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

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

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Experimental Human Infection With Neisseria Gonorrhoeae

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

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Effect of Migalastat on Cardiac Involvement in Fabry Disease

Conditions:   Fabry Disease;   Heart Diseases Intervention:   Diagnostic Test: Cardiological evaluation Sponsors:   Ospedale San Donato;   Amicus Therapeutics;   Institute of Biomedicine and Molecular Immunology - CNR Recruiting (Source: ClinicalTrials.gov)

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Study in Cat-Allergic Patients With Asthma to Evaluate the Efficacy of a Single Dose of REGN1908-1909 to Reduce Bronchoconstriction Upon Cat Allergen Challenge

Conditions:   Cat Allergy;   Mild Asthma Interventions:   Drug: REGN1908-1909;   Drug: Placebo Sponsor:   Regeneron Pharmaceuticals Not yet recruiting (Source: ClinicalTrials.gov)

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

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

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Marrow adiposity as an indicator for insulin resistance in postmenopausal women with newly diagnosed type 2 diabetes – an investigation by chemical shift-encoded water-fat MRI

Publication date: Available online 16 February 2019

Source: European Journal of Radiology

Author(s): Lequn Zhu, Zheng Xu, Guanwu Li, Ying Wang, Xuefeng Li, Xiao Shi, Haiyang Lin, Shixin Chang

Abstract

Background

Marrow fat accumulates in diabetic conditions but remains elusive. The published works on the relationships between marrow fat phenotypes and glucose homeostasis are controversial.

Purpose

To detect the association of insulin resistance with marrow adiposity in postmenopausal women with newly diagnosed type 2 diabetes (T2D) using chemical shift-encoded water–fat MRI.

Methods

We measured vertebral proton density fat fraction (PDFF) by 3T-MRI in 75 newly diagnosed T2D and 20 nondiabetic postmenopausal women. Bone mineral density (BMD), whole body fat mass and lean mass were determined by dual-energy X-ray absorptiometry. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR).

Results

Lumbar spine PDFF was higher in women with T2D (65.9 ± 6.8%) than those without diabetes (59.5 ± 6.1%, P = 0.009). There was a consistent inverse association between the vertebral PDFF and BMD. PDFF had a positive association with glycated hemoglobin and HOMA-IR but not with fasting plasma glucose and insulin. PDFF was significantly increased, and BMD was decreased in a linear trend from the lowest (<1.90) to highest (≥2.77) HOMA-IR quartile. Multivariate linear regression analyses revealed a positive association between log-transformed HOMA-IR and PDFF after adjustment for multiple covariates (ß = 0.382, P < 0.001). The positive association of HOMA-IR with PDFF remained robust when total body lean mass and fat mass, BMD was entered into the multivariate regression model, respectively (ß = 0.293 and ß = 0.251, respectively; all P <0.05).

Conclusions

Elevated HOMA-IR was linked to higher marrow fat fraction in postmenopausal women with newly diagnosed T2D independently of body compositions.

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Marrow adiposity as an indicator for insulin resistance in postmenopausal women with newly diagnosed type 2 diabetes – an investigation by chemical shift-encoded water-fat MRI

Publication date: Available online 16 February 2019

Source: European Journal of Radiology

Author(s): Lequn Zhu, Zheng Xu, Guanwu Li, Ying Wang, Xuefeng Li, Xiao Shi, Haiyang Lin, Shixin Chang

Abstract

Background

Marrow fat accumulates in diabetic conditions but remains elusive. The published works on the relationships between marrow fat phenotypes and glucose homeostasis are controversial.

Purpose

To detect the association of insulin resistance with marrow adiposity in postmenopausal women with newly diagnosed type 2 diabetes (T2D) using chemical shift-encoded water–fat MRI.

Methods

We measured vertebral proton density fat fraction (PDFF) by 3T-MRI in 75 newly diagnosed T2D and 20 nondiabetic postmenopausal women. Bone mineral density (BMD), whole body fat mass and lean mass were determined by dual-energy X-ray absorptiometry. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR).

