Eldecalcitol, an Active Vitamin D 3 Derivative, Prevents Trabecular Bone Loss and Bone Fragility in Type I Diabetic Model Rats

Abstract

Diabetes mellitus is known to adversely affect the bones and be associated with increased fracture risk. We examined whether eldecalcitol (ELD), an active vitamin D₃ derivative, could inhibit the diabetic bone loss in streptozotocin-induced type I diabetic rats. ELD (10, 20, or 40 ng/kg), alfacalcidol (ALF; 25, 50, or 100 ng/kg), or vehicle was administered 5 times per week for 12 weeks from 1 week after diabetes induction. Normal control rats received the vehicle. Bone turnover markers, bone mineral density (BMD), and biomechanical strength of the lumbar spine and femur were measured, and bone histomorphometry was performed. Content of advanced glycation end products (AGEs) in the femoral shaft was also determined. In diabetic rats, serum osteocalcin (OC) concentration was lower and urinary excretion of deoxypyridinoline (DPD) tended to be higher than in normal rats. Areal BMD and maximum load of the lumbar vertebrae and femoral shaft were lower in diabetic rats than in normal rats. All doses of ELD and the highest dose of ALF reduced urinary DPD excretion, but had no effect on serum OC. The 20 and 40 ng/kg doses of ELD prevented decreases in BMD and the highest dose of ELD prevented the reduction in maximum load of the lumbar vertebrae, while ALF did not change these parameters. ELD and ALF did not affect areal BMD or biomechanical strength of the femoral shaft. In diabetic rats, bone volume and trabecular thickness in the trabecular bone of the lumbar vertebrae decreased and trabecular separation increased compared to normal rats. ELD and ALF prevented diabetes-induced deterioration of trabecular microstructure. AGE content in the femoral cortical bone increased in the diabetic rats, and ELD and ALF did not change AGE content compared to the diabetic rats. These results indicated that ELD suppressed bone resorption and prevented trabecular bone loss and deterioration of trabecular microstructure, resulting in prevention of reduction in biomechanical strength in type I diabetic rats.

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Nokia FP4: ecco il nuovo processore di rete più veloce di sempre - Hardware upgrade.it

Nokia FP4: ecco il nuovo processore di rete più veloce di sempre Hardware upgrade.it Il nuovo Nokia PF4 è il risultato di anni di ingegneria e di ricerca e gli sviluppatori della casa madre hanno sfruttato i più recenti progressi in termini di design multi-dimensionale. Ecco che il nuovo FP4 offre anche molte innovazioni ...

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Towards ageing well: Use it or lose it: Exercise, epigenetics and cognition

Abstract

More and more people are living into the 90s or becoming centenarians. But, the gift of increased 'age span' seldom equates with an improved 'health-span'. Governments across the world are expressing concern about the epidemic of chronic disease, and have responded by initiating policies that make prevention, reduction and treatment of chronic disease, a public health priority. But understanding, how to age long and well, with the avoidance of chronic disease and later life complex disease morbidity is challenging. While inherited genes have an undoubted role to play in the chance of maintaining good health or conversely a predilection to developing disease and chronic ill health, there is increasing evidence that behavioural and environmental life-style choices may contribute up to 50% of the variability of human lifespan. Physical exercise is readily available to everyone, and is a simple cheap and effective form of life-style intervention. Exercise appears to help maintain good health and to reduce the risk of developing chronic disease and ill health. Evidence suggests that physical activity improves well-being across many health domains through out life, continues to offer important health benefits in older age groups and tracks with a 'healthy ageing' profile. Although many of the molecular pathways remain to be fully identified, here we discuss how physical activity and exercise is understood to produce changes in the human epigenome, which have the potential to enhance cognitive and psychological health, improve muscular fitness, and lead to better ageing with improved quality of life in older age.

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Are juvenile criminal justice statistics comparable across countries? A study of the data available in 45 European nations

Abstract

This article analyses the data on minors included in the police, prosecution, conviction, prison and probation statistics of 45 European nations in 2010, which were collected in the European Sourcebook of Crime and Criminal Justice Statistics. The main conclusions of the analysis are that comprehensive juvenile justice statistics are seldom available and that the existing data are hardly comparable across countries. The article identifies the main reasons that hamper the comparability: The definition of minors is not harmonized, the rules applied for the construction of the statistics are not the same, and there are differences in the legal procedures foreseen for minors as well as on the type of sanctions that can be imposed to them. As a consequence, European juvenile justice statistics do not provide valid comparable information on the extent of juvenile delinquency, and their reliability as indicators of the social reaction to it is doubtful.

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Kohli's tongue-out gesture from yesterday's match turned into a hilarious meme - Times of India

Times of India

Kohli's tongue-out gesture from yesterday's match turned into a hilarious meme Times of India It happened during 36th over of Bangladesh's innings when Kolhi took Mushfiqur Rahim's catch and then gave him an animated send-off by sticking his tongue out. ... But Kohli should be reminded of Mike Douglas who got oral cancer because ... Read ...

