OtoRhinoLaryngology by Alexandros G.Sfakianakis: Αυγούστου 2016

Τετάρτη 31 Αυγούστου 2016

IL-17A plays a central role in the expression of psoriasis signature genes through the induction of I{kappa}B-{zeta} in keratinocytes

In psoriasis lesions, a diverse mixture of cytokines is up-regulated that influence each other generating a complex inflammatory situation. Although this is the case, the inhibition of IL-17A alone showed unprecedented clinical results in patients, indicating that IL-17A is a critical inducer of psoriasis pathogenesis. To elucidate IL-17A-driven keratinocyte-intrinsic signaling pathways, we treated monolayers of normal human epidermal keratinocytes in vitro with a mixture of six cytokines (IL-17A, TNF-α, IL-17C, IL-22, IL-36 and IFN-) involved in psoriasis to mimic the inflammatory milieu in psoriasis lesions. Microarray and gene set enrichment analysis revealed that this cytokine mixture induced similar gene expression changes with the previous transcriptome studies using psoriasis lesions. Importantly, we identified a set of IL-17A-regulated genes in keratinocytes, which recapitulate typical psoriasis genes exemplified by DEFB4A, S100A7, IL19 and CSF3, based on the differences in the expression profiles of cells stimulated with six cytokines versus cells stimulated with only five cytokines lacking IL-17A. Furthermore, a specific IL-17A-induced gene, NFKBIZ, which encodes IB-, a transcriptional regulator for NF-B, was demonstrated to have a significant role for IL-17A-induced gene expression. Thus, we present novel in vitro data from normal human keratinocytes that would help elucidating the IL-17A-driven keratinocyte activation in psoriasis.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bSEgWa
via IFTTT

Mammary-tumor-educated B cells acquire LAP/TGF-{beta} and PD-L1 expression and suppress anti-tumor immune responses

B lymphocytes play a role in inhibiting the immune response against certain tumors, but the underlying mechanisms are poorly understood. EMT-6 mammary tumors grow well in wild-type (WT) mice but show reduced growth in B-cell-deficient μ^–/– BALB/c mice (BCDM). WT mice demonstrate extensive B-cell infiltration into the tumor bed, reduced CD8⁺ T cell and CD49⁺ NK cell infiltration, and markedly reduced cytolytic T-cell response relative to BCDM. Expression of LAP/TGF-β1, CD80, CD86 and PD-L1 is significantly increased in tumor-infiltrating B cells (TIL-B) relative to splenic B cells. LAP/TGF-β1 expression on TIL-B progressively increased from 5.4±1.7% on day 8 to 43.1±6.1% by day 21 post tumor implantation. Co-culture of EMT-6 tumor cells with Naive-B cells ex vivo generated B cells (EMT6-B) with a similar immunophenotype to TIL-B. Purified TIL-B, or in-vitro-generated EMT6-B suppressed CD4⁺, CD8⁺ and CD4⁺CD25^– T-cell proliferation, and Th1 cytokine secretion, and also suppressed purified NK-cell proliferation in response to IL-15, compared to naive splenic B cells. Acquired B regulatory function required direct tumor cell: B-cell contact, and was partially reversed by antibody to TGF-β or PD-L1, leading to tumor rejection in vivo. B-cell acquisition of a suppressive phenotype following tumor infiltration may result in profound inhibition of T-cell anti-tumor responses.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bKbp2N
via IFTTT

Lung inflammation stalls Th17-cell migration en route to the central nervous system during the development of experimental autoimmune encephalomyelitis

Recruiting pathogenic T cells to the central nervous system (CNS) is a critical step during the development of experimental autoimmune encephalomyelitis (EAE). Here, we report that the absence of autophagy and microtubule-associated protein 1A/1B-light chain 3-associated phagocytosis significantly delayed the onset of EAE in Atg7 conditional knockout (Atg7 CKO) mice in myeloid cells. T-helper cell-cell priming appeared to be normal in the Atg7 CKO mice, but the mice showed significant accumulation of T_h17 cells in the lung. The data suggested that the stalling of T_h17 cells in the lung en route to the CNS caused the delay. The lung of Atg7 CKO mice, in which we previously demonstrated spontaneous mild inflammation, showed high expression of CCL20, a chemokine that attracts T_h17 cells. We have also shown that LPS intranasal instillation delayed EAE onset, suggesting that pulmonary inflammation has an impact on EAE development. Based on our data, therapeutic immunomodulation targeted to the lung, rather than systemically, might be a possible future option to treat multiple sclerosis.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bSDAjh
via IFTTT

Nasal Mucosal Cyst a Clinical and Surgical Dilemma

Abstract

A mucous cyst is a lesion which can show a wide range of symptoms but is benign and most of them can even appear several months or even years after nasal surgeries. Size of the displaced epithelial fragment is a crucial factor for the development of the mucous cyst. Complete resection of the mucous cyst is the ideal treatment. Surfing through the literature we came across 18 cases of mucous cyst formation following nasal surgery. Here we describe a mucous cyst which had resulted from a rhinoplasty procedure the patient had undergone earlier in her life.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c1kdne
via IFTTT

Diets for diagnosis and management of food allergy

The National Institute of Allergy and Infectious Diseases (NIAID) defines a food allergy as "an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food."1 Within this definition, a range of food-related phenomena are captured and further categorized, such as IgE-mediated food allergies, mixed IgE- and non–IgE-mediated food allergies, and non–IgE-mediated food allergies (eg, food protein–induced enterocolitis syndrome [FPIES]). These different types of food allergies are an important consideration in deciding dietary management.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bCz6wI
via IFTTT

Ewing sarcomas of the sino-nasal tract and maxillary bone

Publication date: Available online 31 August 2016
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Jbali Souheil, Kedous Skander, Dhambri Sawssen, Mahfoudhi Sana, Yazid Delia, Mahjoubi Khalil, Gargoura Asma, Ayadi Mouna, Attia Zied, Touati Slim, Gritli Said
Ewing's sarcoma is a malignant tumor belonging to the group of small round cells tumors. Histologically similar to soft tissue neoplasms originally described as primitive neuro-ectodermal tumors (PNET), in the WHO classification, Ewing's sarcoma and PNET are labeled together under the rubric of EWS/PNET. Rarely located in the nasal cavity and the para-nasal sinuses, we report three cases of Ewing's sarcoma of maxillary bone and sinus. Our patients, 2 males and one female, were aged 20, 16 and 13years respectively. The chief complaint was a painful face swelling. The diagnosis was retained on histologic and immuno-histochemical results. In two cases, surgery was performed as primary treatment modality followed by chemo-radiotherapy, which was the only therapeutic modality in the remaining case. After a follow-up of 2, 3 and 8years (for each patient), we did not report local or distant failures.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bHRhgk
via IFTTT

Pathogenesis of Proliferative Lupus Nephritis from a Historical and Personal Perspective

Publication date: Available online 31 August 2016
Source:Clinical Immunology
Author(s): Shu Man Fu, Hongyang Wang, Chao Dai, Sun-sang J. Sung, Felicia Gaskin

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bSnBSj
via IFTTT

Prognostic role of negative plasma EBV DNA level in patients with NPC

Publication date: Available online 30 August 2016
Source:Oral Oncology
Author(s): Enis Ozyar

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bRlkm6
via IFTTT

Low etiologic fraction for human papillomavirus in larynx squamous cell carcinoma

Publication date: October 2016
Source:Oral Oncology, Volume 61
Author(s): M. Taberna, C. Resteghini, B. Swanson, R.K.L. Pickard, B. Jiang, W. Xiao, M. Mena, P. Kreinbrink, E. Chio, M.L. Gillison
BackgroundHuman Papillomavirus (HPV) is a cause of oropharyngeal squamous cell carcinoma (OPSCC), but its pathogenic role in larynx squamous cell carcinoma (LSCC) remains unclear.Material and methodsA single-institutional, retrospective case-series was performed to estimate the etiological fraction (EF) for HPV in LSCC. Eligible cases included 436 consecutive cases of LSCC diagnosed (2005–2014) at The Ohio State University Medical Center. HPV DNA presence was detected by consensus primer PCR (Inno-LiPa) and HPV type-specific qPCR. HPV E6/E7 mRNA expression was detected by type-specific qRT-PCR. Tumor p16 expression was evaluated by immunohistochemistry (IHC).ResultsHPV DNA was detected by Inno-LiPa in 54 of 404 (13.4%, 95% CI 10.2–17.1) evaluable samples but was confirmed by HPV type-specific qPCR in only 14 (3.5%, 95% CI 1.9–5.7). Only 7 of 404 (1.7%, 95% CI 0.7–3.5) LSCC were positive for HPV E6/E7 mRNA expression, including HPV16 (n=4) and 1 each for 11, 26 and 33. In the HPV11-positive tumor, Sanger sequencing discovered 6 nucleotide mutations in the upstream regulation region, E6 and E7. Of 404 LSCC, 18 had strong and diffuse p16 expression.In comparison to a gold standard of HPV E6/E7 mRNA expression, p16 expression had a sensitivity of 71.4% (95% CI 29.0–96.3), specificity of 96.7% (95% CI 94.5–98.3), positive-predictive-value (PPV) of 27.8% (95% CI 9.7–53.5) and negative-predictive-value of 99.5% (95% CI 98.1–99.9).ConclusionThe EF for HPV in LSCC is low (1.7%) in a geographic region with high EF for OPSCC. Low-risk HPV may rarely cause LSCC. Finally, p16 expression has poor PPV for HPV in LSCC.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2crmMAH
via IFTTT

