bone augmentation was performed using anorganic bovine bone in twenty patients with residual bone height <2 mm in at least one site on each side. Trephine samples were removed at the implant insertion site eight months after the grafting procedure, and histological and histomorphometric analyses were performed to examine the relative amount (%) of new bone, anorganic bovine bone, and soft tissue in the grafted area. Based on CBCT evaluation, the sites of implant insertion were classified according to sinus width into narrow, average, and wide, and according to residual bone height into ≤2 mm and >2 mm.

Results

A total of 146 implants were installed and 103 biopsies were evaluated. New bone formation in sites classified as narrow (69 sites), average (19 sites), and wide (15 sites) was 28.5%±9.24, 28.9%±8.61, and 30.3%±7.80, respectively. The mean posterior maxillary residual bone height was 4.0±2.43 mm, and 26 and 77 sites were classified as ≤2 mm and >2 mm, respectively. New bone formation was 26.2%±9.10 and 29.8%±8.67 for residual bone height ≤2 mm and >2 mm, respectively. The differences were non‐significant.

Conclusions

Within the limitations of the present study, posterior residual bone height and sinus width were not factors with influence on new bone formation in sinuses grafted exclusively with anorganic bovine bone after eight months of healing.

This article is protected by copyright. All rights reserved.

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Expression of Toll-like receptors 2 and 4 and its association with matrix metalloproteinases in symptomatic and asymptomatic apical periodontitis

Abstract

To determine Toll-like receptors (TLR)2 and TLR4 expression levels and associate them with matrix metalloproteinases (MMPs) in asymptomatic apical periodontitis (AAP), symptomatic apical periodontitis (SAP), and healthy controls. Apical tissue/lesion samples were obtained from chronic AAP (n = 35) and SAP (n = 29), and healthy periodontal ligament (HPL, n = 10) with indication of tooth extraction, respectively. mRNA expression levels of TLR2, TLR4, MMP-1, MMP-2, MMP-8, and MMP-13 were determined by real-time reverse-transcription polymerase chain reaction. The data were analyzed with Kruskal-Wallis and Dunn's pot hoc test (p < 0.05). The correlation coefficient was obtained using the Spearman correlation (p < 0.05). TLR2, MMP-1, MMP-2, and MMP-13 mRNA levels were the highest in SAP followed by AAP and controls (p < 0.05). TLR4 and MMP-8 were over expressed in AAP and SAP compared to HPL (p < 0.05). TLR2 positively correlated with TLR4, MMP-1, MMP-8, and MMP-13 in SAP (p < 0.05). TLR2 and TLR4 are overexpressed in apical lesions versus healthy periodontal ligament and correlate with collagenolytic MMPs. Particularly, TLR2 is overexpressed in SAP in association with MMP-1, MMP-8, and MMP-13. Our results suggest that the activation of TLR2 along with MMP overexpression might contribute to SAP clinical presentation and progression. TLRs, MMPs, and their interaction can explain the clinical presentations and evolution of apical periodontitis and might represent key targets for new diagnostic and treatment approaches.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BUCYEr

Expression of Toll-like receptors 2 and 4 and its association with matrix metalloproteinases in symptomatic and asymptomatic apical periodontitis

Abstract

To determine Toll-like receptors (TLR)2 and TLR4 expression levels and associate them with matrix metalloproteinases (MMPs) in asymptomatic apical periodontitis (AAP), symptomatic apical periodontitis (SAP), and healthy controls. Apical tissue/lesion samples were obtained from chronic AAP (n = 35) and SAP (n = 29), and healthy periodontal ligament (HPL, n = 10) with indication of tooth extraction, respectively. mRNA expression levels of TLR2, TLR4, MMP-1, MMP-2, MMP-8, and MMP-13 were determined by real-time reverse-transcription polymerase chain reaction. The data were analyzed with Kruskal-Wallis and Dunn's pot hoc test (p < 0.05). The correlation coefficient was obtained using the Spearman correlation (p < 0.05). TLR2, MMP-1, MMP-2, and MMP-13 mRNA levels were the highest in SAP followed by AAP and controls (p < 0.05). TLR4 and MMP-8 were over expressed in AAP and SAP compared to HPL (p < 0.05). TLR2 positively correlated with TLR4, MMP-1, MMP-8, and MMP-13 in SAP (p < 0.05). TLR2 and TLR4 are overexpressed in apical lesions versus healthy periodontal ligament and correlate with collagenolytic MMPs. Particularly, TLR2 is overexpressed in SAP in association with MMP-1, MMP-8, and MMP-13. Our results suggest that the activation of TLR2 along with MMP overexpression might contribute to SAP clinical presentation and progression. TLRs, MMPs, and their interaction can explain the clinical presentations and evolution of apical periodontitis and might represent key targets for new diagnostic and treatment approaches.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BUCYEr