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On this day: June 16 - KEYT - KEYT

KEYT	On this day: June 16 - KEYT KEYT The first roller coaster in the U.S. opens, a Soviet cosmonaut becomes the first woman in space, and the Monterey Pop Festival begins, all on this day. and more »

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Discriminative self-representation sparse regression for neuroimaging-based alzheimer’s disease diagnosis

Abstract

In this paper, we propose a novel feature selection method by jointly considering (1) 'task-specific' relations between response variables (e.g., clinical labels in this work) and neuroimaging features and (2) 'self-representation' relations among neuroimaging features in a sparse regression framework. Specifically, the task-specific relation is devised to learn the relative importance of features for representation of response variables by a linear combination of the input features in a supervised manner, while the self-representation relation is used to take into account the inherent information among neuroimaging features such that any feature can be represented by a weighted sum of the other features, regardless of the label information, in an unsupervised manner. By integrating these two different relations along with a group sparsity constraint, we formulate a new sparse linear regression model for class-discriminative feature selection. The selected features are used to train a support vector machine for classification. To validate the effectiveness of the proposed method, we conducted experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset; experimental results showed superiority of the proposed method over the state-of-the-art methods considered in this work.

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Systematic Review of Diagnostic Criteria Used in Atopic Dermatitis Randomized Controlled Trials

Abstract

Background

Numerous diagnostic criteria for atopic dermatitis are used in clinical trials, which may limit comparison of results.

Objective

We sought to determine the most commonly used atopic dermatitis diagnostic criteria in randomized controlled trials internationally.

Methods

We performed a systematic review of randomized controlled trials with a pharmacological intervention from 2007 to 2016. Cochrane Library, EMBASE, GREAT, LILACS, MEDLINE, and Scopus were searched. Two authors independently performed the study selection and data extraction.

Results

Two hundred and twelve randomized controlled trials met inclusion/exclusion criteria. Overall, ten different diagnostic criteria were used. The Hanifin and Rajka criteria were most commonly used (41.0%), followed by the UK refinement of the Hanifin and Rajka criteria (9.0%), Japanese Dermatological Association criteria (4.2%), and American Academy of Dermatology criteria (3.8%). No diagnostic criteria were specified in 37.3% of randomized controlled trials. The Hanifin and Rajka criteria were the most commonly used atopic dermatitis diagnostic criteria in clinical trials of topical and systemic interventions, across all years between 2007 and 2016, in pediatric and adult populations, in most countries and regions internationally.

Conclusions

The results highlight the lack of uniformity and documentation of atopic dermatitis diagnostic criteria in randomized controlled trials for atopic dermatitis. We recommend harmonizing the diagnostic criteria for atopic dermatitis in future randomized controlled trials.

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General Anesthesia and Young Brain: What is New?.

Considering that growing population of very young children is exposed to general anesthesia every year, it is of utmost importance to understand how and whether such practice may affect the development and growth of their very immature and vulnerable brains. Compelling evidence from animal studies suggests that an early exposure to general anesthesia is detrimental to normal brain development leading to structural and functional impairments of neurons and glia, and long-lasting impairments in normal emotional and cognitive development. Although the evidence from animal studies is overwhelming and confirmed across species examined from rodents to non-human primates, the evidence from human studies is inconsistent and not conclusive at present. In this review we focus on new developments in animal studies of anesthesia-induced developmental neurotoxicity and summarize recent clinical studies while focusing on outcome measures and exposure variables in terms of their utility for assessing cognitive and behavioral development in children. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved

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Mast cells modulate proliferation, migration and stemness of glioma cells through downregulation of GSK3β expression and inhibition of STAT3 activation

Publication date: September 2017
Source:Cellular Signalling, Volume 37
Author(s): Sanaz Attarha, Ananya Roy, Bengt Westermark, Elena Tchougounova
Glioblastoma (GBM) heterogeneity is the main obstacle to efficient treatment due to the existence of subpopulation of cells with increased tumorigenicity and network of tumor associated parenchymal cells in the tumor microenvironment. We previously demonstrated that mast cells (MCs) infiltrate mouse and human gliomas in response to variety of signals in a glioma grade-dependent manner. However, the role of MCs in glioma development and the mechanisms behind MCs-glioma cells interaction remain unidentified.In the present study, we show that MCs upon activation by glioma cells produce soluble factors including IL-6, which are documented to be involved in cancer-related activities. We observe 'tumor educated' MCs decrease glioma cell proliferation and migration, reduce self-renewal capacity and expression of stemness markers but in turn promote glioma cell differentiation. 'Tumor educated' MC derived mediators exert these effects via inactivation of STAT3 signaling pathway through GSK3β down-regulation. We identified 'tumor educated' MC derived IL-6 as one of the contributors among the complex mixture of MCs mediators, to be partially involved in the observed MC induced biological effect on glioma cells.Thus, MC mediated abolition of STAT3 signaling hampers glioma cell proliferation and migration by suppressing their stemness and inducing differentiation via down-regulation of GSK3β expression. Targeting newly identified inflammatory MC-STAT3 axis could contribute to patient tailored therapy and unveil potential future therapeutic opportunities for patients.