Quantitative body mass characterization before and after head and neck cancer radiotherapy: A challenge of height-weight formulae using computed tomography measurement

Publication date: October 2016
Source:Oral Oncology, Volume 61
Author(s): Sasikarn Chamchod, Clifton D. Fuller, Abdallah S.R. Mohamed, Aaron Grossberg, Jay A. Messer, Jolien Heukelom, G. Brandon Gunn, Micheal E. Kantor, Hillary Eichelberger, Adam S. Garden, David I. Rosenthal
ObjectivesWe undertook a challenge to determine if one or more height-weight formula(e) can be clinically used as a surrogate for direct CT-based imaging assessment of body composition before and after radiotherapy for head and neck cancer (HNC) patients, who are at risk for cancer- and therapy-associated cachexia/sarcopenia.Materials and methodsThis retrospective single-institution study included 215 HNC patients, treated with curative radiotherapy between 2003 and 2013. Height/weight measures were tabulated. Skeletal muscle mass was contoured on pre- and post-treatment CT at the L3 vertebral level. Three common lean body mass (LBM) formulae (Hume, Boer, and James) were calculated, and compared to CT assessment at each time point.Results156 patients (73%) had tumors arising in the oropharynx and 130 (61%) received concurrent chemotherapy. Mean pretreatment body mass index (BMI) was 28.5±4.9kg/m² in men and 27.8±8kg/m² in women. Mean post-treatment BMI were 26.2±4.4kg/m² in men, 26±7.5kg/m² in women. Mean CT-derived LBM decreased from 55.2±11.8kg pre-therapy to 49.27±9.84kg post-radiation. Methods comparison revealed 95% limit of agreement of ±12.5–13.2kg between CT and height-weight formulae. Post-treatment LBM with the three formulae was significantly different from CT (p<0.0001). In all instances, no height-weight formula was practically equivalent to CT within±5kg.ConclusionFormulae cannot accurately substitute for direct quantitative imaging LBM measurements. We therefore recommend CT-based LBM assessment as a routine practice of head and neck cancer patient body composition.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bRlZDZ
via IFTTT

Trends of oral cavity, oropharyngeal and laryngeal cancer incidence in Scotland (1975–2012) – A socioeconomic perspective

Publication date: October 2016
Source:Oral Oncology, Volume 61
Author(s): Mitana Purkayastha, Alex D. McMahon, John Gibson, David I. Conway
AimTo examine current incidence trends (1975–2012) of oral cavity (OCC), oropharyngeal (OPC) and laryngeal cancer in Scotland by socioeconomic status (SES).MethodsWe included all diagnosed cases of OCC (C00.3-C00.9, C02-C06 excluding C2.4), OPC (C01, C2.4, C09-C10, C14) and laryngeal cancer (C32) on the Scottish Cancer Registry (1975–2012) and annual midterm population estimates by age, sex, geographic region and SES indices (Carstairs 1991 and Scottish Index of Multiple Deprivation 2009). Age-standardized incidence rates were computed and adjusted Poisson regression rate-ratios (RR) compared subsites by age, sex, region, SES and year of diagnosis.ResultsWe found 28,217 individuals (19,755 males and 8462 females) diagnosed with head and neck cancer (HNC) over the study period. Between 1975 and 2012, relative to the least deprived areas, those living in the most deprived areas exhibited the highest RR (>double) of OCC, OPC and laryngeal cancer, and an almost dose-like response was observed between SES and HNC incidence. Between 2001 and 2012, this socioeconomic inequality tended to increase over time for OPC and laryngeal cancer but remained relatively unchanged for OCC. Incidence rates increased markedly for OPC, decreased for laryngeal cancer and remained stable for OCC, particularly in the last decade. Males exhibited significantly higher RRs compared to females, and the peak age of incidence of OPC was slightly lower than the other subsites.ConclusionContrary to reports that OPC exhibits an inverse socioeconomic profile, Scotland country-level data show that those from the most deprived areas consistently have the highest rates of head and neck cancers.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2crmYzR
via IFTTT

A cohort study into head and neck cancer mortality in Belgium (2001–11): Are individual socioeconomic differences conditional on area deprivation?

Publication date: October 2016
Source:Oral Oncology, Volume 61
Author(s): Paulien Hagedoorn, Hadewijch Vandenheede, Katrien Vanthomme, Didier Willaert, Sylvie Gadeyne
ObjectiveThe aim of this study is to assess to what extent individual and area-level socioeconomic position (SEP) are associated to head and neck cancer (HNC) mortality and to what extent they contribute to regional variation in HNC mortality in Belgium.Materials and methodsData on men aged 40–64 are collected from a population based dataset based on the 2001 Belgian census linked to register data on emigration and mortality for 2001–2011. Individual SEP is measured using education, employment status and housing conditions. Deprivation at municipal level is measured by a deprivation index. Absolute mortality differences are estimated by age standardised mortality rates. Multilevel Poisson models are used to estimate the association and interaction between HNC mortality and individual and area-level SEP, and to estimate the regional variation in HNC mortality.ResultsHNC mortality rates are significantly higher for men with a low SEP and men living in deprived areas. Cross-level interactions indicate that the association between individual SEP and HNC mortality is conditional on area deprivation. HNC mortality in deprived areas is especially high among high-SEP men. As a result, social disparities appear to be smaller in more deprived areas. Regional variation in HNC mortality was significant. Population composition partially explains this regional variation, while area deprivation and cross-level interactions explains little.ConclusionBoth individual and area-level deprivation are important determinants of HNC mortality. Underlying trends in incidence and survival, and risk factors, such as alcohol and tobacco use, should be explored further.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bRlMAW
via IFTTT

MBL2 polymorphisms and the risk of asthma

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jing Shi, Xianying Zhu, Min Xie, Jianmiao Wang, Yuanzhou He, Yongjian Xu, Xiansheng Liu
BackgroundThe association between MBL2 gene polymorphisms and the risk of asthma has been evaluated in multiple studies; however, the results are inconsistent.ObjectiveTo perform a meta-analysis to explore whether MBL2 gene polymorphisms were associated with the risk of asthma.MethodsWe searched PubMed, Web of Science, and Cochrane Library to find relevant articles published up to March 2016. Nine studies, including 2066 cases and 2183 controls, were included in the meta-analysis. The strength of association was evaluated by odds ratio (OR) with 95% confidence interval (CI).ResultsThe results reveal that MBL2 gene polymorphisms (codon 54 A/B, –550 H/L or –221 X/Y) were not associated with the risk of asthma (codon 54 A/B: BB+AB vs AA: OR, 1.02; 95% CI, 0.85–1.23; –550 H/L: LL+HL vs HH: OR, 0.81; 95% CI, 0.63–1.03; –221 X/Y: XX+YX vs YY: OR, 0.85; 95% CI, 0.69–1.04). Subgroup analysis by ethnicity implied that the MBL2 codon 54 A/B polymorphism was not significantly associated with the risk of asthma in Asians (BB+AB vs AA: OR, 0.95; 95% CI, 0.70–1.29) or whites (BB+AB vs AA: OR, 1.07; 95% CI, 0.84–1.35).ConclusionThe results indicated that MBL2 gene polymorphisms (codon 54 A/B, –550 H/L or –221 X/Y) may be not associated with the risk of asthma.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c0Poii
via IFTTT

Role of food and aeroallergen sensitization in eosinophilic esophagitis in adults

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Ashleigh A. Olson, Michael D. Evans, Mats W. Johansson, Chloe H. Kim, David M. Manthei, Eric A. Gaumnitz, Sameer K. Mathur
BackgroundEvaluation of IgE-mediated food sensitivity is frequently performed for patients with eosinophilic esophagitis (EoE). However, the clinical relevance of identifying IgE-mediated sensitivity to foods in adults is unclear.ObjectiveTo determine whether EoE associated with food or aeroallergen sensitivity represents a phenotype of EoE with distinct clinical or biological features.MethodsA medical record review identified 257 patients with a diagnosis of EoE evaluated in the adult allergy clinic at the University of Wisconsin Hospital and Clinics from 2008 to 2013. Patient records were reviewed to capture measures of disease severity, endoscopy results, pathology reports, allergy testing, medical management and patient-reported outcomes.ResultsEvaluation of food sensitization with skin prick testing and/or serum IgE was performed for 93% of patients. Sensitization to at least 1 food was identified in 54% of patients who were more likely to report concomitant asthma, allergic rhinitis, eczema, and/or food allergy compared with nonfood sensitive patients. Aeroallergen sensitivity was identified in 87% of patients tested. Clinical characteristics, including EoE symptoms, disease severity, endoscopic findings, peripheral eosinophilia, and patient-reported outcomes, did not differ between food sensitive and non–food sensitive patients. However, on endoscopy, aeroallergen sensitive patients were more likely to have strictures and less likely to exhibit felinization compared with non–aeroallergen sensitized patients.ConclusionAdults with EoE and IgE-mediated food sensitivity are not phenotypically different than non–food sensitive patients. There is no clear clinical utility in identifying food sensitivity in adults with EoE. Further studies are needed to determine whether aeroallergen sensitivity represents a distinct phenotype of EoE.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8UvKM
via IFTTT

Cutaneous leukocytoclastic vasculitis due to amoxicillin hypersensitivity

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Mercedes Sáenz de Santa María García, Cristina Morales-Cabeza, Blanca Noguerado-Mellado, Patricia Rojas-Pérez-Ezquerra, Jose M. Zubeldia

