Christina El Moussa from 'Flip or Flop' fame got her start studying design in college, along with a business degree that helped in her later house-flipping ...
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Τετάρτη 12 Δεκεμβρίου 2018
Did Christina El Moussa Have a Formal Design Education? What She Studied in College - The Cheat Sheet
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Eating Healthy Now, The New Year & Beyond - The Washington Informer
When you gear up and approach the start line, know that there will be hurdles but don't give up.
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Alternaria‐induced barrier dysfunction of nasal epithelial cells: role of serine protease and reactive oxygen species
Background
Upper airway barrier dysfunction has been associated with chronic rhinosinusitis and allergic rhinitis. Alternaria is commonly found in nasal secretion and plays a role in the pathogenesis of airway diseases. The aim of this study was to investigate the effects of Alternaria on the junctional complex of nasal epithelial cells.
Methods
Air‐liquid interface nasal epithelial cultures from the inferior turbinate of septal surgery patients were stimulated with Alternaria alternate. Production of intracellular reactive oxygen species (ROS) and transepithelial resistance (TER) was measured. The expression of tight junction (TJ) and adherens junction (AJ) molecules was determined using real‐time reverse transcriptase‐polymerase chain reaction, Western blot analysis, and confocal microscopy. Protease activity in Alternaria was determined using protease inhibitors and heat inactivation.
Results
Alternaria enhanced the production of ROS and reduced the TER. Alternaria decreased the messenger RNA and protein expression of TJs (zonula occludens‐1, occludin, and claudin‐1), but did not influence the AJ molecule. When Alternaria was pretreated with serine protease inhibitor and heat inactivation, ROS, TER, and TJ molecule expression returned to their nonstimulated levels.
Conclusion
Serine protease in Alternaria altered nasal epithelial barrier function. Intracellular ROS induced by Alternaria may influence the barrier function of nasal epithelial cells and enhance the inflammatory process of nasal mucosa.
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Gastroesophageal reflux disease increases the risk of chronic rhinosinusitis: a nested case‐control study using a national sample cohort
Background
The purpose of this study was to evaluate the relations between gastroesophageal reflux disease (GERD) and chronic rhinosinusitus (CRS) in a Korean population.
Methods
Subjects from the Korean National Health Insurance Service‒National Sample Cohort, all ≥20 years old, were assessed from 2002 to 2013. In total, 23,489 CRS participants were matched with 93,956 controls at a ratio of 1:4 with respect to age, group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed previous history of GERD in the CRS and control groups. The CRS group included patients identified using International Classification of Diseases 10th edition (ICD‐10) codes (J32) who had treated their CRS ≥2 times and had undergone head and neck computed tomography (CT). The GERD group included patients identified using the ICD‐10 (K21) code who had treated their GERD ≥2 times and had taken a proton pump inhibitor (PPI) for ≥2 weeks. Crude and adjusted odds ratios (ORs) were analyzed using unconditional logistic regression analyses. The 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to age and sex.
Results
The rate of GERD was higher in the CRS group (17.1% [4020 of 23,489]) than in the control group (9.1% [8522 of 93,956]; p < 0.001). The adjusted OR of GERD was 2.04 (95% CI, 1.96‐2.13; p < 0.001) in the CRS group. The results of the subgroup analyses were consistent.
Conclusion
The ORs of GERD were increased in CRS participants. This relationship was consistent in all age and sex groups.
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Wait times for endoscopic sinus surgery influence patient‐reported outcome measures in patients with chronic rhinosinusitis who fulfill appropriateness criteria
Background
Previous studies on the impact of wait times for endoscopic sinus surgery (ESS) in medically recalcitrant chronic rhinosinusitis (rCRS) have not examined its influence on the 5 distinct symptoms domains of the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), and have not applied evidence‐based surgical indications. Our primary study objective was to investigate the impact of ESS wait times on postoperative SNOT‐22 global and symptom domain scores in patients with rCRS deemed "appropriate" surgical candidates.
Methods
This was a retrospective analysis of adult patients with rCRS undergoing ESS, categorized as "appropriate" surgical candidates. Primary outcome measure was change in SNOT‐22 global/symptom domain score (preoperative – 6‐month postoperative). Correlational analyses were performed between wait time and change in SNOT‐22 global and symptom domain scores. For significant negative correlations, the threshold wait time to generate a worsening in health‐related quality‐of‐life (HRQoL) equivalent to the mean clinically important difference (MCID) was calculated.