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Systematic identification and characterization of miRNAs and piRNAs from porcine testes

Abstract

microRNAs (miRNAs) and PIWI-interacting RNAs (piRNAs) execute important regulatory roles in testis development and spermatogenesis, while previous studies mainly focus on the expression profiles in immature and mature porcine testes, which may cause a bottleneck for further understanding their complex physiological processes in porcine testes development and spermatogenesis. Thus, we presented the expression and characterization of miRNAs and piRNAs in DS (60-day-old), DN (90-day-old), DT (120-day-old) and DF (150-day-old) pig testes. In total, 12,834,628, 13,359,726, 12,851,249 and 12,938,601 clean reads were generated from these libraries, respectively. 293 mature and 36 novel miRNAs as well as 4923 piRNA clusters were identified from pig testes, and they showed an age-dependent manner. GO enrichment analysis of miRNA target genes and piRNA generated genes showed that they participated widely in regulating the pig spermatogenesis process. In addition, 12 differentially expressed miRNAs were randomly selected to validate using qRT-PCR. Our results provided novel comprehensive expression profiles of miRNAs and piRNAs in pig testes at different stages of sexual maturity, which will promote our knowledge of them in regulating the pig testes development and spermatogenesis process.

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Identification and comparative analysis of the pearl oyster Pinctada fucata hemocytes microRNAs in response to Vibrio alginolyticus infection

Abstract

MicroRNAs (miRNAs) are a class of noncoding RNA molecules that function as negative regulators of gene expression and play important roles in a wide spectrum of biological processes, including in immune response. However, the physiological regulation function of Pinctada fucata miRNAs, specially their immunomodulation has not been explored yet. Here, two small RNA libraries from hemocytes of P. fucata with or without Vibrio alginolyticus infection were constructed and sequenced using the high-throughput Illumina deep sequencing technology. In total, 11,939,992 and 11,083,327 raw reads, corresponding to 10,993,546 and 9,988,179 clean reads, were respectively obtained in the control and infected libraries. A total of 276 miRNAs, including 225 known miRNAs and 51 putative novel miRNAs, were identified by bioinformatic analysis. By using pairwise comparison between two libraries, 93 miRNAs were found to be significantly differentially expressed, with 42 and 51 miRNAs exhibiting up-regulation and down-regulation, respectively. Thereinto, some known miRNAs were considered to be immune-related. Real-time PCR were implemented for 6 miRNAs co-expressed in the control and infected samples, and agreement was confirmed between the high-throughput sequencing and real-time PCR data. After miRNA targets were predicted, GO and KEGG pathway enrichment analysis were performed, and the results indicated that ten of the differentially expressed miRNAs were involved in immune-related pathways, and might participate in the host immune response to V. alginolyticus. These results of identification and comparative analysis of miRNAs might deepen our understanding of host-pathogen interactions and immune defense mechanisms in P. fucata.

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Genome-wide analysis of the PHB gene family in Glycine max (L.) Merr.

Abstract

Prohibitins (PHBs) have one SPFH domain in common and present in species ranging from prokaryotes to eukaryotes. Although a number of researches on PHBs were performed in different plant species, a systematic analysis of the PHB family in soybean is still remains uncharacterized. In the present study, 24 putative PHB genes have been first systemically identified in soybean. According to phylogenetic analysis, these GmPHBs could be classified into four groups. Gene structures and motif patterns showed high levels of conservation within the phylogenetic subgroups. Several members of this family have undergone purifying selection based on Ka/Ks analysis on duplicated PHB genes in soybean. We performed microsynteny analysis across four legume species based on the comparisons among the specific regions contained in PHB genes. As a result, numerous microsyntenic gene pairs among soybean, Medicago, Lotus and Phaseolus were identified. Most soybean PHB genes exhibited different expression levels in various tissues and developmental stages through expression analysis using publicly available RNA-seq datasets. The 11 GmPHB genes from III_B subgroup were examined by qPCR for their expression in two soybean cultivar after infection by Phytophthora sojae. Besides three GmPHB genes previous reported by us, here other four genes also were rapidly induced by P. sojae infection in the resistant genotype, while induction was very weak in the susceptible genotype. The comprehensive overview of the PHB gene family in soybean genome will provide useful information for further functional analysis of the PHB gene family in soybean.