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c0P6Iq
via IFTTT

Variability of blood eosinophil count as an asthma biomarker

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Sameer K. Mathur, Paul S. Fichtinger, Michael D. Evans, Elizabeth A. Schwantes, Nizar N. Jarjour

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8UPcg
via IFTTT

Approach to the evaluation of adverse antibiotic reactions in patients with cystic fibrosis

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Daniel H. Petroni, Moira L. Aitken, Erin Ham, Sarah Chung, Lori Menalia, Matthew C. Altman, Andrew G. Ayars
BackgroundAdverse drug reactions (ADRs) to antibiotics in patients with cystic fibrosis (CF) are common and often mislabeled as allergies. The labeling of an antibiotic reaction as an allergy can lead to the use of antibiotics that are less efficacious, are more expensive, or have a greater risk of adverse effects.ObjectiveTo establish a safe approach for the evaluation of ADRs to antibiotics in patients with CF to help clarify future use of these medications.MethodsPatients with CF whose antibiotic allergies were causing difficulty in their medical management were referred for an allergy evaluation that consisted of a thorough drug allergy history and antibiotic testing if appropriate. If the history was not consistent with a true hypersensitivity reaction (HSR) and test results were negative, the patient underwent a challenge to the offending agent(s) to rule out an HSR. Challenges were only performed if the medication was indicated for future use.ResultsA total of 17 patients (mean age, 32.4 years) underwent a thorough allergy evaluation. A total of 17 antibiotic challenges were performed in 11 patients without a reaction consistent with an HSR or severe delayed reaction. Only 2 medications had a history consist with an HSR, and it was recommended that they undergo a desensitization procedure if the drug was required.ConclusionIf treatment with appropriate antibiotics becomes difficult in patients with CF because of drug allergies, then referral to an allergist can help safely identify treatment options. Our findings suggest that a thorough evaluation by an allergy specialist can lead to more appropriate treatment options in patients with CF.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c0P1nY
via IFTTT

Clinical associations in the diagnosis of vocal cord dysfunction

Publication date: Available online 31 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Rung-Chi Li, Umesh Singh, Hugh Porter Windom, Stephen Gorman, Jonathan A. Bernstein
BackgroundDiagnosis of VCD is complicated by its symptom similarities to asthma. Although clinical history, spirometry, and fiberoptic nasolaryngoscopy are used for VCD diagnosis, videostroboscopy is considered the gold standard. However, little is know about patient characteristics that might suggest a VCD diagnosis is more likely.ObjectiveTo identify clinical characteristics of patients suspected of having VCD that would increase the likelihood of an accurate diagnosis before videostroboscopy.MethodsRecords of 55 patients were reviewed for a cross-sectional, retrospective study. Individuals selected were suspected of having VCD because of poor clinical response to asthma medications, absence of objective criteria for diagnosis of asthma (eg, normal forced expiratory volume in 1 second without reversibility, normal exhaled nitric oxide, equivocal methacholine challenge test), or both. We used χ² analyses to determine significant univariate associations of various patient characteristics. Multivariate regression analysis was then performed using those variables identified as being significant predictors by univariate analysis.ResultsA significant association between VCD and age and between VCD and shortness of breath (SOB) was found. Further analysis revealed that at ages younger than 35 years, with every 5-year decrement in age, patients suspected of having VCD in which SOB is the presenting symptom are more likely to have a positive VCD diagnosis by a factor of 1.3.ConclusionClinical presentation of younger patients with SOB in conjunction with lack of objective criteria for an asthma diagnosis, poor response to asthma medications, or both is highly predictive of VCD and should prompt an objective stroboscopic evaluation to confirm the diagnosis.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8V9Yx
via IFTTT

Long QT syndrome and life-threatening anaphylaxis

Publication date: Available online 30 August 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jennifer L. White, Robert J. Kahoud, James T.C. Li, Ronna L. Campbell, Michael J. Ackerman

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c0P17s
via IFTTT

Development of a virtual reality training system for endoscope-assisted submandibular gland removal

Publication date: Available online 31 August 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Takehiro Miki, Toshinori Iwai, Kazunori Kotani, Jianwu Dang, Hideyuki Sawada, Minoru Miyake
PurposeEndoscope-assisted surgery has widely been adopted as a basic surgical procedure, with various training systems using virtual reality developed for this procedure. In the present study, a basic training system comprising virtual reality for the removal of submandibular glands under endoscope assistance was developed. The efficacy of the training system was verified in novice oral surgeons.Material and MethodsA virtual reality training system was developed using existing haptic devices. Virtual reality models were constructed from computed tomography data to ensure anatomical accuracy. Novice oral surgeons were trained using the developed virtual reality training system.ResultsThe developed virtual reality training system included models of the submandibular gland and surrounding connective tissues and blood vessels entering the submandibular gland. Cutting or abrasion of the connective tissue and manipulations, such as elevation of blood vessels, were reproduced by the virtual reality system. A training program using the developed system was devised. Novice oral surgeons were trained in accordance with the devised training program.ConclusionsOur virtual reality training system for endoscope-assisted removal of the submandibular gland is effective in the training of novice oral surgeons in endoscope-assisted surgery.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8V477
via IFTTT

Reversal of cigarette smoke extract-induced sinonasal epithelial cell barrier dysfunction through Nrf2 Activation

Background

Environmental factors such as inhaled pollutants like cigarette smoke may play a significant role in diseases of the upper airway including chronic rhinosinusitis (CRS). Recent studies have shown that cigarette smoke causes impaired airway epithelial cell barrier function likely through environmental oxidative stress related pathways. The purpose of this study is to explore whether enhancing nuclear factor erythroid 2 [NF-E2]-related factor 2 [Nrf2], the body's master antioxidant system, can ameliorate cigarette smoke–induced sinonasal epithelial cell (SNEC) barrier dysfunction.

Methods

Human SNECs (HSNECs) were grown from control patients at the air-liquid interface (ALI). HSNECs were stimulated with cigarette smoke extract (CSE) with and without pharmacologic activation of Nrf2. HSNECs were then stained for the epithelial cell junctional proteins zonula occludens 1 (ZO-1) and junctional adhesion molecule A (JAM-A) using confocal microscopy. In addition, transepithelial electrical resistance (TER) was measured in cultures before and after stimulation with CSE.

Results

CSE stimulation caused a global disruption of the epithelial junctional proteins ZO-1 and JAM-A along with an associated decrease in TER levels. Enhancing Nrf2 levels prior to stimulation with CSE was associated with increased localization of ZO-1 and JAM-A levels at the cell surface and statistically significant increases in TER levels.

Conclusion

This is the first study to demonstrate that cigarette smoke induced SNEC barrier dysfunction is reversible by Nrf2 activation. The Nrf2 antioxidant pathway may represent a potential therapeutic target for cigarette smoke–associated sinonasal inflammation.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bC75oY
via IFTTT

Successful repair of intraoperative cerebrospinal fluid leaks improves outcomes in endoscopic skull base surgery

Background

The impact of failed cerebrospinal fluid leak (CSF) leak repair in endoscopic skull base surgery has not been adequately studied.

Methods

In this investigation we reviewed patients who had undergone endoscopic skull base surgery between 2002 and 2014 at 7 international centers. Demographic variables, comorbidities, tumor characteristics, and repair techniques were evaluated to determine association with successful repair of CSF leak. Postoperative complications and length of stay were compared among groups.

Results

Data were collected on 2097 patients who were divided into 3 groups: (1) those with no intraoperative leak (n = 1533); (2) those with successful repair of their intraoperative leak (n = 452); and (3) those with failed repair (n = 112). Compared with successful repair, failed repair was associated with an increased risk of intracranial infection (odds ratio [OR], 5.6; 95% confidence interval [CI], 5.3-13.15), pneumocephalus (OR, 16; 95% CI, 5.8-44.4), 30-day readmission (OR, 8.4; 95% CI, 5.3-13.5), reoperation (OR, 115.4; 95% CI, 56.3-236.8), and prolonged hospital stay (14.9 vs 7.0 days, p < 0.01). Outcomes in patients who had successful repairs of intraoperative leaks were similar to those who never had leakage. Intraoperative use of pedicled nasoseptal flaps was associated with successful repair (OR, 0.60; 95% CI, 0.34-0.92).

Conclusion

Intraoperative CSF leaks are a frequent and expected occurrence during endoscopic skull base surgery. Failed CSF leak repair has a significant impact on patient outcomes, with increased rates of postoperative pneumocephalus, intracranial infections, reoperation, deep vein thrombosis, readmission, and prolonged hospital stay. Recognition and repair of intraoperative CSF leaks reduces postoperative complications. Use of pedicled nasoseptal flaps improves outcomes in reconstructing defects at higher risk for postoperative leak.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bClnBh
via IFTTT

The influence of subway station design on noise levels

Objectives/Hypothesis

To investigate the impact of subway station design on platform noise levels.

Study Design

Observational.

Methods

Continuous A-weighted decibel (dBA) sound levels were recorded in 20 New York City subway stations, where trains entered on either a straight track or curved track in 10 stations each. Equivalent continuous noise levels (L_eq) at various locations on the boarding platform (inbound end, midplatform, and outbound end) during train entry and exit were compared between the straight and curved stations in broadband as well as narrow one-third octave bands.