The Effects of Air Pollution on the Development of Atopic Disease

Abstract

Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO₂₎, nitric oxide (NO), sulfur dioxide (SO₂₎, particulate matter (PM_2.5 and PM₁₀), carbon monoxide (CO), and carbon dioxide (CO₂). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BTXLrT

After Peanut Allergy Rx, Eating Small Bits of Peanut Might Help: Study

MONDAY, Feb. 25, 2019 -- Immunotherapy for peanut allergy, where patients are fed tiny bits of peanut to help curb the allergy, might work better if patients continue to eat small amounts of the nut after completion of therapy, new research... (Source: Drugs.com - Daily MedNews)

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After Peanut Allergy Rx, Eating Small Bits of Peanut Might Help: Study

MONDAY, Feb. 25, 2019 -- Immunotherapy for peanut allergy, where patients are fed tiny bits of peanut to help curb the allergy, might work better if patients continue to eat small amounts of the nut after completion of therapy, new research... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T1IlfT

After Peanut Allergy Rx, Eating Small Bits of Peanut Might Help: Study

MONDAY, Feb. 25, 2019 -- Immunotherapy for peanut allergy, where patients are fed tiny bits of peanut to help curb the allergy, might work better if patients continue to eat small amounts of the nut after completion of therapy, new research... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T1IlfT

After Peanut Allergy Rx, Eating Small Bits of Peanut Might Help: Study

MONDAY, Feb. 25, 2019 -- Immunotherapy for peanut allergy, where patients are fed tiny bits of peanut to help curb the allergy, might work better if patients continue to eat small amounts of the nut after completion of therapy, new research... (Source: Drugs.com - Daily MedNews)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2T1IlfT

Occlusal height difference between maxillary central and lateral incisors: should aesthetic perception influence bracket placement?

Abstract

Background

The aim of this study was to verify anecdotal evidence that the maxillary central-to-lateral occlusal height difference (OHD) of more than 0.5 mm is a feature displayed in the majority of media and to discuss its implications for individualized orthodontic treatment planning.

Methods

Photographs of smiling female models were collected from a variety of printed advertisements and allocated to 3 groups (n = 30 each): 1 dental, 2 fashion and 3 orthodontics. Group 4 used female patient images from orthodontic textbooks, assuming an OHD of 0.5 mm between maxillary central and lateral incisors. OHD was assessed by measuring the incisor height on the photographs and using average values to establish height differences.

Results

The average maxillary central-to-lateral incisor OHD differences were 1.39 mm (dental literature), 1.34 mm (fashion advertisements), 1.23 mm (orthodontics) and 0.62 mm (orthodontic textbooks) respectively. The differences between the advertisement groups were not significant (P >  0.05), but for orthodontic textbooks they were (P <  0.001).

Conclusions

Advertisers seem to prefer greater maxillary central-to-lateral OHD compared to commonly used bracket placement protocols. Therefore, discussing OHD at start of treatment is recommended; modification of commonly used bracket placement protocols may be helpful to achieve desired aesthetic outcome.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BTh5W5

Occlusal height difference between maxillary central and lateral incisors: should aesthetic perception influence bracket placement?

Abstract

Background

The aim of this study was to verify anecdotal evidence that the maxillary central-to-lateral occlusal height difference (OHD) of more than 0.5 mm is a feature displayed in the majority of media and to discuss its implications for individualized orthodontic treatment planning.