Results

Lumbar spine PDFF was higher in women with T2D (65.9 ± 6.8%) than those without diabetes (59.5 ± 6.1%, P = 0.009). There was a consistent inverse association between the vertebral PDFF and BMD. PDFF had a positive association with glycated hemoglobin and HOMA-IR but not with fasting plasma glucose and insulin. PDFF was significantly increased, and BMD was decreased in a linear trend from the lowest (<1.90) to highest (≥2.77) HOMA-IR quartile. Multivariate linear regression analyses revealed a positive association between log-transformed HOMA-IR and PDFF after adjustment for multiple covariates (ß = 0.382, P < 0.001). The positive association of HOMA-IR with PDFF remained robust when total body lean mass and fat mass, BMD was entered into the multivariate regression model, respectively (ß = 0.293 and ß = 0.251, respectively; all P <0.05).

Conclusions

Elevated HOMA-IR was linked to higher marrow fat fraction in postmenopausal women with newly diagnosed T2D independently of body compositions.

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Patient-reported outcomes of symptom burden in patients receiving surgical or nonsurgical treatment for low-intermediate risk oropharyngeal squamous cell carcinoma: A comparative analysis of a prospective registry

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Moran Amit, Kate Hutcheson, Jhankruti Zaveri, Jan Lewin, Michael E Kupferman, Amy C Hessel, Ryan P Goepfert, G. Brandon Gunn, Adam S Garden, Renata Ferraratto, C. Dave Fuller, Samantha Tam, Neil D. Gross

Abstract

Purpose

To explore treatment-related changes in symptom burden and quality of life (QOL) in oropharyngeal squamous cell cancer (OPSCC) patients treated surgically and non-surgically.

Patients and Methods

Eighty-six patients with human papillomavirus–associated OPSCC treated at the Head and Neck Center at The University of Texas MD Anderson Cancer Center were recruited to a prospective registry study between 2014 and 2016 and completed the core, head and neck-specific, and symptom interference sections of the MD Anderson symptom inventory (MDASI) multi-symptom questionnaire and the EQ-5D health status assessment as a measure of QOL at four time points.

Results

Longitudinal improvements from post-treatment nadir were observed across all groups. For patients treated with single modality, symptom interference, but not core and head and neck specific, MDASI scores were significantly better at 6 months in patients treated with surgery than radiation (P = 0.04). For patients treated with multiple modalities, scores for each of the three domains (i.e., core, head and neck -specific, and interference MDASI) were significantly better in the surgical group than the nonsurgical group at treatment completion (P = 0.0003, P = 0.0006 and P = 0.02) and 6 weeks (P = 0.001, P = 0.05 and P = 0.04), but not 6 months (P = 0.11, P = 0.16 and P = 0.040). No significant differences in EQ5D health status were observed between groups at any time point, reflecting similar overall QOL in all groups.

Conclusion

Symptom burden and QOL improves after treatment in OPSCC survivors over time regardless of whether primary surgical or nonsurgical treatment is used, although acute symptom profiles may differ.

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Patterns of EBV-positive cervical lymph node involvement in head and neck cancer and implications for the management of nasopharyngeal carcinoma T0 classification

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Wei-Jie Luo, Yan-Fen Feng, Rui Guo, Ling-Long Tang, Lei Chen, Guan-Qun Zhou, Wen-Fei Li, Xu Liu, Ying Sun, Ai-Hua Lin, Jun Ma, Yan-Ping Mao

Abstract

Objectives

Epstein-Barr virus (EBV)-positive cervical lymph node (CLN) metastasis of unknown primary origin is classified as nasopharyngeal carcinoma (NPC) T0 by the American Joint Committee on Cancer staging manual (8th edition). We aimed to investigate the possible primary sites and patterns of EBV-positive CLN metastases and to provide implications for the management of NPC T0 classification.

Materials and methods

We retrospectively reviewed 269 patients with newly diagnosed EBV-positive CLN metastatic disease who underwent EBV detection via EBV-encoded RNA in situ hybridization. Fifteen patients with unknown primary tumors underwent follow-up after initial treatment.

Results

In patients with EBV-positive CLNs, the most common primary sites after the nasopharynx (51.7%) were the salivary gland (24.5%), lung (7.8%), oropharynx (3.3%), nasal cavity/maxillary (3.3%), oral cavity (2.2%), orbit (1.1%), and liver (0.4%). No primary site was found in 15 patients (5.6%). For salivary gland malignancies, level II and I were the most frequently involved regions. Tumors arising from the lung or liver metastasized to the lower neck (level IV, V, and VI) rather than the upper neck. After initial treatment, 2/15 patients with EBV-positive CLNs of unknown primary exhibited primary NPC and oropharyngeal tumor, respectively. Further, even without prophylactic irradiation to the nasopharynx, only one of 13 unknown primary patients developed NPC.