Results

Overall, curved stations trended louder than straight stations, although the difference in broadband L_eq did not reach statistical significance (curve, 83.4 dBA; straight, 82.6 dBA; P = .054). Noise levels were significantly louder at the inbound end of the platform during train entry (inbound, 89.7 dBA; mid, 85.5 dBA; outbound, 78.7 dBA; P < .001) and at the outbound end during train exit (inbound, 79.7 dBA; mid, 85.3 dBA; outbound, 89.1 dBA; P < .001). Narrow band analysis showed that curved stations were significantly louder than straight stations at 100 Hz and high frequencies from 8 to 20 kHz. Peak impact levels ranged from 104 to 121 dBA.

Conclusions

Curved stations have a different noise profile compared to straight stations and are significantly louder than straight stations at high frequencies. Designing stations with straight tracks within the platform can help reduce commuter noise exposure.

Level of Evidence

NA Laryngoscope, 2016

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bC6krr
via IFTTT

Design, construction, and technical implementation of a web-based interdisciplinary symptom evaluation (WISE) - a heuristic proposal for orofacial pain and temporomandibular disorders

Medical symptoms independent of body location burden individuals to varying degrees and may require care by more than one expert. Various paper and computer-based tools exist that aim to comprehensively captur...

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bSheNm
via IFTTT

Exploring the Potential of Laser Capture Microdissection Technology in Integrated Oral BioSciences

Abstract

Laser capture microdissection (LCM) is a high end research and diagnostic technology that helps in obtaining pure cell populations for the purpose of cell or lesion specific genomic and proteomic analysis. Literature search on the application of LCM in oral tissues was made through PUBMED. There is ample evidence to substantiate the utility of LCM in understanding the underlying molecular mechanism involving an array of oral physiological and pathological processes, including odontogenesis, taste perception, eruptive tooth movement, oral microbes, and cancers of the mouth and jaw tumors. This review is aimed at exploring the potential application of LCM in oral tissues as a high-throughput tool for integrated oral sciences. The indispensable application of LCM in the construction of lesion specific genomic libraries with emphasis on some of the novel molecular markers thus discovered is also highlighted.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bBSk0F
via IFTTT

Diagnostic Performance of MR Imaging of Three Major Salivary Glands for Sjögren's Syndrome

Abstract

Objective

We analyzed the diagnostic performance of the MR imaging findings of the parotid, submandibular, and sublingual glands to discriminate between patients with and without Sjögren's syndrome.

Methods

We retrospectively analyzed the correlation between the MR imaging and histopathological findings obtained from 69 patients with clinically suspected Sjögren's syndrome. We evaluated the heterogeneous signal intensity distribution on T1- and T2-weighted images, the multiple high-signal-intensity spots on MR sialograms, and the volume of the parotid, submandibular, and sublingual salivary glands.

Results

The multiple high-signal-intensity spots in the parotid gland showed the highest sensitivity and diagnostic accuracy (82% and 83%, respectively). In addition, the multiple high-signal-intensity spots and the heterogeneous signal intensity distribution in the submandibular gland showed high specificity (100% and 88%, respectively). The volume of the submandibular gland, but not that of the parotid or sublingual gland, was smaller in patients with Sjögren's syndrome.

Conclusions

The presence of multiple high-signal-intensity spots on an MR sialogram in the parotid gland should be considered the best diagnostic indicator for Sjögren's syndrome. The presence of spots, heterogeneity, and the change to smaller volumes in the submandibular gland were also helpful because of their high specificity, particularly in advanced cases.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bBDHiN
via IFTTT

Study of Dentoxol® Mouthrinse for Oral Mucositis

Condition: Oral Mucositis
Interventions: Device: Dentoxol; Device: Placebo
Sponsor: Ingalfarma SpA
Recruiting - verified August 2016

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cbOWeK
via IFTTT

Pembrolizumab in Combination With Cisplatin and Intensity Modulated Radiotherapy (IMRT) in Head and Neck Cancer

Condition: Head and Neck Squamous Cell Carcinoma
Interventions: Drug: Pembrolizumab; Drug: Cisplatin; Radiation: IMRT
Sponsors: University of Pittsburgh; Merck Sharp & Dohme Corp.
Recruiting - verified August 2016

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c0i6jy
via IFTTT

Improving medical students’ knowledge and skill in communicating with people with acquired communication disorders

.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bB8q0H
via IFTTT

Optimizing functional upper extremity reconstruction—Simultaneous free anterolateral thigh flap and tendon transfers—A case report

Abstract

Composite upper extremity defects involving muscle–tendon units are amongst the most formidable reconstructive challenges and mandate functional restoration in addition to stable soft-tissue coverage. Here, the authors present a case of a composite defect involving the extensor muscle–tendon units of the forearm resulting from surgical resection of a recurrent Merkel cell cancer. Functional restoration was achieved via multiple tendon transfers followed by soft tissue coverage with a free anterolateral thigh (ALT) flap. No donor- or recipient-site complications were encountered and complete flap survival was noted. Following a 6-week period of immobilization, physical therapy and range of motion exercises were initiated. Excellent functional outcome and high patient satisfaction were noted at 8 weeks postoperatively. In summary, simultaneous tendon transfers and microsurgical tissue transfer may provide a potentially superior approach for upper extremity reconstruction in complex composite defects.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bC9FK6
via IFTTT

[Not Available].

http:--production.springer.de-OnlineReso

[Not Available].

MMW Fortschr Med. 2016 Jun 9;158(11):76

Authors: Siegmund-Schultze N

PMID: 27271425 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bZLBlx
via IFTTT

[Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

[Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

Praxis (Bern 1994). 2016 Jun 8;105(12):693-7

Authors: Wirth HP

Abstract
Prevalence of H. pylori (HP) is declining, whereas reflux disease and the proportion of non-steroidal antiinflammatory drugs (NSAR) to HP-induced ulcers increase. Eradication heals HP-ulcer disease, interrupts cancerous progression and can improve dyspeptic symptoms. NSAR-ulcers heal under proton pump inhibitor (PPI) therapy but tend to recur after reexposition. Anticoagulants and antiplatlet agents increase the risk additionally. PPI reduces NSAR-ulcer recurrence. Reflux patients with severe inflammation and complications often need long-term therapy. Barrett's esophagus patients are at risk of esophageal adenocarcinoma.

PMID: 27269775 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7PzFL
via IFTTT

Rapid progressive long esophageal stricture caused by gastroesophageal reflux disease after pylorus-preserving pancreatoduodenectomy.

Rapid progressive long esophageal stricture caused by gastroesophageal reflux disease after pylorus-preserving pancreatoduodenectomy.

BMC Surg. 2016;16:19

Authors: Fukaya M, Abe T, Nagino M

Abstract
BACKGROUND: Delayed gastric emptying (DGE) is a major postoperative complication after pylorus-preserving pancreatoduodenectomy (PpPD) and sometimes causes reflux esophagitis. In most cases, this morbidity is controllable by proton-pump inhibitor (PPI) and very rarely results in esophageal stricture. Balloon dilation is usually performed for benign esophageal stricture, and esophagectomy was rarely elected. In the present case, there were two important problems of surgical procedure; how to perform esophageal reconstruction after PpPD and whether to preserve the stomach or not.
CASE PRESENTATION: A 63-year-old man underwent PpPD and Child reconstruction with Braun anastomosis for lower bile duct carcinoma. Two weeks after surgery DGE occurred, and a 10 cm long stricture from middle esophagus to cardia developed one and a half month after surgery in spite of the administration of antacids. Balloon dilation was performed, but perforation occurred. It was recovered with conservative treatment. Even the administration of a proton pump inhibitor (PPI) for approximately five mouths did not improve esophageal stricture. Simultaneous 24-h pH and bilirubin monitoring confirmed that this patient was resistant to PPI. We performed middle-lower esophagectomy with total gastrectomy to prevent gastric acid from injuring reconstructed organ and remnant esophagus through a right thoracoabdominal incision, and we also performed reconstruction with transverse colon, adding Roux-Y anastomosis, to prevent bile reflux to the remnant esophagus. Minor leakage developed during the postoperative course but was soon cured by conservative treatment. The patient started oral intake on the 25th postoperative day (POD) and was discharged on the 34th POD in good condition.
CONCLUSION: Long esophageal stricture after PpPD was successfully treated by middle-lower esophagectomy and total gastrectomy with transverse colon reconstruction through a right thoracoabdominal incision. Conventional PD or SSPPD with Roux-en Y reconstruction rather than PpPD should be selected to reduce the risk of DGE and prevent bile reflux, in performing PD for patients with hiatal hernia or rapid metabolizer CYP2C19 genotype; otherwise, fundoplication such as Nissen and Toupet should be added.

PMID: 27090811 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cb8yzG
via IFTTT

Aetiology and pathology of otitis media with effusion in adult life.

Aetiology and pathology of otitis media with effusion in adult life.