Results
A total of 104 patients with a mean ± standard deviation (SD) wait time of 310.8 ± 155.9 days were analyzed. Postoperative SNOT‐22 global and symptom domain scores significantly improved postoperatively. Wait time for ESS was negatively correlated with change in SNOT‐22 global, rhinologic, extranasal rhinologic, and ear/facial domain scores (p < 0.05), and a wait time threshold of 287, 452, 421, and 381 days corresponded to a decrease equivalent to the MCID, respectively.
Conclusion
We identified less improvement in HRQoL after ESS with increasing surgical wait time. Moreover, prolonged wait times may result in less improvement in disease‐specific symptoms, but do not appear to worsen psychological or sleep dysfunction.
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Socioeconomic factors impact quality of life outcomes and olfactory measures in chronic rhinosinusitis
Background
Healthcare disparities related to socioeconomic factors may adversely impact disease states and treatment outcomes. Among patients with chronic rhinosinusitis (CRS), the impact of socioeconomic factors on outcomes following endoscopic sinus surgery (ESS) remains uncertain.
Methods
Adult patients with refractory CRS were prospectively enrolled into an observational, multi‐institutional cohort study between March 2011 and June 2015. Socioeconomic factors analyzed included household income, insurance status, years of education completed, race, age, and ethnicity. Income was stratified according to the Thompson and Hickey model. The 22‐item Sino‐Nasal Outcome Test (SNOT‐22) and Brief Smell Identification Test (BSIT) were completed preoperatively and postoperatively.
Results
A total of 392 patients met inclusion criteria. Higher age and male gender were associated with better mean preoperative SNOT‐22 scores (both p < 0.02), whereas Medicare insurance status and male gender were associated with worse preoperative mean BSIT scores (both p < 0.02). Postoperatively, higher household income ($100,001+/year) and lower age were associated with a greater likelihood of improving at least 1 minimal clinically important difference (MCID) on SNOT‐22 scores (OR = 2.40 and 1.03, respectively, both p < 0.05), while no factors were associated with increased odds of achieving a MCID on BSIT scores.
Conclusions
Preoperative olfactory function and postoperative quality of life (QOL) improvement were associated with metrics of socioeconomic status in patients with CRS electing ESS. The odds of experiencing a clinically meaningful QOL improvement were more than twice as likely for patients with the highest household income level compared to other income tiers. Further investigation is warranted to identify barriers to postoperative improvement.
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Effect of the Nasal Gel " Nascum ®-Plus " on Allergic Symptoms
Condition: Rhinitis, Allergic, Seasonal Interventions: Drug: Nascum Plus; Other: ACC Sponsors: Fraunhofer-Institute of Toxicology and Experimental Medicine; M et P Pharma AG Enrolling by invitation (Source: ClinicalTrials.gov)
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MAPS & ITEC Cohorts: 6-8 Years Follow-up
Conditions: Immunotherapy; Allergy and Immunology; Asthma Interventions: Drug: House dust-mite SLIT; Drug: Normal saline Sponsors: University of Southampton; Isle of Wight NHS Trust Recruiting (Source: ClinicalTrials.gov)
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DOT Diary Longitudinal Pilot
Conditions: Adherence, Medication; Risk Behavior; Pre-Exposure Prophylaxis; HIV Prevention Interventions: Drug: Emtricitabine / Tenofovir Disoproxil Oral Tablet; Other: DOT Diary mobile app Sponsors: Public Health Foundation Enterprises, Inc.; National Institute of Mental Health (NIMH); San Francisco Department of Public Health; Emory University; AiCure; National Institute of Allergy and Infectious Diseases (NIAID) Not yet recruiting (Source: ClinicalTrials.gov)
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Local immune parameters as potential predictive markers in head and neck squamous cell carcinoma patients receiving induction chemotherapy and cetuximab
Abstract
Background
The aim of this study was to determine whether tumor‐associated immune cells may predict response to therapy and disease outcome in head and neck squamous cell carcinoma (HNSCC) patients receiving induction chemotherapy and cetuximab.
Methods
Paraffin‐embedded pretreatment biopsy samples from 45 patients with stage III‐IV resectable HNSCC were investigated retrospectively by immunohistochemistry for density of different immune cell types based on expression of CD8, FOXP3, CD134, CD137, PD‐1, CD20, NKp46, dendritic cell lysosomal‐associated membrane protein (DC‐LAMP), CD16, CD68, and myeloperoxidase. Results were analyzed for possible correlations with clinicopathologic parameters, response to therapy, and survival.