Conclusions

The origins of EBV-positive CLNs may not be restricted to the nasopharynx alone, and are likely to involve the head and neck or non-head and neck regions. NPC T0 classification should be cautiously assigned to such tumors.

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Patient-reported outcomes of symptom burden in patients receiving surgical or nonsurgical treatment for low-intermediate risk oropharyngeal squamous cell carcinoma: A comparative analysis of a prospective registry

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Moran Amit, Kate Hutcheson, Jhankruti Zaveri, Jan Lewin, Michael E Kupferman, Amy C Hessel, Ryan P Goepfert, G. Brandon Gunn, Adam S Garden, Renata Ferraratto, C. Dave Fuller, Samantha Tam, Neil D. Gross

Abstract

Purpose

To explore treatment-related changes in symptom burden and quality of life (QOL) in oropharyngeal squamous cell cancer (OPSCC) patients treated surgically and non-surgically.

Patients and Methods

Eighty-six patients with human papillomavirus–associated OPSCC treated at the Head and Neck Center at The University of Texas MD Anderson Cancer Center were recruited to a prospective registry study between 2014 and 2016 and completed the core, head and neck-specific, and symptom interference sections of the MD Anderson symptom inventory (MDASI) multi-symptom questionnaire and the EQ-5D health status assessment as a measure of QOL at four time points.

Results

Longitudinal improvements from post-treatment nadir were observed across all groups. For patients treated with single modality, symptom interference, but not core and head and neck specific, MDASI scores were significantly better at 6 months in patients treated with surgery than radiation (P = 0.04). For patients treated with multiple modalities, scores for each of the three domains (i.e., core, head and neck -specific, and interference MDASI) were significantly better in the surgical group than the nonsurgical group at treatment completion (P = 0.0003, P = 0.0006 and P = 0.02) and 6 weeks (P = 0.001, P = 0.05 and P = 0.04), but not 6 months (P = 0.11, P = 0.16 and P = 0.040). No significant differences in EQ5D health status were observed between groups at any time point, reflecting similar overall QOL in all groups.

Conclusion

Symptom burden and QOL improves after treatment in OPSCC survivors over time regardless of whether primary surgical or nonsurgical treatment is used, although acute symptom profiles may differ.

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Patterns of EBV-positive cervical lymph node involvement in head and neck cancer and implications for the management of nasopharyngeal carcinoma T0 classification

Publication date: April 2019

Source: Oral Oncology, Volume 91

Author(s): Wei-Jie Luo, Yan-Fen Feng, Rui Guo, Ling-Long Tang, Lei Chen, Guan-Qun Zhou, Wen-Fei Li, Xu Liu, Ying Sun, Ai-Hua Lin, Jun Ma, Yan-Ping Mao

Abstract

Objectives

Epstein-Barr virus (EBV)-positive cervical lymph node (CLN) metastasis of unknown primary origin is classified as nasopharyngeal carcinoma (NPC) T0 by the American Joint Committee on Cancer staging manual (8th edition). We aimed to investigate the possible primary sites and patterns of EBV-positive CLN metastases and to provide implications for the management of NPC T0 classification.

Materials and methods

We retrospectively reviewed 269 patients with newly diagnosed EBV-positive CLN metastatic disease who underwent EBV detection via EBV-encoded RNA in situ hybridization. Fifteen patients with unknown primary tumors underwent follow-up after initial treatment.

Results

In patients with EBV-positive CLNs, the most common primary sites after the nasopharynx (51.7%) were the salivary gland (24.5%), lung (7.8%), oropharynx (3.3%), nasal cavity/maxillary (3.3%), oral cavity (2.2%), orbit (1.1%), and liver (0.4%). No primary site was found in 15 patients (5.6%). For salivary gland malignancies, level II and I were the most frequently involved regions. Tumors arising from the lung or liver metastasized to the lower neck (level IV, V, and VI) rather than the upper neck. After initial treatment, 2/15 patients with EBV-positive CLNs of unknown primary exhibited primary NPC and oropharyngeal tumor, respectively. Further, even without prophylactic irradiation to the nasopharynx, only one of 13 unknown primary patients developed NPC.