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Gender- and Sport-Specific Associations Between Religiousness and Doping Behavior in High-Level Team Sports

Abstract

Religiousness is known to be specifically associated with substance abuse, but there is an evident lack of studies investigating the association between religiousness and doping behavior as a specific type of substance abuse in athletes. This study aimed to provide evidence for possible gender- and sport-specific associations between religiousness and doping behavior among team-sport athletes of both genders. The participants were 886 athletes (21.9 ± 3.8 years of age; 352 females) involved in four sports: volleyball (n = 154; 78 females), handball (n = 206; 68 females), soccer (n = 316; 110 females) and basketball (n = 230; 96 females) from Croatia and Slovenia (all traditionally Roman Catholics). The data were collected using a previously validated structured questionnaire that examined sociodemographic, sport- and doping-related factors. In addition, religiousness was captured by the Santa Clara Strength of Religious Faith questionnaire (SCSRF). Gender-stratified simple logistic regressions were applied to determine associations between covariates and doping behavior (criterion). There was no significant difference in potential doping behavior between males and females (OR 1.06, 95 % CI 0.76–1.46), while females reported higher religiousness (SCSRF: 23.11 ± 3.23 and 25.46 ± 7.2 for males and females, respectively; t test = 1.82, p < 0.05). Younger female athletes and those with higher SCSRF score are found to be less prone to doping behavior. When models were adjusted for personal opinion about doping presence in sport and age, the SCSRF remained a significant predictor of potential doping behavior (OR 0.95, 95 % CI 0.91–0.99). For males, the belief that doping was present in sport was strongly associated with a higher likelihood of doping. Our results suggest that highly religious females involved in three of the studies sports (i.e., volleyball, handball and basketball) show a weaker tendency toward doping. Meanwhile, there is no evidence that religiousness influences doping behavior among male team-sport athletes. Therefore, sport-specific and gender-specific approach in studying possible relationships that exist between religiousness and different types of misusing substances in sport is warranted.

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Health Impacts of Religious Practices and Beliefs Associated with The Church of Jesus Christ of Latter-Day Saints

Abstract

The aim of the study is to discuss the relationship between lifestyle marked by The Church of Jesus Christ of Latter-day Saints and health. PubMed, CINAHL, PsycINFO, WOS y Scopus were the databases used for this literature review, with these descriptors: "Mormons", "mormons religion", "health". Inclusion criteria were articles with full text available, published between 2005 and 2016, in English or Spanish language. Results show that following the restrictive Mormon doctrine generates beneficial effects for the health. Habits related to toxics and food, as well as social support, from family and Mormon community are an important basis for good health. On the other hand, not following the prescriptions or leaving the group, opposed sexual identities or not fulfilling the roles associated with women are associated with worse mental and physical health.

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The Relationship Between the Religious Beliefs of the Diabetic Patients and Depression in a Diabetes Clinic in Iran

Abstract

Nowadays, diabetes is prevalent, and it can leave severe psychotic effects and causes depression; thus, it is necessary to consider effective factors to fight against diabetic patients' mental conditions. It seems that the role of religion is significant, and by augmenting religious attitudes, diabetic patient's depression intensity can be decreased. The purpose of the present study is to examine the relationship between religious beliefs and depression of diabetic patients in diabetes clinic of Ali Asghar Hospital in Zahedan. This is a descriptive analytical and cross-sectional study. Out of total 350 diabetic patients, 70 were selected by easy sampling method. Data gathering tool was Bach's religious beliefs and depression standard questionnaires. K² statistical test and Pearson's correlation index have been used for data analysis. SPSS software version 16 was used to analyze the data. The results of the study showed that there was not any relationship among age, sex, education, illness duration and family member's history of depression and depression. Results of the study showed that stronger religious beliefs decrease the depression severity (P < 0.001). Therefore, it is necessary to strengthen patient's religious attitudes by proper plans to decrease depression, and some strategies are presented in the study for these plans.

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Spiritual Well-Being and Spiritual Distress in Cancer Patients Undergoing Chemotherapy: Utilizing the SWBQ as Component of Holistic Nursing Diagnosis

Abstract

Holistic nursing care requires attention to the spiritual dimension. This is particularly important when caring for patients with cancer. This research presents the results of the assessment of spiritual well-being using the Spiritual Well-Being Questionnaire (SWBQ) to validate the nursing diagnosis of spiritual distress. Structured interviews were conducted with 169 patients in one hospital in Portugal. We concluded that the SWBQ is a useful and reliable instrument to assess spiritual distress, which highlights the importance of listening to patients and questioning them about spiritual needs as well as the importance of differential diagnosis aimed at effective interventions.

