Radiographic scoring methods in rheumatoid arthritis and psoriatic arthritis

Abstract

Structural changes of bone and cartilage are the hallmarks of rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Radiography can help in making diagnosis and in differentiating PsA and RA from other articular diseases. Radiography is still considered the preferred imaging method to assess disease progression, reflecting cumulative damage over time. The presence of bone erosions in RA is as an indicator of irreversible articular damage. Radiographic features of PsA are characteristic and differ from those observed in RA, especially in the distribution of affected joints and in the presence of destructive changes and bone proliferation at the same time. Semiquantitative scoring methods are designed to measure the degree of radiographically detectable joint damage and of changes over time. Several radiographic scoring methods that had been developed originally for RA have been adopted for the use in PsA. This review discusses the use of conventional radiography for diagnosing and detecting early structural changes in RA and PsA and providing a historical overview of commonly used scoring methods.

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Radiographic scoring methods in rheumatoid arthritis and psoriatic arthritis

Abstract

Structural changes of bone and cartilage are the hallmarks of rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Radiography can help in making diagnosis and in differentiating PsA and RA from other articular diseases. Radiography is still considered the preferred imaging method to assess disease progression, reflecting cumulative damage over time. The presence of bone erosions in RA is as an indicator of irreversible articular damage. Radiographic features of PsA are characteristic and differ from those observed in RA, especially in the distribution of affected joints and in the presence of destructive changes and bone proliferation at the same time. Semiquantitative scoring methods are designed to measure the degree of radiographically detectable joint damage and of changes over time. Several radiographic scoring methods that had been developed originally for RA have been adopted for the use in PsA. This review discusses the use of conventional radiography for diagnosing and detecting early structural changes in RA and PsA and providing a historical overview of commonly used scoring methods.

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

Robotic cochlear implantation: feasibility of a multiport approach in an ex vivo model

Abstract

Purpose

A recent clinical trial has shown the feasibility of robotic cochlear implantation. The electrode was inserted through the robotically drilled tunnel and an additional access through the external auditory canal was created to provide for means of visualization and manipulation. To obviate the need for this additional access, the utilization of multiple robotically drilled tunnels targeting the round window has been proposed. The objective of this study was to assess the feasibility of electrode insertion through a robotic multiport approach.

Methods

In four ex vivo human head specimens (left side), four trajectories through the facial recess (2x) and the retrofacial and suprameatal region were planned and robotically drilled. Optimal three-port configurations were determined for each specimen by analyzing combinations of three of the four trajectories, where the three trajectories were used for the electrode, endoscopic visualization and manipulative assistance. Finally, electrode insertions were conducted through the optimal configurations.

Results

The electrodes could successfully be inserted, and the procedure sufficiently visualized through the facial recess drill tunnels in all specimens. Effective manipulative assistance for sealing the round window could be provided through the retrofacial tunnel.

Conclusions

Electrode insertion through a robotic three-port approach is feasible. Drill tunnels through the facial recess for the electrode and endoscope allow for optimized insertion angles and sufficient visualization. Through a retrofacial tunnel effective manipulation for sealing is possible.

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Robotic cochlear implantation: feasibility of a multiport approach in an ex vivo model

Abstract

Purpose

A recent clinical trial has shown the feasibility of robotic cochlear implantation. The electrode was inserted through the robotically drilled tunnel and an additional access through the external auditory canal was created to provide for means of visualization and manipulation. To obviate the need for this additional access, the utilization of multiple robotically drilled tunnels targeting the round window has been proposed. The objective of this study was to assess the feasibility of electrode insertion through a robotic multiport approach.

Methods

In four ex vivo human head specimens (left side), four trajectories through the facial recess (2x) and the retrofacial and suprameatal region were planned and robotically drilled. Optimal three-port configurations were determined for each specimen by analyzing combinations of three of the four trajectories, where the three trajectories were used for the electrode, endoscopic visualization and manipulative assistance. Finally, electrode insertions were conducted through the optimal configurations.

Results

The electrodes could successfully be inserted, and the procedure sufficiently visualized through the facial recess drill tunnels in all specimens. Effective manipulative assistance for sealing the round window could be provided through the retrofacial tunnel.