Conclusions

The origins of EBV-positive CLNs may not be restricted to the nasopharynx alone, and are likely to involve the head and neck or non-head and neck regions. NPC T0 classification should be cautiously assigned to such tumors.

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Angioedema following initiation of Glecaprevir/ Pibrentasvir while on Sitagliptin

Publication date: Available online 16 February 2019

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

Author(s): Amanda Schneider, Manish Ramesh

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The efficacy of cotton ball packing after endoscopic sinus surgery: A prospective, randomized, controlled trial

Publication date: Available online 17 February 2019

Source: Auris Nasus Larynx

Author(s): Seon-Lin Kim, Sung-Dong Kim, Han-Seul Na, Jae-Wook Kim, Keun-Ik Yi, Sue-Jean Mun, Kyu-Sup Cho

Abstract

Objective

The blocking of airflow into sinonasal cavity may decrease postoperative crusting and the development of adhesions. The purpose of this study was to investigate the efficacy of cotton ball packing in patients following endoscopic sinus surgery (ESS).

Methods

Thirty nine patients with chronic rhinosinusitis requiring the same extent of ESS were included. As a part of postoperative care, the patients were instructed to perform a nasal saline irrigation and apply a nasal spray in each nostril, and then informed to put a cotton ball in a one side of nostril, and the other side was kept to be empty as a control. Patients' subjective symptoms, patients' pain while receiving sinonasal cavity debridement, time required to perform debridement, and postoperative wound healing were evaluated.

Results

Although cotton ball packing resulted in less discomfort for postnasal drip, rhinorrhea, headache, and facial pain than no packing, there were no statistically significant differences between the groups. The cotton ball packing was associated with significantly less pain on while performing postoperative debridement, therefore less time was needed to perform debridement. The cotton ball packing appears to improve wound healing within the sinus cavities up to 1 month postoperatively.

Conclusion

The use of the cotton ball packing after ESS results in significantly less formation of crusts and adhesions, leading to decreasing pain and time during postoperative debridement and promoting faster wound healing.

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Angioedema following initiation of Glecaprevir/ Pibrentasvir while on Sitagliptin

Publication date: Available online 16 February 2019

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

Author(s): Amanda Schneider, Manish Ramesh

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The efficacy of cotton ball packing after endoscopic sinus surgery: A prospective, randomized, controlled trial

Publication date: Available online 17 February 2019

Source: Auris Nasus Larynx

Author(s): Seon-Lin Kim, Sung-Dong Kim, Han-Seul Na, Jae-Wook Kim, Keun-Ik Yi, Sue-Jean Mun, Kyu-Sup Cho

Abstract

Objective

The blocking of airflow into sinonasal cavity may decrease postoperative crusting and the development of adhesions. The purpose of this study was to investigate the efficacy of cotton ball packing in patients following endoscopic sinus surgery (ESS).

Methods

Thirty nine patients with chronic rhinosinusitis requiring the same extent of ESS were included. As a part of postoperative care, the patients were instructed to perform a nasal saline irrigation and apply a nasal spray in each nostril, and then informed to put a cotton ball in a one side of nostril, and the other side was kept to be empty as a control. Patients' subjective symptoms, patients' pain while receiving sinonasal cavity debridement, time required to perform debridement, and postoperative wound healing were evaluated.

Results

Although cotton ball packing resulted in less discomfort for postnasal drip, rhinorrhea, headache, and facial pain than no packing, there were no statistically significant differences between the groups. The cotton ball packing was associated with significantly less pain on while performing postoperative debridement, therefore less time was needed to perform debridement. The cotton ball packing appears to improve wound healing within the sinus cavities up to 1 month postoperatively.

Conclusion

The use of the cotton ball packing after ESS results in significantly less formation of crusts and adhesions, leading to decreasing pain and time during postoperative debridement and promoting faster wound healing.

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Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?

Publication date: Available online 16 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Cory M. Resnick, Carly E. Calabrese, Salim Afshar, Bonnie L. Padwa

ABSTRACT

Purpose

Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.