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Role of Religiosity in Psychological Well-Being Among Medical and Non-medical Students

Abstract

Religion has been generally considered as a protective factor for the psychological health of the people. As many studies have publicized a high prevalence of psychological morbidities among the medical students during their academic stages of medical schools, it is significant to investigate whether religiosity functions as a protective factor, to explore religiosity as a predictor of psychological well-being in a sample of medical students, and to compare the results of medical students as well as non-medical students with respect to religiosity and psychological well-being. The study is carried out in Federal Medical and Dental College and International Islamic University, Islamabad. The present study examined a sample of 120 medical students from Federal Medical and Dental College and 120 non-medical students from International Islamic University, Islamabad. Purposive sampling was used. The respondents completed religious orientation scale and scale of psychological well-being scale along with a demographic data sheet. In order to measure the study variables, linear regression and t test were used. The findings revealed that religiosity is a strong predictor of psychological well-being. Extrinsic and intrinsic religiosity predicts psychological well-being among the students. The results indicated a significant difference in psychological well-being between medical and non-medical students. No significant difference was found in religiosity of medical and non-medical students. The gender differences in religiosity and psychological well-being were found to be insignificant. The results emphasize that psychological well-being is prophesied by religiosity. The present research suggests further investigations and also endows with trends for psychological evaluation, development of religious beliefs, and interventions for augmenting psychological well-being among the medical students.

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Psychometric Evaluation of the Filipino Versions of the Duke University Religion Index and the Spiritual Coping Strategies Scale in Filipino Hemodialysis Patients

Abstract

This study evaluated the psychometric properties of the Filipino versions of the Duke University Religion Index (DUREL-F) and the Spiritual Coping Strategies scale (SCS-F) for hemodialysis (HD) patients in the Philippines. A convenient sample of 162 HD patients was included in this descriptive, cross-sectional study. The DUREL-F and SCS-F exhibited acceptable internal consistency and stability reliability, as well as excellent content and construct validity. The findings confirmed the soundness of the psychometric properties of the two scales. Thus, they can be used for timely and accurate assessment of religiosity and spiritual coping utilization among Filipino patients receiving HD.

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“One Big Family”: Pastoral Care and Treatment Seeking in an Egyptian Coptic Church in England

Abstract

Little is known about Coptic migrants' chronic disease health beliefs and treatment-seeking behaviours. Interviews to explore these issues and their relationship with church membership were conducted with 15 Coptic migrants in Southern England. Obesity and cardiovascular disease (CVD) were most frequently identified as health risks for Coptic migrants. CVD was ascribed to stress and considered amenable to spiritual healing. Lay referral to medical practitioners who were church members was common but may devalue perceptions of family medicine. The Coptic Church functions as a community that addresses members' wider vulnerability. Central to this is the "parish nurse" role of the priest.

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Spirituality and Religiosity and Its Role in Health and Diseases

Abstract

Religiosity is a factor involved in the management of health and diseases/patient longevity. This review article uses comprehensive, evidence-based studies to evaluate the nature of religiosity that can be used in clinical studies, thus avoiding contradictory reports which arise from misinterpretation of religiosity. We conclude that religiosity is multidimensional in nature and ultimately associated with inherent protection against diseases and overall better quality of life. However, a number of untouched aspects of religiosity need to be investigated further before we can introduce religiosity in its fully functional form to the realm of health care.

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The Association Between Muslim Religiosity and Young Adult College Students’ Depression, Anxiety, and Stress

Abstract

Depression, anxiety, and stress are among major psychological disorders being predominant in present day. This study proposed to analyze the role of Muslim religiosity in male students showing these mental indications. A sample including 723 Pakistani young adults enrolled at college level was randomly chosen. Muslim Religiosity Measurement Scale and Depression, Anxiety and Stress Scale were utilized to gather information. Discoveries uncover an inverse relationship between conduct and affiliation with the symptoms of mental disorders, anxiety and stress among the respondents. Results bolster the incorporation of religious dimensions in psychological wellness and mental well-being thought of young adults in Pakistan.

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“No More Buzz”: A Qualitative Study of the Current Response to HIV in the Anglican Church in the Western Cape, South Africa

Abstract

Using a triangulation design combining participant observation, survey results, and interviews, this paper studies the current form of the response to HIV in the local Anglican Church in the Western Cape, South Africa. The results show that people are generally aware of HIV. The "buzz" around HIV has, however, subsided. The local church does not directly engage HIV anymore, and HIV is more mentioned than talked about. HIV stigma continues to pose a challenge. To work towards the prevention of HIV, the local church needs to put HIV back on the agenda and continue to speak about the virus.

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On the Inner Life of Physicians: Analysis of Family Medicine Residents’ Written Reflections

Abstract

This qualitative study introduces the broad and inclusive concept of the "inner life of physicians" and analyzes the written reflections (N = 756) of family medicine residents (N = 33) during their residency as indicative of the physicians' inner lives. Residents completed reflective entries without specific prompts. Researchers describe unsolicited emergent categorical themes indicative of a robust inner life of the physician. Nurturing physicians' inner life through reflection allows physicians to recognize, identify, and respond to daily emotional events. Reflections about the state of physicians' inner lives can formulate and express fundamental human questions that concern: (a) troubling human experiences (e.g., suffering, death, luck, destiny, and death); (b) questions that surface in practicing their profession; (c) spiritually explicit questions on their beliefs and practices. Physicians' inner lives can become a "place" where physicians look for answers and explore options for dealing with their human and professional challenges, thus enhancing the humanistic aspects of medical practice.