J Laryngol Otol. 2016 May;130(5):418-24

Authors: Mills R, Hathorn I

Abstract
OBJECTIVES: To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults.
METHOD: A review of the English language literature from 1970 to the present was conducted.
RESULTS: The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease.
CONCLUSION: There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

PMID: 26976514 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/1RkuSJ9
via IFTTT

Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

http:--avesyayincilik.com-resimler-resim

Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

Turk J Pediatr. 2015 May-Jun;57(3):258-65

Authors: Önal Z, Çullu-Çokuğraş F, Işıldak H, Kaytaz A, Kutlu T, Erkan T, Doğusoy G

Abstract
Gastroesophageal reflux is considered a risk factor for recurrent or persistent upper and lower respiratory tract conditions including asthma, chronic cough, sinusitis, laryngitis, serous otitis and paroxysmal laryngospasm. Fifty-one subjects with recurrent (more than three) episodes of upper respiratory tract infection (URTI), serous otitis or sinusitis who had been admitted to an earnose- throat (ENT) outpatient clinic during the previous year were enrolled in the present study to evaluate the presence of laryngeal and/or esophageal reflux. The participants, who were randomly selected, were questioned about symptoms of reflux, including vomiting, abdominal pain, failure to thrive, halitosis, bitter taste in the mouth, chronic cough, heartburn, constipation and hoarseness. All subjects had an endoscopic examination, an otoscopic examination, a tympanogram and upper GI system endoscopy. Esophagitis was diagnosed endoscopically and histologically. The likelihood of occurrence of esophagitis was found to be higher only among subjects with postglottic edema/erythema as determined by pathological laryngeal examination. The reflux complaints reported did not predict the development of esophagitis, but the odds of esophagitis occurring were ninefold greater among subjects with recurrent otitis. Of the subjects, 45.1% were Helicobacter pylori-positive. However, no association was found between esophagitis and Helicobacter pylori positivity. The likelihood of the occurrence of esophagitis was found to be increased in the presence of recurrent otitis media and/or postglottic edema, irrespective of the presence of reflux symptoms. We concluded that, in contrast to the situation where adults are concerned, the boundaries for discriminating laryngopharyngeal reflux from gastroesophageal reflux are somewhat blurred in pediatric patients.

PMID: 26701945 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7OJZI
via IFTTT

Optimization of parameter settings in cine-MR imaging for diagnosis of swallowing.

Optimization of parameter settings in cine-MR imaging for diagnosis of swallowing.

Bull Tokyo Dent Coll. 2014;55(3):131-7

Authors: Ohkubo M, Higaki T, Nishikawa K, Otonari-Yamamoto M, Sugiyama T, Ishida R, Wako M, Sano T

Abstract
Videofluorography is frequently used to evaluate swallowing and is considered the "gold standard" among imaging modalities. This modality, however, has several disadvantages, including radiation exposure and limitations in the detection of soft tissues. Conversely, magnetic resonance imaging (MRI) offers excellent contrast resolution in soft tissue without radiation exposure. A major drawback of MRI in evaluating swallowing, however, is that temporal resolution is poor. The aim of this study was to investigate a new cine-MRI modality. Imaging parameters were optimized and the efficacy of this new technique is discussed. Three techniques for speeding up MRI were combined: true fast imaging with steady state precession, generalized auto-calibrating partially parallel acquisition, and key-hole imaging. The effects of the receiver coils used, receiving bandwidth, slice thickness, and flip angle on each image were determined. The optimal imaging parameters obtained comprised a reduction factor of 2, receiving bandwidth of 1,000 Hz/pixel (repetition time of 151.7 milliseconds and echo time of 1.4 milliseconds), flip angle of 50°, and slice thickness of 6 mm. Neck and spine coils were used. Under these conditions, the new cine-MR imaging technique investigated showed a temporal resolution of 0.1 sec/slice (10 frames/sec). Even with optimized parameter settings, this technique did not allow a true temporal resolution of 30 frames/sec by a large margin. Motion artifacts persisted. Further study is needed on how to speed up this technique.

PMID: 25212558 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bQEDMu
via IFTTT

speech and language; +16 new citations

16 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

speech and language

These pubmed results were generated on 2016/08/31

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bQCro9
via IFTTT

Modelling the effect of round window stiffness on residual hearing after cochlear implantation

Publication date: Available online 30 August 2016
Source:Hearing Research
Author(s): Stephen J. Elliott, Guangjian Ni, Carl A. Verschuur
Preservation of residual hearing after cochlear implantation is now considered an important goal of surgery. However, studies indicate an average post-operative hearing loss of around 20 dB at low frequencies. One factor which may contribute to post-operative hearing loss, but which has received little attention in the literature to date, is the increased stiffness of the round window, due to the physical presence of the cochlear implant, and to its subsequent thickening or to bone growth around it. A finite element model was used to estimate that there is approximately a 100-fold increase in the round window stiffness due to a cochlear implant passing through it. A lumped element model was then developed to study the effects of this change in stiffness on the acoustic response of the cochlea. As the round window stiffness increases, the effects of the cochlear and vestibular aqueducts become more important. An increase of round window stiffness by a factor of 10 is predicted to have little effect on residual hearing, but increasing this stiffness by a factor of 100 reduces the acoustic sensitivity of the cochlea by about 20 dB, below 1 kHz, in reasonable agreement with the observed loss in residual hearing after implantation. It is also shown that the effect of this stiffening could be reduced by incorporating a small gas bubble within the cochlear implant.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bBjABz
via IFTTT

[Not Available].

[Not Available].

MMW Fortschr Med. 2016 Jun 9;158(11):76

Authors: Siegmund-Schultze N

PMID: 27271425 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bZLBlx
via IFTTT

[Dysphagia and Sonography: what Association?].

[Dysphagia and Sonography: what Association?].

Praxis (Bern 1994). 2016 Jun 8;105(12):709-13

Authors: Donati T, Badini M, Schwarzenbach HR

Abstract
Achalasia is a primary esophageal motility disorder characterized by dysphagia, chest pain, and drug-resistant reflux symptoms. A detailed anamnesis and esophageal manometry are essential tools for a correct diagnosis. We present a case of a 31 years old woman with typical achalasia symptoms misdiagnosed for many years due to a complex background picture. Despite the evolution in medical sciences, this clinical case underlines the cornerstones of medical profession: patient-physician relation and bedside clinical approach. At the same time, it confirms the increasing role of ultrasonography as a simple but essential tool for a complete general-internal medicine evaluation.

PMID: 27269778 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7Plys
via IFTTT

[Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

[Dyspepsia, Ulcer Disease – Helicobacter pylori, Gastroesophageal Reflux Disease].

Praxis (Bern 1994). 2016 Jun 8;105(12):693-7

Authors: Wirth HP

PMID: 27269775 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7PzFL
via IFTTT

[Between intent and inability-management of malnutrition on medical wards of a centre hospital in Switzerland: patients' experience and perceptions].

http:--econtent.hogrefe.com-pb-assets-ho

[Between intent and inability-management of malnutrition on medical wards of a centre hospital in Switzerland: patients' experience and perceptions].

Pflege. 2016;29(3):115-23

Authors: Haldemann-Jenni E, Fierz K, Frei IA

Abstract
BACKGROUND: Malnutrition is a common phenomenon in acute care institutions accounting for many negative health consequences for the patient. In many hospitals, therefore, malnutrition risk screening and nutrition management programs were established; however, programs were commonly developed without integrating the patients' perspective. It is unknown if the program covers the patients' needs and if the interventions are worthwhile.
AIM: Because patient experience is known solely from everyday conversations, the aim of the study was to explore affected patients' experience regarding nutrition management.
METHOD: The study has a qualitative, inductive approach. From September 2011 till May 2012, seven women and one man were interviewed. To analyse the guided interviews, content analysis was used.
RESULTS: The analysis shows that patients find themselves between 'to want but not be able to eat'. Patients at risk encounter barriers due to their physical condition, such as swallowing- and chewing pain, nausea and dysgeusia and barriers associated with the system when ordering meals, such as fixed mealtimes, a limited variety of the menu and non-tasting supplements. To overcome these barriers patients are left to develop self-management strategies and to be in charge of their nutrition.
CONCLUSIONS: Therefore, targeted training for caregivers is a key, enabling them to support patients individually in their nutrition management. At the same time, institutional barriers must be removed.

PMID: 27213226 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7PCle
via IFTTT

Rapid progressive long esophageal stricture caused by gastroesophageal reflux disease after pylorus-preserving pancreatoduodenectomy.

Rapid progressive long esophageal stricture caused by gastroesophageal reflux disease after pylorus-preserving pancreatoduodenectomy.

BMC Surg. 2016;16:19

Authors: Fukaya M, Abe T, Nagino M

PMID: 27090811 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cb8yzG
via IFTTT

Aetiology and pathology of otitis media with effusion in adult life.

Aetiology and pathology of otitis media with effusion in adult life.

J Laryngol Otol. 2016 May;130(5):418-24

Authors: Mills R, Hathorn I

PMID: 26976514 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/1RkuSJ9
via IFTTT

Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

Turk J Pediatr. 2015 May-Jun;57(3):258-65

Authors: Önal Z, Çullu-Çokuğraş F, Işıldak H, Kaytaz A, Kutlu T, Erkan T, Doğusoy G

PMID: 26701945 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c7OJZI
via IFTTT

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children.

Nutrients. 2015 Nov;7(11):9400-15

Authors: Penagini F, Mameli C, Fabiano V, Brunetti D, Dilillo D, Zuccotti GV

Abstract
Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children.

PMID: 26580646 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bZLRB6
via IFTTT

Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson's disease.

Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson's disease.