Methods

This is a prospective cohort study of consecutive patients that had asymptomatic third molars extracted with intravenous sedation at Boston Children's Hospital from June-October 2018 by 3 attending surgeons. To be included, patients had to have had four third molars removed. Patients were excluded if they had a concomitant procedure, preoperative infection, postoperative inflammatory complication, chronic pain condition, or did not complete the study. Postoperative prescriptions and instructions included: (1) oxycodone 5mg tablets, take 1 every 6 hours as needed, dispense #6; (2) ibuprofen 600mg tablets, take 1 every 6 hours as needed, dispense #20; (3) acetaminophen 325mg tablets, take 2 every 6 hours as needed, dispense #40. Subjects reported medication use via electronic questionnaire each day for 7 postoperative days. Descriptive statistics were calculated.

Results

81 subjects (56% female, mean age 19.4±7.7 years) were included. The average number of oxycodone tablets used was 0.04±0.24, and the highest daily use of oxycodone was on postoperative day (POD) 2 (1.0±0.0 tablets). Oxycodone was taken by 3 subjects (4%) on POD 1, 4 (5%) on POD 2, 2 (3%) on PODs 3 and 4, and 0 on PODs 5-7. Seventy-five subjects (93%) used no postoperative oxycodone; 466 prescribed oxycodone tablets remained unfilled or unused. ibuprofen 600mg was used for 4.6±2.2 PODs and acetaminophen 650mg was used for 3.4±1.9 days.

Conclusion

Oral opioid use following third molar extractions is minimal. Caution is necessary to avoid over-prescribing.

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Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?

Publication date: Available online 16 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Cory M. Resnick, Carly E. Calabrese, Salim Afshar, Bonnie L. Padwa

ABSTRACT

Purpose

Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.

Methods

This is a prospective cohort study of consecutive patients that had asymptomatic third molars extracted with intravenous sedation at Boston Children's Hospital from June-October 2018 by 3 attending surgeons. To be included, patients had to have had four third molars removed. Patients were excluded if they had a concomitant procedure, preoperative infection, postoperative inflammatory complication, chronic pain condition, or did not complete the study. Postoperative prescriptions and instructions included: (1) oxycodone 5mg tablets, take 1 every 6 hours as needed, dispense #6; (2) ibuprofen 600mg tablets, take 1 every 6 hours as needed, dispense #20; (3) acetaminophen 325mg tablets, take 2 every 6 hours as needed, dispense #40. Subjects reported medication use via electronic questionnaire each day for 7 postoperative days. Descriptive statistics were calculated.

Results

81 subjects (56% female, mean age 19.4±7.7 years) were included. The average number of oxycodone tablets used was 0.04±0.24, and the highest daily use of oxycodone was on postoperative day (POD) 2 (1.0±0.0 tablets). Oxycodone was taken by 3 subjects (4%) on POD 1, 4 (5%) on POD 2, 2 (3%) on PODs 3 and 4, and 0 on PODs 5-7. Seventy-five subjects (93%) used no postoperative oxycodone; 466 prescribed oxycodone tablets remained unfilled or unused. ibuprofen 600mg was used for 4.6±2.2 PODs and acetaminophen 650mg was used for 3.4±1.9 days.

Conclusion

Oral opioid use following third molar extractions is minimal. Caution is necessary to avoid over-prescribing.

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Lambeau de SIEA en reconstruction mammaire : quelle place par rapport au DIEP ?

Publication date: Available online 16 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): J. Quilichini, M. Hivelin, P. Le Masurier, T. Guihard, L. Lantieri

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Lambeau de SIEA en reconstruction mammaire : quelle place par rapport au DIEP ?

Publication date: Available online 16 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): J. Quilichini, M. Hivelin, P. Le Masurier, T. Guihard, L. Lantieri

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Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case

Temporomandibular joint (TMJ) ankylosis is the abnormal fusion of TMJ anatomical components that impedes free jaw movements. This restriction in motion ranges from minimal to complete inability to open the jaw. 1 This condition can be categorized into true or false categories in which true ankylosis is attributed to pathological conditions of the TMJ, whereas false ankylosis (Pseudoankylosis) is applied to restrictions of movement resulting from extracapsular abnormalities outside the TMJ. 2-3 Literature reveals that trauma is the first leading cause of temporomandibular joint disorder (TMD).

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