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Religion and Happiness: A Study Among University Students in Turkey

Abstract

This study tests the hypothesis that higher levels of positive religious affect are associated with higher levels of personal happiness among a sample of 348 students studying at a state university in Turkey who completed the Ok Religious Attitude Scale (Islam), the Oxford Happiness Inventory, and the short-form Eysenck Personality Questionnaire Revised. The data reported a small but statistically significant association between religiosity and happiness after taking sex and individual differences in personality into account.

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The Role of Existential Beliefs Within the Relation of Centenarians’ Health and Well-Being

Abstract

The purpose of this study was to explore the role of existential beliefs in mediating the influence of health on centenarians' well-being. A total of 80 centenarians (mean age 101.1; SD = 1.3; 81.3 % women) with no/minor cognitive impairment were included. The OARS questionnaire for diseases and functional capacity (ADL, IADL), the Satisfaction with Life Scale, and the existential beliefs subscale were used for data collection. The findings suggest that existential resources are a crucial element for mitigating the impact of health constraints in subjective well-being in this population. Appropriate models of intervention for very old age that recognize the importance of religion, spirituality, and meaning of life are to be considered.

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Perceptions of Chaplains’ Value and Impact Within Hospital Care Teams

Abstract

Many scholars have written about the role of spirituality in health care. One mechanism for incorporating spirituality into the care of patients is to integrate clinically trained chaplains into hospital care teams. We examined in a mixed-methods fashion, the effects of this type of integrated care team within a teaching hospital setting. The quality and impact of chaplain involvement were studied from patient and physician-in-training perspectives, using data from more than 200 patients and physicians in training. Findings clearly show that clinically trained chaplains can contribute meaningful expertise and real value to the quality and comprehensiveness of patient and physician experiences.

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Spirit or Fleeting Apparition? Why Spirituality’s Link with Social Support Might Be Incrementally Invalid

Abstract

Previously published path models apparently confirm the belief-as-benefit perspective that spirituality boosts well-being via social support. The broad acceptance of such findings has motivated recommendations that clinical psychologists and psychiatrists routinely assess their patients' spiritual status. Skeptics retort that past findings are statistically confounded and that numinous beliefs and well-being are unrelated. A multivariate regression analysis testing whether spirituality explains variance in social support after personality traits are simultaneously included is reported. Although spirituality displays a significant positive correlation and partial correlation (after controlling for socio-demographics) with social support, regression analysis specifying agreeableness and conscientiousness—individual differences related to both spirituality and social support—as predictors renders spirituality nonsignificant. In summary, spirituality's correlation with social support appears spurious; demonstrating the hazards of relying on simple associations and highlighting the urgent need for researchers to utilize statistical methods capable of establishing cause and parsing effects across rival theoretical explanations.

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The Application of Ibadah (Worship) in Counseling: Its Importance and Implications to Muslim Clients

Abstract

Ibadah is one of the important components in Islamic teachings other than aqidah (belief) and akhlaq (moral). Its importance is determined through the purpose for creation of humans, namely to be devoted to Allah. In the context of counseling discipline, however, the element of ibadah or worship (submission) of Allah is not applied in the counseling process and is not recognized as one of the spiritual therapies able to help the client know his true potential in decision-making and problem-solving. Hence, the purpose of this study is to determine the importance of applying ibadah in counseling and its implications to the client. This study selects survey research as the method to collect data from clients. A set of questionnaire instruments was constructed and distributed to 30 clients selected through convenience sampling. Data obtained from research questionnaire are then analyzed using descriptive statistical technique. Research outcome finds that application of ibadah is very important in counseling and has four implications for the client: the client is able to control his behavior, gain peace of mind, control his emotions and becomes increasingly diligent in ibadah.

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Religious Coping with Sexual Stigma in Young Adults with Same-Sex Attractions

Abstract

The present study assessed religious coping with sexual stigma in 260 young adults with same-sex attractions. Although the majority of the sample rarely utilized religious coping, a significant minority of participants frequently turned to religion to deal with sexual stigma. Controlling for demographic and general religious variables, positive religious coping (e.g., connecting with God) was associated with beneficial outcomes, and negative religious coping (e.g., frustrations with one's spiritual community) related to poorer adjustment to sexual stigma. Data are presented on how religious coping varied as a function of religiosity and sexual identity development (e.g., disclosure of sexual orientation to others).

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Bilateral HPV Positive Squamous Cell Carcinoma In Situ of Conjunctiva.

A 45 year-old woman presented with blurred vision and irritation of the left eye. Clinical examination revealed a superior palpebral conjunctival lesion consistent with a diagnosis of papilloma. She was lost to follow up despite repeated attempts to schedule a biopsy, and presented again after an extended period with bilateral disease. Subsequent biopsy confirmed bilateral squamous cell carcinoma in situ which was human papilloma virus-16 positive by molecular testing. She declined further treatment; during the subsequent year, the lesions extended across the bulbar conjunctiva bilaterally. (C) 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Wrexham mum preparing to have tongue removed in order to save her life - LeaderLive

LeaderLive

Wrexham mum preparing to have tongue removed in order to save her life LeaderLive A woman with an incredibly rare form of cancer hopes to be able to communicate with her children despite preparing to have her tongue removed. Emma Jellicoe, 35, of Tanyfron, has been diagnosed with sclerosing microcystic adenocarcinoma, a cancer of ...