Conclusions

Electrode insertion through a robotic three-port approach is feasible. Drill tunnels through the facial recess for the electrode and endoscope allow for optimized insertion angles and sufficient visualization. Through a retrofacial tunnel effective manipulation for sealing is possible.

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Cochlear ablation in neonatal rats disrupts inhibitory transmission in the medial nucleus of the trapezoid body

Publication date: Available online 8 February 2019Source: Neuroscience LettersAuthor(s): Bohdana Hruskova, Johana Trojanova, Michaela Kralikova, Adolf Melichar, Stepanka Suchankova, Jolana Bartosova, Jana Svobodova Burianova, Jiri Popelar, Josef Syka, Rostislav TurecekAbstractInhibitory circuits in the auditory brainstem undergo multiple postnatal changes that are both activity-dependent and activity-independent. We tested to see if the shift from GABA- to glycinergic transmission, which occurs in the rat medial nucleus of the trapezoid body (MNTB) around the onset of hearing, depends on sound-evoked neuronal activity. We prevented the activity by bilateral cochlear ablations in early postnatal rats and studied ionotropic GABA and glycine receptors in MNTB neurons after hearing onset. The ...

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Long-term Conductive Auditory Deprivation During Early Development Causes Irreversible Hearing Impairment and Cochlear Synaptic Disruption

In this study, a mouse model of conductive auditory deprivation (CAD) was achieved using external auditory canal closure on postnatal day 12, which marks the onset of external ear canal opening. Short-term (2 weeks) and long-term (6 weeks) deprivations involving external ear canal closure were conducted. Mice were examined immediately, 4 weeks, and 8 weeks after deprivation. Short-term deprivation induced reversible auditory brainstem response (ABR) threshold and latencies of ABR wave I, whereas long-term deprivation caused irreversible ABR thresholds and latencies of ABR wave I. Complete recovery of ribbon synapses and latencies of ABR wave I were observed in the short-term group. In contrast, we observed irreversible ABR thresholds, latencies of ABR wave I, and quantity of ribbon synapse...

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Cochlear ablation in neonatal rats disrupts inhibitory transmission in the medial nucleus of the trapezoid body

Publication date: Available online 8 February 2019Source: Neuroscience LettersAuthor(s): Bohdana Hruskova, Johana Trojanova, Michaela Kralikova, Adolf Melichar, Stepanka Suchankova, Jolana Bartosova, Jana Svobodova Burianova, Jiri Popelar, Josef Syka, Rostislav TurecekAbstractInhibitory circuits in the auditory brainstem undergo multiple postnatal changes that are both activity-dependent and activity-independent. We tested to see if the shift from GABA- to glycinergic transmission, which occurs in the rat medial nucleus of the trapezoid body (MNTB) around the onset of hearing, depends on sound-evoked neuronal activity. We prevented the activity by bilateral cochlear ablations in early postnatal rats and studied ionotropic GABA and glycine receptors in MNTB neurons after hearing onset. The ...

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

Long-term Conductive Auditory Deprivation During Early Development Causes Irreversible Hearing Impairment and Cochlear Synaptic Disruption

In this study, a mouse model of conductive auditory deprivation (CAD) was achieved using external auditory canal closure on postnatal day 12, which marks the onset of external ear canal opening. Short-term (2 weeks) and long-term (6 weeks) deprivations involving external ear canal closure were conducted. Mice were examined immediately, 4 weeks, and 8 weeks after deprivation. Short-term deprivation induced reversible auditory brainstem response (ABR) threshold and latencies of ABR wave I, whereas long-term deprivation caused irreversible ABR thresholds and latencies of ABR wave I. Complete recovery of ribbon synapses and latencies of ABR wave I were observed in the short-term group. In contrast, we observed irreversible ABR thresholds, latencies of ABR wave I, and quantity of ribbon synapse...

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Validation of the Thai version of the family reported outcome measure (FROM-16)© to assess the impact of disease on the partner or family members of patients with cancer

Cancer not only impairs a patient's physical and psychosocial functional behaviour, but also contributes to negative impact on family members' health related quality of life. Currently, there is an absence of ...

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Can physical activity compensate for low socioeconomic status with regard to poor self-rated health and low quality-of-life?

Both high socioeconomic status (SES) and high physical activity (PA) are associated with better self-rated health (SRH) and higher quality-of-life (QoL).