Methods

Photographs of smiling female models were collected from a variety of printed advertisements and allocated to 3 groups (n = 30 each): 1 dental, 2 fashion and 3 orthodontics. Group 4 used female patient images from orthodontic textbooks, assuming an OHD of 0.5 mm between maxillary central and lateral incisors. OHD was assessed by measuring the incisor height on the photographs and using average values to establish height differences.

Results

The average maxillary central-to-lateral incisor OHD differences were 1.39 mm (dental literature), 1.34 mm (fashion advertisements), 1.23 mm (orthodontics) and 0.62 mm (orthodontic textbooks) respectively. The differences between the advertisement groups were not significant (P >  0.05), but for orthodontic textbooks they were (P <  0.001).

Conclusions

Advertisers seem to prefer greater maxillary central-to-lateral OHD compared to commonly used bracket placement protocols. Therefore, discussing OHD at start of treatment is recommended; modification of commonly used bracket placement protocols may be helpful to achieve desired aesthetic outcome.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BTh5W5

Statistics make their “official entry” in the European Annals of Otorhinolaryngology Head & Neck Diseases

Publication date: Available online 26 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): Q. Lisan, C. Martin, O. Laccourreye

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Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on cervical lymphatic malformation in adults and children: Diagnosis

Publication date: Available online 25 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J. Lerat, A. Bisdorff-Bresson, M. Borsic, C. Chopinet, V. Couloignier, N. Fakhry, P. Fayoux, F. Jegoux, A. Larralde, N. Leboulanger, R. Nicollas, S. Pondaven Letourmy, SFORL work group

Abstract

Objectives

The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children.

Methods

A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence.

Results

The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tDZFIM

Statistics make their “official entry” in the European Annals of Otorhinolaryngology Head & Neck Diseases

Publication date: Available online 26 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): Q. Lisan, C. Martin, O. Laccourreye

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2H7xg5P

Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on cervical lymphatic malformation in adults and children: Diagnosis

Publication date: Available online 25 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J. Lerat, A. Bisdorff-Bresson, M. Borsic, C. Chopinet, V. Couloignier, N. Fakhry, P. Fayoux, F. Jegoux, A. Larralde, N. Leboulanger, R. Nicollas, S. Pondaven Letourmy, SFORL work group

Abstract

Objectives

The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children.

Methods

A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence.

Results

The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2tDZFIM

The Effects of Air Pollution on the Development of Atopic Disease

Abstract

Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO₂₎, nitric oxide (NO), sulfur dioxide (SO₂₎, particulate matter (PM_2.5 and PM₁₀), carbon monoxide (CO), and carbon dioxide (CO₂). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BTXLrT

The Effects of Air Pollution on the Development of Atopic Disease

Abstract

Air pollution is defined as the presence of noxious substances in the air at levels that impose a health hazard. Thus, there has been long-standing interest in the possible role of indoor and outdoor air pollutants on the development of respiratory disease. In this regard, asthma has been of particular interest but many studies have also been conducted to explore the relationship between air pollution, allergic rhinitis, and atopic dermatitis. Traffic-related air pollutants or TRAP refers to a broad group of pollutants including elemental carbon, black soot, nitrogen dioxide (NO₂₎, nitric oxide (NO), sulfur dioxide (SO₂₎, particulate matter (PM_2.5 and PM₁₀), carbon monoxide (CO), and carbon dioxide (CO₂). In this review, we aim to examine the current literature regarding the impact of early childhood exposure to TRAP on the development of asthma, allergic rhinitis, and atopic dermatitis. Although there is growing evidence suggesting significant associations, definitive conclusions cannot be made with regard to the effect of TRAP on these diseases. This conundrum may be due to a variety of factors, including different definitions used to define TRAP, case definitions under consideration, a limited number of studies, variation in study designs, and disparities between studies in consideration of confounding factors. Regardless, this review highlights the need for future studies to be conducted, particularly with birth cohorts that explore this relationship further. Such studies may assist in understanding more clearly the pathogenesis of these diseases, as well as other methods by which these diseases could be treated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BTXLrT

A systematic review of hearing and vestibular function in carriers of the Pro51Ser mutation in the COCH gene

Abstract

Background and objectives

The Pro51Ser (P51S) COCH mutation is characterized by a late-onset bilateral sensorineural hearing loss (SNHL) and progressive vestibular deterioration. The aim of this study was to carry out a systematic review of all reported hearing and vestibular function data in P51S COCH mutation carriers and its correlation with age.