J Neural Transm (Vienna). 2015 Nov;122(11):1553-61

Authors: Lee KD, Koo JH, Song SH, Jo KD, Lee MK, Jang W

Abstract
Dysphagia is an important issue in the prognosis of Parkinson's disease (PD). Although several studies have reported that oropharyngeal dysphagia may be associated with cognitive dysfunction, the exact relationship between cortical function and swallowing function in PD patients is unclear. Therefore, we investigated the association between an electrophysiological marker of central cholinergic function, which reflected cognitive function, and swallowing function, as measured by videofluoroscopic studies (VFSS). We enrolled 29 early PD patients. Using the Swallowing Disturbance Questionnaire (SDQ), we divided the enrolled patients into two groups: PD with dysphagia and PD without dysphagia. The videofluoroscopic dysphagia scale (VDS) was applied to explore the nature of the dysphagia. To assess central cholinergic dysfunction, short latency afferent inhibition (SAI) was evaluated. We analyzed the relationship between central cholinergic dysfunction and oropharyngeal dysphagia and investigated the characteristics of the dysphagia. The SAI values were significantly different between the two groups. The comparison of each VFSS component between the PD with dysphagia group and the PD without dysphagia group showed statistical significance for most of the oral phase components and for a single pharyngeal phase component. The total score on the VDS was higher in the PD with dysphagia group than in the PD without dysphagia group. The Mini-Mental State Examination and SAI values showed significant correlations with the total score of the oral phase components. According to binary logistic regression analysis, SAI value independently contributed to the presence of dysphagia in PD patients. Our findings suggest that cholinergic dysfunction is associated with dysphagia in early PD and that an abnormal SAI value is a good biomarker for predicting the risk of dysphagia in PD patients.

PMID: 26199040 [PubMed - in process]

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bZLUMZ
via IFTTT

Factors of detection of Bacillus cereus strains in eye cream

Abstract

Bacillus cereus has been associated with clinical infections and is also the cause of post-traumatic endophthalmitis as well as endogenous eye infections, which can result in blindness. Cosmetics, although preserved, can be contaminated during manufacture or use, and thus cause serious health issues.

Objective

We investigated the detection factors of Bacillus in eye cream preserved with parabens, including the nonionic surfactants used as neutralizers such as Tween 80, a blend of Tween 60 and Span 80, Tween 20 and selective media.

Methods

Eye cream samples were first mixed with neutralizers and individually inoculated with B. cereus strains, B. mycoides, B. subtilis or B. thuringiensis at a final concentration of 5 log CFU/g. The inoculated samples with and without neutralizers were analyzed after 30 min and during 84-day storage at room temperature. Presumptive colonies of Bacillus were enumerated on the varieties of Bacillus agar by spiral-plating techniques and Most Probable Number (MPN) method.

Results

The recovery counts of all Bacillus strains were between 4.10 and 4.58 log CFU/g in samples with Tween 80 and from 3.62 to 4.53 CFU/g in samples with TS after 30 min. Tween 20 was the least effective neutralizer. The challenged organisms, in samples without neutralizer, B. subtilis ATCC 15563 and B. cereus 4227A were detected at 1.83 and 1.49 log CFU/g after 30 min, respectively.

Conclusion

This study showed that Tween 80 was the best neutralizer for reducing the antimicrobial effect of parabens. BACARA^® and R&F plating media showed typical reaction of Bacillus cereus strains.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cqsl2e
via IFTTT

Effect of different alcohols on stratum corneum kallikrein 5 and phospholipase A2 together with epidermal keratinocytes and skin irritation

Alcoholic based-hand rubs (ABHRs) have a key role to play in mitigating the transmission of pathogens in health care settings [1]. Up to 100 applications of a product per day may be necessary to achieve full hand hygiene compliance (HHC) [2] andhealthcare workers (HCWs) are at increased risk for occupational dermatitis because of such frequent washing and use of hand sanitizers [3]. The specific alcohol used in an ABHR may be n-propanol, isopropanol or ethanol depending on the country or region.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bQs3fY
via IFTTT

Intraperitoneal curcumin and vitamin E combination for the treatment of cisplatin-induced ototoxicity in rats

Publication date: October 2016
Source:International Journal of Pediatric Otorhinolaryngology, Volume 89
Author(s): Harun Soyalıç, Fikret Gevrek, Sema Koç, Mustafa Avcu, Mehmet Metin, İbrahim Aladağ
IntroductionCisplatin ototoxicity is characterized by irreversible, progressive, bilateral sensorineural hearing loss at high frequencies, accompanied by tinnitus. The aim of this study is to demonstrate the protective action of curcumin alone or in combination with vitamin E against cisplatin-induced ototoxicity in animal models.Material and methodsThe study included 42 rats. Experimental animals were randomized into 6 groups. In the first group, intra-peritoneal cisplatin was administered alone. In the second group, intra-peritoneal cisplatin and curcumin were administered together. In the third group, intra-peritoneal cisplatin and vitamin E were administered together. In the fourth group, intra-peritoneal cisplatin was administered together with curcumin in combination with vitamin E. In the fifth group, intra-peritoneal curcumin was administered alone. The sixth group was sacrificed directly without administration of any drugs. A distortion product otoacoustic emission (DPOAE) test was applied to both ears of all experimental animals. Curcumin was administered 1 h before cisplatin treatment continued for three successive days. Vitamin E was administered only as a single dose 30 min prior to cisplatin. All animals were sacrificed following DPOAE testing on the 5th day of cisplatin administration. Histopathological findings included a TUNEL (TdT-mediated deoxyuridine triphosphate nick end-labeling) assay, and the percentage of apoptotic cells was calculated. DPOAE values and the percentage of apoptotic cells were compared before and after treatment and between experimental groups.ResultsIn Group 1, DPOAE values were significantly decreased at all frequencies (3000 Hz, 4000 Hz and 6000 Hz; P < 0.05). In Groups 2, 3, 4 and 5 there was no significant difference between the pre- and post-treatment DPOAE results (p > 0.05). Apoptotic index values were lower in all treatment groups compared to the cisplatin group, however the difference was only statistically significant in group 3 (p = 0.009).ConclusionIn rats, cisplatin ototoxicity can be prevented with curcumin or curcumin-vitamin E combination.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cqszX6
via IFTTT

Τρίτη 30 Αυγούστου 2016

Infektion des nichtprothetisch versorgten Gelenkes

Zusammenfassung

Hintergrund

Die septische Arthritis des nativen Gelenkes ist ein typischer orthopädischer Notfall. Eine frühzeitige Diagnosestellung mit konsekutiver Einleitung einer adäquaten Therapie ist für die Prognose entscheidend.

Fragestellung

Ziel der vorliegenden Arbeit ist es, einen Überblick über die aktuellen Empfehlungen zu Epidemiologie, Diagnostik und Therapie der septischen Arthritis des nativen Gelenkes zu geben.

Ergebnisse

Die septische Arthritis entsteht hämatogen durch septische Streuung oder aber durch eine meist iatrogen verursachte direkte Inokulation von Bakterien in das Gelenk. Neben Patienten, die sich einem orthopädischen Gelenkeingriff unterziehen, sind solche mit degenerativen und entzündlichen Gelenkerkrankungen, Kleinkinder, ältere Menschen, Immunsupprimierte und i. v. Drogenkonsumenten besonders gefährdet, an einer septischen Arthritis zu erkranken. Staphylococcus aureus ist der am häufigsten isolierte Erreger, gefolgt von Streptokokken. Die Diagnose stützt sich neben anamnestischen, klinischen, laborchemischen und bildgebenden Befunden wesentlich auf die mikroskopische und mikrobiologische Untersuchung des Gelenkpunktats, wobei die differenzialdiagnostische Abgrenzung gegen nichtinfektiöse Arthritiden im Einzelfall schwierig sein kann. Die Therapie wird bei hinreichendem klinischem Verdacht auch vor Keimnachweis begonnen und besteht in einer zunächst kalkulierten, dann erregerspezifischen antibiotischen Therapie sowie einer Drainage des Gelenkergusses. In Deutschland ist die operative, in der Regel arthroskopische Gelenkspülung die Therapie der Wahl, wenngleich eine Überlegenheit gegenüber repetitiven Gelenkaspirationen nicht gezeigt werden konnte.

Nicht abschließend geklärt sind weiterhin das optimale antibiotische Regime hinsichtlich Art, Applikationsweg und Dauer der antibiotischen Therapie und die Bedeutung einer additiven Kortikoidtherapie zur Modulation der überschießenden Immunantwort.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2byyJEN
via IFTTT

Transanale Bergung vs. Minilaparotomie

Zusammenfassung

Hintergrund

In den letzten Jahren entwickelten sich die klassischen minimalinvasiven Operationsverfahren zur Kolonresektion immer weiter. Ziel ist die Verringerung bzw. Vermeidung einer Bauchdeckenverletzung mit weniger postoperativen Schmerzen, einer schnelleren Rekonvaleszenz und einer besseren Ästhetik. Ein aktueller Ansatz ist die totale laparoendoskopische Operation des linksseitigen Kolons (total laparoendoscopic colectomy, LEC) mit transanaler Präparatebergung. Das Ziel unserer Untersuchung war der Vergleich der LEC mit der konventionellen OP (laparoscopic assisted surgery; LAS) mit Bergeschnitt.

Methodik

Es wurden 168 Patienten (LEC:112, LAS:56) mit Divertikelerkrankungen, Rektumprolaps sowie benigne und maligne Tumoren konsekutiv eingeschlossen und retrospektiv ausgewertet. Das Präparat wurde bei der LEC mit einem speziell entwickelten Rektoskop transanal geborgen, bei der LAS wurde eine Minilaparotomie von 5 cm durchgeführt. Der primäre Endpunkt war der postoperative Schmerz; sekundäre Endpunkte waren Operationszeit, peri- und postoperative Komplikationen, die Anzahl und Länge der Präparate, zusätzlicher Analgetikabedarf und Krankenhausverweildauer.