Results
Of the immune cell types studied, we found significant association with response to induction chemotherapy only in the case of DC‐LAMP+ mature dendritic cells and PD‐1+ lymphocytes; density of DC‐LAMP+ cells also correlated with progression‐free survival.
Conclusion
DC‐LAMP+ mature dendritic cells and PD‐1+ cells may be implicated in response to induction chemotherapy and cetuximab in HNSCC patients.
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Pilot Study of Short Term Aspirin on the Biologic and Immunologic Changes of the Fallopian Tube
Conditions: Fallopian Tube Cancer; Fallopian Tube Infection Intervention: Drug: Aspirin 81 mg Sponsor: University of Oklahoma Not yet recruiting (Source: ClinicalTrials.gov)
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Cetirizine Chewable Bioequivalence and Food Effect Study
Condition: Allergy Interventions: Drug: Cetirizine 10mg; Drug: Cetirizine 10 mg; Drug: Ceterizine 10 mg Sponsor: Johnson& Johnson Consumer Inc., McNeil Consumer Healthcare Division Not yet recruiting (Source: ClinicalTrials.gov)
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Pathway based prognostic gene expression profile of buccal and gingivo‐buccal oral squamous cell carcinoma in smokeless tobacco chewers
Abstract
Background
The objective was to study comprehensive mRNA expression profiles of buccal mucosa oral squamous cell carcinoma (OSCC‐BM) and gingivo‐buccal OSCC (OSCC‐GB) in smokeless tobacco chewers to understand the biological behavior of OSCC at these specific sites and identify diagnostic and prognostic markers.
Methods
High throughput RNA sequencing transcriptome of fresh buccal mucosa (4 samples) and gingivo‐buccal (4 samples) OSCC with normal oral mucosa (3 samples) was performed on Illumina NextSeq500 paired end sequencing with 75x2bp.
Results
In the comparison between OSCC and normal, there were 402 differentially expressed genes (DEGs); between OSCC‐BM and normal, there were 467 DEGs; and between OSCC‐GB and normal oral tissue, there were 608 DEGs. Pathway‐based analysis of gene expression was done. The inflammation mediated by chemokine and cytokine signaling pathway had the maximum gene hits.
Conclusions
FZD2 and its interactions with the cadherins have a role in invasion and metastasis. immunosurveillance is evident in OSCC‐GB with the downregulation of CADM1.
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High‐dose versus standard‐dose radiation therapy for cervical esophageal cancer: A retrospective single‐institution study
Abstract
Background
To evaluate the role of definitive radiotherapy using higher‐than‐standard‐dose radiation of 50 Gy for carcinoma of the cervical esophagus (CCE).
Methods
We reviewed 79 patients with stage I‐III CCE, treated between 2000 and 2012. Patients received 5‐fluorouracil/cisplatin‐based chemotherapy concurrently and were divided into high‐dose (≥59.4 Gy, n = 44) and standard‐dose (<59.4 Gy, n = 35) groups.
Results
The median follow‐up was 35 months for surviving patients. The high‐dose group had significantly better 3‐year local (90.0% vs 60.4%, P = .001) and locoregional (70.4% vs 45.3%, P = .04) control. Progression‐free (45.4% vs 37.5%, P = .32) and overall (58.4% vs 49.1%, P = .69) survival rates were not different. High‐dose radiation was an independent prognostic factor for locoregional control (P = .04). No differences in late toxicities (esophageal stenosis or tracheoesophageal fistula) were observed.
Conclusion
High‐dose radiation for CCE improves local and locoregional control, without increasing severe toxicities.
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A systematic review of validated tools assessing functional and aesthetic outcomes following fibula free flap reconstruction of the mandible
Abstract
Background
Segmental mandibulectomy impairs health‐related quality of life (QoL), by altering speech, mastication, swallowing, and facial aesthetics. Fibula free flap (FFF) used for mandible reconstruction is known to improve outcomes; however, minimal information exists in the literature regarding patient‐reported outcomes. We aim to assess how current studies evaluate patient perception following segmental mandibulectomy and FFF mandible reconstruction.
Methods
Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, a search was conducted for publications involving FFF mandible reconstruction from 2005 to 2017 using PubMed, Cochrane, EMBASE, Web of Science, and PsychInfo.
Results
Of 2212 articles identified initially, only 7 studies were deemed suitable. Six studies used the University of Washington Quality of Life questionnaire, 3 Oral Health Impact Profile, and 1 used European Organization for Research and Treatment of Cancer Head and Neck (EORTC‐H&N35).