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When Science is Not Enough: A Framework Towards More Customer-Focused Drug Development

Abstract

Introduction

The purpose of this study was to identify the key barriers to a customer-focused drug development process and develop a comprehensive framework to overcome them.

Methods

The paper draws on existing literature, both academic and practitioner, across a range of disciplines (innovation management, marketing, organizational behavior, behavioral economics, health economics, industry reports). On the basis of this extensive review, a conceptual framework is developed that offers concrete suggestions on how organizations can overcome the barriers and enable a more customer-focused development process.

Results

The barriers to collaboration are organized into three distinct categories (economic, behavioral, organizational), and within each category, a one-to-one mapping between barriers and solutions is developed.

Conclusion

The framework is specifically designed with the objective of offering actionable and practical advice to executives who face these challenges in their organizations. The paper provides a unique theoretical contribution by synthesizing findings from several academic disciplines with concrete examples from the pharmaceutical industry.

Funding

Mundipharma International Limited.

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Expression of ezrin and moesin in primary breast carcinoma and matched lymph node metastases

Abstract

Ezrin, radixin, moesin (ERM) are important membrane-cytoskeletal crosslinkers and are suggested to play important role in cancer progression and metastasis. Even though ERM proteins were generally considered to be functionally redundant and the most studied was ezrin, recent studies highlight their distinct roles in metastatic process. Little information is available regarding the role of individual ERM proteins and their phosphorylated forms in human breast cancer. Our study is the first to examine expression of ezrin, moesin and their phosphorylated forms in primary breast tumors and matched lymph node metastases (LNMs) and their correlation with clinicopathological variables. A total of 88 primary breast cancer, 91 LNMs, 54 intraductal carcinoma and 26 normal adjacent breast tissue samples from tissue microarrays were studied. Expression was determined by immunohistochemistry, the intensity and number of positive cells was scored. Statistical analysis of protein expression and patients' age, tumor grade and hormonal status was performed. No statistical significant difference was found in ezrin, moesin, p-ezrinTyr353 and pan-p-ezrinThr567/radixinThr564/moesinThr558 expression between primary tumors and LNMs. Even though it was not significant, moesin expression varied between primary tumors, intraductal carcinoma, normal breast adjacent tissue and LNMs. A significant positive correlation between moesin and tumor grade has been proven. Even though primary tumors and matched LNMs did not show different expression patterns, moesin correlated significantly with higher tumor grade. Its positivity in intraductal carcinoma and normal breast tissue adjacent to cancer might indicate its role in tumor intiation/progression.

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Wrexham mum preparing to have tongue removed in order to save her life - LeaderLive

LeaderLive

Wrexham mum preparing to have tongue removed in order to save her life LeaderLive Emma Jellicoe, 35, of Tanyfron, has been diagnosed with sclerosing microcystic adenocarcinoma, a cancer of the salivary glands. She is one of just eight people in the UK and 300 worldwide to be fighting this form of cancer. Friends have organised a ...

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Transmission analysis of TGFB1 gene polymorphisms in non-syndromic cleft lip with or without cleft palate

Transforming growth factor beta1 (TGF-β1) plays a significant role in craniofacial development. Previous linkage studies reported that the TGF-β1-locus at 19q13.1 harbour predisposing genes for non-syndromic oral clefts. In the present study case parents triads were evaluated to find the transmission effects of genetic variants in TGF- β1 towards non-syndromic cleft lip or palate (NSCL/P).

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Adenotonsillectomy outcomes in children with sleep apnea and narcolepsy

To identify improvements in daytime sleepiness following adenotonsillectomy in children with non-severe obstructive sleep apnea and narcolepsy.

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Response to the letter to the editor regarding ‘‘Evaluation of vitamin D levels in children with primary epistaxis’’

We would like to thank Mr. Akdoğan and Mr. Hızal for their interest in our study entitled ''Evaluation of vitamin D levels in children with primary epistaxis,'' and we appreciate their valuable comments [1].

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Letter to the editor regarding ‘Evaluation of vitamin D levels in children with primary epistaxis’

We are writing in reference to the paper titled ''Evaluation of vitamin D levels in children with primary epistaxis'' [1]. Almis et al. aimed to investigate whether there is a relationship between serum 25-hydroxy vitamin D [25(OH)D 3] values and incidences of primary epistaxis among children. For that purpose, the authors compared 42 primary epistaxis cases and 55 matched controls, retrospectively, and found that serum 25(OH)D 3 values were lower in the primary epistaxis group compared with the healthy control group.