Ergebnisse

Der postoperative Schmerzscore (VAS) unterschied sich nicht signifikant zwischen den Behandlungsgruppen; jedoch war bei den LAS-Patienten eine zusätzliche Schmerzmedikation notwendig (p < 0,001). Die mediane Operationszeit für die LEC (120 min) war aufgrund der Lernkurve etwas länger als bei der LAS (100 min); reduzierte sich aber bei den letzten 50 LEC-Operationen auf 95 min. Die Krankenhausverweildauer war bei der LEC-Gruppe (6 Tage) einen Tag kürzer (p = 0,003). Komplikationsraten unterschieden sich nicht.

Diskussion

Die totale laparoendoskopische Operation des linksseitigen Kolons mit transanaler Bergung vermeidet eine Minilaparotomie und deren Morbiditäten. Die LEC-Operation ist für eine größere Patientenanzahl, einschließlich übergewichtiger Patienten, gut durchführbar. Die gezeigten Vorteile dieser Methode, wie reduzierter Analgetikaverbrauch, kürzere Krankenhausverweildauer und schnellere Rekonvaleszenz, müssen durch randomisiert-kontrollierte Studien mit längerem Follow-up bestätigt werden.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bTEycP
via IFTTT

Gastric pull-up reconstruction after treatment for advanced hypopharyngeal and cervical esophageal cancer

Publication date: Available online 29 August 2016
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): Y. Marion, G. Lebreton, C. Brévart, T. Sarcher, A. Alves, E. Babin
ObjectivesIn advanced hypopharyngeal and cervical esophageal carcinoma, the choice of reconstruction technique after total circumferential pharyngolaryngectomy (TCPL) remains controversial. We studied results of digestive tract reconstruction using gastric pull-up, concomitant or secondary to TCPL or after failure of reconstruction.Material and methodsTwenty-four patients treated by gastric pull-up after TCPL for advanced hypopharyngeal or cervical esophageal carcinoma between December 1998 and January 2011 were retrospectively reviewed.ResultsTwo-year survival was 37.5% (n=9). Thirty-day mortality was 4.1% (n=1), but 3 more patients died before discharge. Perioperative morbidity was 54.1% (n=13), including 9 fistulas (37.5%). Seventeen patients (71%) recovered oral feeding.ConclusionGastric pull-up is an interesting reconstruction technique after TCPL with invasion of the esophageal mouth, allowing comfortable oral feeding, but with non-negligible morbidity and mortality. Long-term survival is not high, partly due to the unfavorable prognosis of advanced hypopharyngeal and cervical esophageal tumor. The present high rate of fistula raises doubts for this surgery as second-line reconstruction after primary failure.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c5WzD7
via IFTTT

Tympanosclerosis Presenting as Mass: Workup and Differential

Introduction. Tympanosclerosis is a commonly encountered entity within ENT clinics and primary care settings. Recognizing ear pathology is essential for correct management. Oftentimes the diagnosis is clear; however in certain cases further workup to rule out other more insidious disease processes is warranted. Case Report. We present a case of tympanosclerosis which presented as an ear mass without classic appearance of tympanosclerosis. Through imaging and biopsy the diagnosis of tympanosclerosis was made. The patient was treated surgically with good outcome. Discussion. Various ear pathologies, with different treatment algorithms, may present as clinically similar to one another. Differential diagnosis for this case included tympanosclerosis, cholesteatoma, or other middle ear masses. We review these entities and discuss their pathophysiology and implications on management.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8NEl0
via IFTTT

Nationwide epidemiological study of insomnia in Japan

Publication date: Available online 30 August 2016
Source:Sleep Medicine
Author(s): Osamu Itani, Yoshitaka Kaneita, Takeshi Munezawa, Kazuo Mishima, Maki Jike, Sachi Nakagome, Mikiko Tokiya, Takashi Ohida
BackgroundThis study was a nationwide epidemiological study of insomnia in Japan. It was conducted because very few studies on this topic have previously been performed for the general Japanese population.MethodsAn interview survey on symptoms of insomnia (difficulty initiating sleep, difficulty maintaining sleep with difficulty resuming sleep, and early morning awakening with difficulty resuming sleep) and daytime dysfunction was conducted on the general nationwide population in the winter (February) and summer (August) of 2008. Data from 2614 participants who provided valid responses (age range 20–95 years, valid response rate 54.2%) were analyzed.ResultsThe prevalence of difficulty initiating sleep, difficulty maintaining sleep with difficulty resuming sleep, and early morning awakening with difficulty resuming sleep was 8.3%, 5.8%, and 5.8%, respectively, in men, and 11.0%, 8.1%, and 7.4%, respectively, in women. The prevalence of insomnia was 12.2% in men and 14.6% in women, and the prevalence of insomnia with daytime dysfunction was 3.2% in men and 4.2% in women. The results of logistic regression analyses indicated that the factors aggravating insomnia for men were unemployment and having mental health issues, and for women they were being aged ≥70 years, completing fewer years of schooling, and having mental health issues. Seasonality and regionality in association with insomnia were also examined, but no significant associations were found.ConclusionIn the present survey, insomnia was defined by using criteria that were closer to the clinical diagnostic criteria (eg, coexistence of both difficulty resuming sleep and daytime dysfunction was considered). Therefore, it is believed that the results of this study were representative of the clinical actuality of insomnia in Japan.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8IrJC
via IFTTT

Brain imaging and networks in restless legs syndrome

Publication date: Available online 29 August 2016
Source:Sleep Medicine
Author(s): Giovanni Rizzo, Xu Li, Sebastiano Galantucci, Massimo Filippi, Yong Won Cho
Several studies provide information useful to our understanding of restless legs syndrome (RLS), using various imaging techniques to investigate different aspects putatively involved in the pathophysiology of RLS, although there are discrepancies between these findings.The majority of magnetic resonance imaging (MRI) studies using iron-sensitive sequences support the presence of a diffuse, but regionally variable low brain-iron content, mainly at the level of the substantia nigra, but there is increasing evidence of reduced iron levels in the thalamus. Positron emission tomography (PET) and single positron emission computed tomography (SPECT) findings mainly support dysfunction of dopaminergic pathways involving not only the nigrostriatal but also mesolimbic pathways. None or variable brain structural or microstructural abnormalities have been reported in RLS patients; reports are slightly more consistent concerning levels of white matter. Most of the reported changes were in regions belonging to sensorimotor and limbic/nociceptive networks. Functional MRI studies have demonstrated activation or connectivity changes in the same networks. The thalamus, which includes different sensorimotor and limbic/nociceptive networks, appears to have lower iron content, metabolic abnormalities, dopaminergic dysfunction, and changes in activation and functional connectivity. Summarizing these findings, the primary change could be the reduction of brain iron content, which leads to dysfunction of mesolimbic and nigrostriatal dopaminergic pathways, and in turn to a dysregulation of limbic and sensorimotor networks. Future studies in RLS should evaluate the actual causal relationship among these findings, better investigate the role of neurotransmitters other than dopamine, focus on brain networks by connectivity analysis, and test the reversibility of the different imaging findings following therapy.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bPDZBJ
via IFTTT

Impact of sleep on osteoporosis: Sleep quality is associated with bone stiffness index

Publication date: Available online 29 August 2016
Source:Sleep Medicine
Author(s): Nobuo Sasaki, Saeko Fujiwara, Hidehisa Yamashita, Ryoji Ozono, Kazushi Teramen, Yasuki Kihara
ObjectiveThe aim of the present study was to investigate the impact of sleep on osteoporosis.MethodsThe study used a baseline examination of the Hiroshima Sleep and Healthcare study, which was a cross-sectional and cohort study that addressed the association of sleep habits with lifestyle-related diseases. A total of 1032 participants (25−85 years of age) who underwent health examinations were included. Sleep habits, including its timing (bed time), quantity (time in bed [TIB]), and quality were assessed using the Pittsburgh Sleep Quality Index (PSQI). The bone stiffness index (SI), a marker of osteoporosis, was measured using quantitative ultrasound systems.ResultsBed time (r = 0.065, p < 0.05), TIB (r = −0.064, p < 0.05), and global PSQI score (r = −0.126, p < 0.0001) significantly correlated with SI. Multiple regression analyses revealed that after adjusting for age, sex, body mass index, smoking, and alcohol intake, the global PSQI score (β = −0.053, p < 0.05) was significantly associated with SI, whereas bed time or TIB was not. Among each component of PSQI, sleep disturbances (β = −0.084, p < 0.005) were significantly associated with SI.ConclusionPoor sleep quality may be associated with osteoporosis. In particular, increased sleep disturbances may be a key factor in the association between poor sleep quality and osteoporosis.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8Gxcj
via IFTTT