Conclusions
There is a paucity of information in published reports on QoL outcomes following mandible reconstruction with FFF. In the era of patient‐centered health care, observations warrant attention from researchers for physician‐assessed patient‐reported measures to factor in QoL expectation during surgical decision‐making about the choice of reconstruction.
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The Pharmacokinetics, Safety, and Tolerability of Abacavir/Dolutegravir/Lamivudine Dispersible and Immediate Release Tablets in HIV-1-Infected Children Less Than 12 Years of Age
Condition: HIV Infections Interventions: Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Dispersible Tablets; Drug: Abacavir (ABC)/Dolutegravir (DTG)/Lamivudine (3TC) Immediate Release Tablets (Immediate release) Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); International Maternal Pediatric Adolescent AIDS Clinical Trials Network; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institute of Mental Health (NIMH); ViiV Hea lthcare Ltd. Not yet recruiting (Source: ClinicalTrials.gov)
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Prospective cross‐sectional study assessing prevalence and factors affecting trismus after multimodal treatment for oral cancers
Abstract
Background
Trismus is a common complication following treatment for oral cancers. However, its incidence in site‐specific cancers is not adequately studied. The purpose of this study was to assess the prevalence and risk factors associated with trismus in treated patients with oral cancer.
Methods
The maximal mouth opening in treated oral cancers was measured. Logistic regression analysis was performed to find risk factors for developing trismus in the entire cohort and in a subgroup of patients with gingivobuccal complex cancers.
Results
A total of 401 patients were enrolled. The prevalence of trismus was 72.8%. On multivariate analysis, adjuvant therapy and submucous fibrosis were independent predictors. Reconstruction and method of reconstruction did not affect trismus. Bialveolar resections had significantly higher incidence of trismus.
Discussion
High prevalence of trismus was seen in patients following multimodal therapy for oral cancers. Adequate reconstruction alone may not prevent trismus and aggressive rehabilitation is key to its prevention.
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Effect of serpinE1 overexpression on the primary tumor and lymph node, and lung metastases in head and neck squamous cell carcinoma
Abstract
Background
Serpin Family E Member 1 (SerpinE1) overexpression associates with poor clinical outcome in head and neck squamous cell carcinoma (HNSCC) patients. This study analyzed the role of serpinE1 in HNSCC dissemination.
Methods
We studied the phenotypic characteristics and dissemination of HNSCC cells overexpressing serpinE1 using an orthotopic model and the association between serpinE1 overexpression and clinicopathological variables in patients included in The Cancer Genome Atlas database.
Results
SerpinE1 overexpression increased proliferation, tumor budding, and the stromal component, while inhibiting apoptosis in primary tumors. It also enhanced the affectation and metastatic growth in lymph nodes, and the dispersion and growth of metastatic foci in the lung. High serpinE1 expression was associated with larger tumor size, undifferentiated tumors, lymph node metastasis, extracapsular spread, and the presence of perineural and angiolymphatic invasion.
Conclusion
SerpinE1 overexpression promotes tumor aggressiveness and metastatic dissemination to lymph nodes and lung consistently with its association with poor outcome in HNSCC patients.
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Evaluation of the theranostic properties of gadolinium‐based nanoparticles for head and neck cancer
Abstract
Background
The aim of the study was to evaluate the benefits of the combination of Gadolinium‐based nanoparticles AGuIX and radiotherapy on the recurrence free survival after tumor resection in a head and neck animal orthotopic model.
Methods
Human head and neck CAL33 orthotopic tumors were implanted in female NMRI nude mice. The biodistribution of AGuIX was studied by fluorescence imaging. Tumor resection was performed 19 days after tumor implantation. Radiotherapy was performed 23 days after resection (10 Gy), 1 hour after AGuIX IV injection.
Results
After systemic administration, AGuIX passively accumulated in the orthotopic tumors. After tumor surgery, the combination of AGuIX with radiotherapy significantly improved the recurrence free survival and the median survival time (196 days) compared to irradiated only mice (75 days).
Conclusion
This study demonstrated the improvement of the recurrence free survival following combination of AGuIX injection with radiotherapy after Head and neck tumor resection.
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Development of Metabolic Syndrome in Children and Adolescents With Leukemia and Lymphomas
Condition: Metabolic Syndrome Intervention: Sponsor: Federal Research Institute of Pediatric Hematology, Oncology and Immunology Recruiting (Source: ClinicalTrials.gov)
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