Materials and methods

Scientific databases including Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and Web of Science were searched to accumulate information about hearing outcome and vestibular function. Eleven genotype–phenotype correlation studies of the P51S COCH variant were identified and analyzed.

Results

The SNHL starts at the age of 32.8 years. The Annual Threshold Deterioration is 3 decibel hearing loss (dB HL) per year (1–24 dB HL/year). Profound SNHL was observed at 76 years on average (60–84 years). 136 individual vestibular measurements were collected from 86 carriers. The onset of the vestibular dysfunction was estimated around 34 years (34–40 years), and vestibular deterioration rates were higher than those of the SNHL, with complete bilateral loss observed between 49 and 60 years.

Conclusion

Both audiometric and vestibular data were processed with much different methodologies and pre-symptomatic P51S carriers were systematically underrepresented. Further delineation of this correlation would benefit cross-sectional and longitudinal study involving all (pre-symptomatic and symptomatic) P51S carriers.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IALHS1

Cost analysis of office-based transnasal esophagoscopy

Abstract

Purpose

Although office-based transnasal esophagoscopy has been investigated extensively, a cost analysis is still lacking. We performed a cost analysis combined with feasibility study for two diagnostic processes: patients with globus pharyngeus and/or dysphagia, and hypopharyngeal carcinoma.

Methods

Prospective cohort study.

Results

Forty-one procedures were performed, of which 35 were fully completed. The procedure was well tolerated with mild complaints such as nasal or pharyngeal pain and burping. Four complications occurred: two minor epistaxis and two vasovagal reactions. In patients with globus pharyngeus and/or dysphagia, transnasal esophagoscopy resulted in a cost saving of €94.43 (p 0.026) per procedure, compared to our regular diagnostic process. In patients with suspicion of hypopharyngeal carcinoma, cost savings were €831.41 (p 0.000) per case.

Conclusions

Cost analysis showed that office-based transnasal esophagoscopy can provide significant cost savings for the current standard of care. Furthermore, this procedure resulted in good patient acceptability and few complications.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2TkJAG4

A systematic review of hearing and vestibular function in carriers of the Pro51Ser mutation in the COCH gene

Abstract

Background and objectives

The Pro51Ser (P51S) COCH mutation is characterized by a late-onset bilateral sensorineural hearing loss (SNHL) and progressive vestibular deterioration. The aim of this study was to carry out a systematic review of all reported hearing and vestibular function data in P51S COCH mutation carriers and its correlation with age.

Materials and methods

Scientific databases including Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and Web of Science were searched to accumulate information about hearing outcome and vestibular function. Eleven genotype–phenotype correlation studies of the P51S COCH variant were identified and analyzed.

Results

The SNHL starts at the age of 32.8 years. The Annual Threshold Deterioration is 3 decibel hearing loss (dB HL) per year (1–24 dB HL/year). Profound SNHL was observed at 76 years on average (60–84 years). 136 individual vestibular measurements were collected from 86 carriers. The onset of the vestibular dysfunction was estimated around 34 years (34–40 years), and vestibular deterioration rates were higher than those of the SNHL, with complete bilateral loss observed between 49 and 60 years.

Conclusion

Both audiometric and vestibular data were processed with much different methodologies and pre-symptomatic P51S carriers were systematically underrepresented. Further delineation of this correlation would benefit cross-sectional and longitudinal study involving all (pre-symptomatic and symptomatic) P51S carriers.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IALHS1

Cost analysis of office-based transnasal esophagoscopy

Abstract

Purpose

Although office-based transnasal esophagoscopy has been investigated extensively, a cost analysis is still lacking. We performed a cost analysis combined with feasibility study for two diagnostic processes: patients with globus pharyngeus and/or dysphagia, and hypopharyngeal carcinoma.