Sleep quality in temporomandibular disorder cases

Publication date: Available online 30 August 2016
Source:Sleep Medicine
Author(s): Ksenija Rener-Sitar, Mike T. John, Snigdha S. Pusalavidyasagar, Dipankar Bandyopadhyay, Eric L. Schiffman
ObjectiveThe aim of this study was to characterize self-reported sleep quality (SQ) in patients with temporomandibular disorder (TMD) and to compare their results with those of healthy controls.MethodsThe Pittsburgh Sleep Quality Index (PSQI) was used to measure SQ in a convenience sample of 609 TMD patients and 88 controls. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic nomenclature was used, but Axis I diagnoses were based on the consensus of two reliable criterion examiners and not the RDC/TMD algorithms. The PSQI scores for TMD patients were calculated also for the RDC/TMD Axis II measures assessing chronic pain and disability, depression, and nonspecific physical symptoms. PSQI scores of the TMD patients were compared with those from controls.ResultsTMD patients with 1 to 5 TMD diagnoses (n = 609) had a mean PSQI score of 7.0 (95% confidence interval [CI] = 6.7−7.4). In comparison, the mean score was 5.2 (95% CI = 4.6−5.9) for control subjects. For the subset of TMD patients with pain-free diagnoses (n = 113), the PSQI score was similar to controls with 5.1 (95% CI = 4.5−5.6), whereas it was significantly different for patients with pain-related diagnoses 7.5 (95% CI = 6.6−8.3; n = 87). Although the number of TMD diagnoses and participant age had some influence on SQ, psychosocial status and pain-related impairment assessed with RDC/TMD Axis II measures had the strongest association with SQ, in particular, dysfunctional chronic pain.ConclusionSQ is impaired in TMD patients with pain-related diagnoses, and even more in those with dysfunctional pain. This relationship between sleep and pain suggests that SQ should be assessed in TMD pain patients, especially in those with significant Axis II involvement.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8GWey
via IFTTT

Notch1 regulates invasion and metastasis of head and neck squamous cell carcinoma by inducing EMT through c-Myc

As 50% of patients of head and neck squamous carcinoma (HNSCC) exhibit poor prognosis, the identification of new therapeutic targets is required. Recently, there have been several reports about the correlation between Notch1 and HNSCC, but the precise mechanism is still obscure. Therefore, in this study, we examined the involvement of Notch1 in HNSCC by using HNSCC cell lines and surgical specimens.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bCUs8J
via IFTTT

Mano-videoendoscopic assessment in the evaluation of the pharyngeal contraction and upper esophageal sphincter function in dysphagic patients

Mano-videoendoscopy (MVE) is a manometry technique with endoscopic confirmation of the pressure catheter. This study aimed to investigate the possibility of replacing a videofluorographic swallowing study (VFSS) with MVE for the precise evaluation of the pharyngeal contraction and the upper esophageal sphincter (UES) function.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bz8ICf
via IFTTT

Prospective study of treatment outcomes with lag screw versus Herbert screw fixation in mandibular fractures

The principle of axial compression for better adaptation of fracture segments, with the advantage of increased stability and early function, is a promising means of avoiding the bulky rigid plates used previously. This study was done to compare the treatment outcomes between Herbert screw and lag screw fixation in mandibular fractures. Thirty patients with oblique displaced or undisplaced mandibular fractures requiring open reduction and internal fixation with rigid screw fixation, under general anaesthesia, were included.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cc6MRR
via IFTTT

Immediate Effects of the Vocal Function Exercises Semi-Occluded Mouth Posture on Glottal Airflow Parameters: A Preliminary Study

The study aimed to quantify immediate alterations in the airflow glottogram between the Vocal Function Exercises semi-occluded mouth posture (/ol/ with lip buzz) and the sustained vowel /o/ in individuals with normal voices, and to determine if noted changes were in agreement with established semi-occluded vocal tract aerodynamic theory. Based on semi-occluded vocal tract aerodynamic theory, we hypothesized the following immediate changes in the flow glottogram during the /ol-buzz/ condition: a greater open quotient, a greater skewing quotient, a greater maximum flow declination rate, increased average airflow, decreased peak airflow, and increased minimum airflow.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2cc5CFS
via IFTTT

Voice Therapy Effect on Mutational Falsetto Patients: A Vocal Aerodynamic Study

The study aims to evaluate the effectiveness of voice therapy (VT) and analyze the vocal aerodynamic characteristics in mutational falsetto (MF) patients.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c2mzAN
via IFTTT

m-TOR inhibitor as potential radiosensitizer for head and neck squamous cell carcinoma: A case report of an organ transplant patient and review of the literature

We report here a case of severe and unusual skin toxicity in a patient treated with a combination of radiation therapy and cetuximab and concurrently receiving sirolimus (m-tor inhibitor) for renal transplant.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8f5ew
via IFTTT

Normalizing Microbiota-Induced Retinoic Acid Deficiency Stimulates Protective CD8 T Cell-Mediated Immunity in Colorectal Cancer

All-trans-retinoic acid (atRA) plays crucial roles in shaping intestinal immunity. Bhattacharya et al. show that, in the context of colon cancer, microbiota-induced intestinal inflammation alters atRA metabolism, leading to a colonic atRA deficit and exacerbation of colon carcinogenesis. atRA supplementation ameliorates colon carcinogenesis in a CD8+ T cell-dependent manner.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bCHdF4
via IFTTT

Hematopoietic Stem Cells Are the Major Source of Multilineage Hematopoiesis in Adult Animals

The role of hematopoietic stem cells (HSCs) in steady-state hematopoiesis remains controversial. Here, Sawai et al. use lineage tracing to reveal a major contribution of HSCs to all blood cell lineages, including myeloid cells and lymphocytes, throughout adult life.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2byZ9mR
via IFTTT

Facial expression drawings and the full cup test: valid tools for the measurement of swelling after dental surgery

Assessment of postoperative swelling is subjective and depends on the patient's opinion. The aim of this study was to evaluate the validity of facial expression drawings and the full cup test and to compare their performance with that of other scales in measuring postoperative swelling. Fifty patients who had one of several procedures were included. All patients were asked to fill in a form for six days postoperatively (including the day of operation) that contained four scales to rate the amount of swelling: facial expression drawings, the full cup test, the visual analogue scale (VAS), and the verbal rating scale (VRS).

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bCJU9C
via IFTTT

Mediastinal abscess and empyema complicating an odontogenic infra-temporal fossa abscess

Odontogenic infection can spread through fascial planes into adjacent anatomical spaces. Spread to the mediastinum is rare but well-described and may be associated with thoracic empyema1,2 and mortality from mediastinal spread is thought to be around 30% to 40%.3 Our patient developed a mediastinal abscess and empyema from an odontogenic abscess of the infratemporal fossa.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2bz0U3s
via IFTTT

Different cognitive functions discriminate gait performance in younger and older women: A pilot study

Publication date: October 2016
Source:Gait & Posture, Volume 50
Author(s): Joaquin U. Gonzales, C. Roger James, Hyung Suk Yang, Daniel Jensen, Lee Atkins, Brennan J. Thompson, Kareem Al-Khalil, Michael O'Boyle
AimCognitive dysfunction is associated with slower gait speed in older women, but whether cognitive function affects gait performance earlier in life has yet to be investigated. Thus, the objective of this study was to test the hypothesis that cognitive function will discriminate gait performance in healthy younger women.MethodsFast-pace and dual-task gait speed were measured in 30 young to middle-aged (30–45y) and 26 older (61–80y) women without mild cognitive impairment. Visuoperceptual ability, working memory, executive function, and learning ability were assessed using neuropsychological tests. Within each age group, women were divided by the median into lower and higher cognitive function groups to compare gait performance.ResultsYounger women with higher visuoperceptual ability had faster fast-pace (2.25±0.30 vs. 1.98±0.18m/s, p≤0.01) and dual-task gait speed (2.02±0.27 vs. 1.69±0.25m/s, p≤0.01) than women with lower visuoperceptual ability. The difference in dual-task gait speed remained significant (p=0.02) after adjusting for age, years of education, and other covariates. Dividing younger women based on other cognitive domains showed no difference in gait performance. In contrast, working memory and executive function discriminated dual-task gait speed (p<0.05) in older women after adjusting for age and education.ConclusionTo our knowledge, this is the first study to show that poorer cognitive function even at a relatively young age can negatively impact mobility. Different cognitive functions discriminated gait performance based on age, highlighting a possible influence of aging in the relationship between cognitive function and mobility in women.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c8jq1r
via IFTTT

Programmed cell death in periodontitis: recent advances and future perspectives

Abstract

Periodontitis is a highly prevalent infectious disease, characterized by destruction of the periodontium, and is the main cause of tooth loss. Periodontitis is initiated by periodontal pathogens, while other risk factors including smoking, stress, and systemic diseases aggravate its progression. Periodontitis affects many people worldwide, but the molecular mechanisms by which pathogens and risk factors destroy the periodontium are unclear. Programmed cell death (PCD), different from necrosis, is an active cell death mediated by a cascade of gene expression events, and can be mainly classified into apoptosis, autophagy, necroptosis, and pyroptosis. Although PCD is involved in many inflammatory diseases, its correlation with periodontitis is unclear. After reviewing the relevant published articles, we found that apoptosis has indeed been reported to play a role in periodontitis. However, the role of autophagy in periodontitis needs further verification. Additionally, implication of necroptosis or pyroptosis in periodontitis remains unknown. Therefore, we recommend future studies, which will unravel the pivotal role of PCD in periodontitis, allowing us to prevent, diagnose, and treat the disease, as well as predict its outcomes.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c5t5VY
via IFTTT

Speech rhythm in Kannada speaking adults who stutter

.

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c5oIua
via IFTTT

Motivational Interviewing With Focus on Diet and Weight Gain in Pregnant Women With Type 2 Diabetes

Conditions: Type 2 Diabetes; Pregnancy
Intervention: Behavioral: Motivational interviewing
Sponsors: Rigshospitalet, Denmark; Odense University Hospital
Recruiting - verified August 2016

from #ENT via xlomafota13 on Inoreader http://ift.tt/2c5n2AJ
via IFTTT