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

Validation of the Thai version of the family reported outcome measure (FROM-16)© to assess the impact of disease on the partner or family members of patients with cancer

Cancer not only impairs a patient's physical and psychosocial functional behaviour, but also contributes to negative impact on family members' health related quality of life. Currently, there is an absence of ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2E0riRX

Can physical activity compensate for low socioeconomic status with regard to poor self-rated health and low quality-of-life?

Both high socioeconomic status (SES) and high physical activity (PA) are associated with better self-rated health (SRH) and higher quality-of-life (QoL).

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

Traitement des nécroses du tendon d’Achille sans reconstruction tendineuse : à propos de quatre cas

Publication date: Available online 8 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Monnerie, D. Le Nen, W. Hu, H. Letissier, N. Kerfant

Résumé

Introduction

La prise en charge des pertes de substances combinées du tendon d'Achille et de la peau est difficile. Il ne s'agit pourtant pas de situations exceptionnelles après chirurgie du tendon d'Achille. Les données de la littérature sont vastes et il n'existe actuellement pas de consensus quant à la technique de reconstruction du tendon.

Cas cliniques

Nous rapportons quatre cas de nécrose purulente du tendon d'Achille compliquant un peignage ou la suture d'une rupture tendineuse. Après parage de l'ensemble des tissus nécrotiques, la perte de substance a été couverte par un lambeau perforant fascio-cutané ou par une greffe de peau mince sans reconstruction du tendon sous-jacent.

Discussion et conclusion

Les résultats fonctionnels sont très satisfaisants avec de bonnes mobilités articulaires et une reprise de la marche sans boiterie pour tous les patients. La fibrose permet de reconstituer un véritable néotendon confirmé à l'IRM. Les avantages sont nombreux par rapport à d'autres méthodes : un seul temps opératoire est nécessaire, la gestion postopératoire est simple et elle permet d'éviter certaines difficultés techniques liées à la reconstruction tendineuse. Une plus large série serait nécessaire pour conforter ces résultats.

Summary

Introduction

Management of the combined loss of Achilles tendon and skin is difficult. However, these are not exceptional situations after Achilles tendon surgery. Data from the literature are extensive and there is currently no consensus on the technique of tendon reconstruction.

Case reports

We report four cases of purulent necrosis of the Achilles tendon complicating longitudinal incision or suturing of a tendon rupture. After debridement of necrotic tissue, the defect was covered either by a fasciocutaneous perforating flap or a thin skin graft without reconstruction of the underlying tendon.

Discussion and conclusion

The functional results are very satisfactory with good joint mobilities and a resumption of walking without lameness for all patients. Fibrosis can reconstitute a true neo-tendon confirmed on MRI. The advantages are many compared to other methods: a single operating time is necessary, the postoperative management is simple and it avoids certain technical difficulties related to tendon reconstruction. A larger series would be needed to support these results.

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

Traitement des nécroses du tendon d’Achille sans reconstruction tendineuse : à propos de quatre cas

Publication date: Available online 8 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Monnerie, D. Le Nen, W. Hu, H. Letissier, N. Kerfant

Résumé

Introduction

La prise en charge des pertes de substances combinées du tendon d'Achille et de la peau est difficile. Il ne s'agit pourtant pas de situations exceptionnelles après chirurgie du tendon d'Achille. Les données de la littérature sont vastes et il n'existe actuellement pas de consensus quant à la technique de reconstruction du tendon.

Cas cliniques

Nous rapportons quatre cas de nécrose purulente du tendon d'Achille compliquant un peignage ou la suture d'une rupture tendineuse. Après parage de l'ensemble des tissus nécrotiques, la perte de substance a été couverte par un lambeau perforant fascio-cutané ou par une greffe de peau mince sans reconstruction du tendon sous-jacent.

Discussion et conclusion

Les résultats fonctionnels sont très satisfaisants avec de bonnes mobilités articulaires et une reprise de la marche sans boiterie pour tous les patients. La fibrose permet de reconstituer un véritable néotendon confirmé à l'IRM. Les avantages sont nombreux par rapport à d'autres méthodes : un seul temps opératoire est nécessaire, la gestion postopératoire est simple et elle permet d'éviter certaines difficultés techniques liées à la reconstruction tendineuse. Une plus large série serait nécessaire pour conforter ces résultats.