Methods

Prospective cohort study.

Results

Forty-one procedures were performed, of which 35 were fully completed. The procedure was well tolerated with mild complaints such as nasal or pharyngeal pain and burping. Four complications occurred: two minor epistaxis and two vasovagal reactions. In patients with globus pharyngeus and/or dysphagia, transnasal esophagoscopy resulted in a cost saving of €94.43 (p 0.026) per procedure, compared to our regular diagnostic process. In patients with suspicion of hypopharyngeal carcinoma, cost savings were €831.41 (p 0.000) per case.

Conclusions

Cost analysis showed that office-based transnasal esophagoscopy can provide significant cost savings for the current standard of care. Furthermore, this procedure resulted in good patient acceptability and few complications.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2TkJAG4

Super Bowl Stuttering Slight Should Not Go Unnoticed

Super Bowl LIII opened with four and a half minutes of Peyton Manning plugging his creative genius—a scene featuring gladiators—to a room of executives who seem doubtful of his brilliant idea. He proceeds to tell them he's already rented the Colosseum for the actual shoot. Then John Malkovich, standing in the middle of the Colosseum, enters via video call and begins talking about what a trite concept Manning is proposing. Before Malkovich begins his rant, however, one of the executives exclaims in disbelief that John Malkovich is actually at the Roman Colosseum, Peyton Manning states condescendingly, "Of course he's at the Roman Colosseum. Was I stuttering earlier?" Innocent verbal nip? Comedic remark? Witty humor? Viewer comments ranged from, "This might be the m...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EzBjpT

Super Bowl Stuttering Slight Should Not Go Unnoticed

Super Bowl LIII opened with four and a half minutes of Peyton Manning plugging his creative genius—a scene featuring gladiators—to a room of executives who seem doubtful of his brilliant idea. He proceeds to tell them he's already rented the Colosseum for the actual shoot. Then John Malkovich, standing in the middle of the Colosseum, enters via video call and begins talking about what a trite concept Manning is proposing. Before Malkovich begins his rant, however, one of the executives exclaims in disbelief that John Malkovich is actually at the Roman Colosseum, Peyton Manning states condescendingly, "Of course he's at the Roman Colosseum. Was I stuttering earlier?" Innocent verbal nip? Comedic remark? Witty humor? Viewer comments ranged from, "This might be the m...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EzBjpT

Super Bowl Stuttering Slight Should Not Go Unnoticed

Super Bowl LIII opened with four and a half minutes of Peyton Manning plugging his creative genius—a scene featuring gladiators—to a room of executives who seem doubtful of his brilliant idea. He proceeds to tell them he's already rented the Colosseum for the actual shoot. Then John Malkovich, standing in the middle of the Colosseum, enters via video call and begins talking about what a trite concept Manning is proposing. Before Malkovich begins his rant, however, one of the executives exclaims in disbelief that John Malkovich is actually at the Roman Colosseum, Peyton Manning states condescendingly, "Of course he's at the Roman Colosseum. Was I stuttering earlier?" Innocent verbal nip? Comedic remark? Witty humor? Viewer comments ranged from, "This might be the m...

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EzBjpT

Super Bowl Stuttering Slight Should Not Go Unnoticed

Super Bowl LIII opened with four and a half minutes of Peyton Manning plugging his creative genius—a scene featuring gladiators—to a room of executives who seem doubtful of his brilliant idea. He proceeds to tell them he's already rented the Colosseum for the actual shoot. Then John Malkovich, standing in the middle of the Colosseum, enters via video call and begins talking about what a trite concept Manning is proposing. Before Malkovich begins his rant, however, one of the executives exclaims in disbelief that John Malkovich is actually at the Roman Colosseum, Peyton Manning states condescendingly, "Of course he's at the Roman Colosseum. Was I stuttering earlier?" Innocent verbal nip? Comedic remark? Witty humor? Viewer comments ranged from, "This might be the m...

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

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EzBjpT