Summary

Introduction

Management of the combined loss of Achilles tendon and skin is difficult. However, these are not exceptional situations after Achilles tendon surgery. Data from the literature are extensive and there is currently no consensus on the technique of tendon reconstruction.

Case reports

We report four cases of purulent necrosis of the Achilles tendon complicating longitudinal incision or suturing of a tendon rupture. After debridement of necrotic tissue, the defect was covered either by a fasciocutaneous perforating flap or a thin skin graft without reconstruction of the underlying tendon.

Discussion and conclusion

The functional results are very satisfactory with good joint mobilities and a resumption of walking without lameness for all patients. Fibrosis can reconstitute a true neo-tendon confirmed on MRI. The advantages are many compared to other methods: a single operating time is necessary, the postoperative management is simple and it avoids certain technical difficulties related to tendon reconstruction. A larger series would be needed to support these results.

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

Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of ...

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Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SA36OJ

Does procalcitonin have a role in the pathogenesis of nasal polyp?

Abstract

Purpose

The aim of this study is to investigate serum and tissue procalcitonin (PCT) levels in patients with nasal polyps.

Methods

The study was designed to be prospectively controlled and included 26 patients chronic rhinosinusitis with nasal polyp (CRSwNP) endoscopically diagnosed and as a control group 25 chronic rhinosinusitis without nasal polyp (CRSsNP). NP specimens, nasal mucosal tissue and venous blood samples of both groups were collected and PCT levels determined by Elisa method. The results were compared statistically.

Results

Serum PCT values were 1319.5 pg/mL in the NP group and 818.8 pg/mL in the control group. The difference between the groups was statistically significant (p = 0.0001). In the NP group, the average PCT value of the polyp tissue was 1521.5 pg/gr, while the mean PCT value of the control group in the nasal mucosa was 414.6 pg/gr. There was a statistically significant difference between the groups (p = 0.0001). The tissue cut-off value of PCT 750 was significant [area under curve 0.940 (0.863–1.00)]. Serum PCT 950 cut-off value was significant [area under curve 0.860 (0.748–0.972)] activity (CI: 95%).

Conclusions

This is the first study of its kind to objectively examine PCT in the polyp and serum of CRSwNP patients. PCT may serve as a diagnostic biomarker in nasal polyps.

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

Does procalcitonin have a role in the pathogenesis of nasal polyp?

Abstract

Purpose

The aim of this study is to investigate serum and tissue procalcitonin (PCT) levels in patients with nasal polyps.

Methods

The study was designed to be prospectively controlled and included 26 patients chronic rhinosinusitis with nasal polyp (CRSwNP) endoscopically diagnosed and as a control group 25 chronic rhinosinusitis without nasal polyp (CRSsNP). NP specimens, nasal mucosal tissue and venous blood samples of both groups were collected and PCT levels determined by Elisa method. The results were compared statistically.

Results

Serum PCT values were 1319.5 pg/mL in the NP group and 818.8 pg/mL in the control group. The difference between the groups was statistically significant (p = 0.0001). In the NP group, the average PCT value of the polyp tissue was 1521.5 pg/gr, while the mean PCT value of the control group in the nasal mucosa was 414.6 pg/gr. There was a statistically significant difference between the groups (p = 0.0001). The tissue cut-off value of PCT 750 was significant [area under curve 0.940 (0.863–1.00)]. Serum PCT 950 cut-off value was significant [area under curve 0.860 (0.748–0.972)] activity (CI: 95%).

Conclusions

This is the first study of its kind to objectively examine PCT in the polyp and serum of CRSwNP patients. PCT may serve as a diagnostic biomarker in nasal polyps.

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Comment on “Nonsurgical Management of Medication-Related Osteonecrosis of the Jaws Using Local Wound Care” by Hadaya et al

Publication date: Available online 8 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Takako Nishida, Yoshinori Fujita, Yoshinari Myoken

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Comment on “Nonsurgical Management of Medication-Related Osteonecrosis of the Jaws Using Local Wound Care” by Hadaya et al

Publication date: Available online 8 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Takako Nishida, Yoshinori Fujita, Yoshinari Myoken

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