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Otoplasty for prominent ears – demographics and surgical timing in different populations

Prominent ears are seen in approximately 5% of the population. This benign condition can be treated surgically to reduce or prevent psychological and social problems, most commonly in children before the start of school. Our aim was to examine the demographic characteristics of patients undergoing prominent ear surgery in Finland, and compare findings with international data.

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Comparison of home sleep apnea testing versus laboratory polysomnography for the diagnosis of obstructive sleep apnea in children

Obstructive sleep apnea (OSA) affects 1-5% of pediatric patients. Laboratory polysomnography is expensive, not always available, and is inconvenient for patients. Our study investigates the diagnostic ability of an unattended ambulatory monitor for the diagnosis of pediatric OSA.

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Utilization and trends in surgical instrument use in pediatric adenotonsillectomy

Examine trends in surgical instrument usage for pediatric adenotonsillectomy.

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Undifferentiated sarcoma of the sphenoid sinus

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Masaya Nagaishi, Kensuke Suzuki, Yoshiki Sugiura, Issei Takano, Yoshihiro Tanaka, Akio Hyodo
Paranasal sinuses sarcomas are rare and no treatments have been established. We report a young-adult case of sphenoid sinus sarcoma treated by carbon-ion radiotherapy. The patient presented with progressive left-sided visual impairment. A tumor was then identified and partial resection by transnasal approach was performed. The resected mass showed typical morphology of mesenchymal tumor, and morphological and molecular analyses ruled out a predominant-differentiation phenotype. The pathological diagnosis was undifferentiated sarcoma. The residual lesion was treated with carbon-ion radiotherapy, and tumor progression was absent for one year. The patient died of the tumor regrowth 20 months after initial diagnosis. Although this case had a poorer outcome compared with cases of the more-common sarcoma types, our experience suggested that carbon-ion radiotherapy is potentially beneficial in unresectable undifferentiated sarcomas cases of sphenoid sinus.



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A case grafted with polyglycolic acid sheets and fibrin glue for protection after temporary resection of a metastatic cervical skin tumor

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Takashi Matsuzuka, Masahiro Suzuki, Masakazu Ikeda, Kaoru Sato, Junko Fujimoto, Rumi Hosaka, Yuko Tanji, Shu Soeda, Shigeyuki Murono
The aim of this case report was to evaluate the usefulness of a grafting with polyglycolic acid sheet and a fibrin glue spray (PGA sheet grafting) after resection of a cervical skin tumor. A 61-year-old woman presented with left cervical skin tumor resistance to chemo-radiotherapy. She had been undergoing multimodal therapy for ovarian serous papillary adenocarcinoma for the previous six years. Although she had a poor general condition and a cervical skin tumor of 9cm in diameter, which was painful and easy bleeding, had offensive smell, she hoped to return to her job. Under local anesthesia, resection was performed, and PGA sheet grafting were used to shield the skin defect. After resection, she was relieved from pain, and could stay home without daily wound treatment. One and half months after resection, the wound was almost epithelialized. The PGA sheets consist of soft, elastic, nonwoven fabric made of PGA. In recent years, PGA sheet grafting has been widely used in the reconstruction and was chosen to shield the skin defect for this case. PGA sheet grafting after resection of cervical skin tumor can be an acceptable method for palliative care to relieve pain, bleeding, offensive smell, and ugly appearance.



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Squamous cell carcinoma of the retromolar trigone: Treatment outcomes

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Hideaki Nishi, Takeshi Shinozaki, Toshifumi Tomioka, Takashi Maruo, Ryuichi Hayashi
ObjectiveSquamous cell carcinoma (SCC) of the retromolar trigone is uncommon, accounting for 1.4% of all oral cancer cases in Japan. Few studies have examined the optimal treatment for this cancer. The aim of this study was to evaluate the outcome of treatment for primary SCC of the retromolar area.MethodsWe retrospectively analyzed the outcome and prognosis of 45 patients (38 men, 7 women) with SCC of the retromolar trigone who underwent treatment in our department between July 1992 and March 2011.ResultsMean age was 62.4 years. Clinical stages were: stage I (n=4, 8.9%); stage II (n=10, 22.2%); stage III (n=5, 11.1%); and stage IVa (n=26, 57.8%). Surgical resection was performed in all patients and 6 patients also received postoperative radiotherapy. Reconstructive surgery using free flaps was performed in 38 patients; postoperative complications occurred in 5 of these patients. The 3-year local control rate was 80%, and the 3-year over all survival rates for stage I, II, III, and IV disease were 100%, 80%, 40%, and 49.2%, respectively. Cause of death was the original disease in 23 cases and other diseases in 2 cases. The most common cause of death from the original disease was cervical lymph node metastasis.ConclusionThe presence of cervical lymph node metastasis was a negative prognostic factor. Marginal mandibulectomy may be selected for patients without distinct bone-marrow infiltration.



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The extended bundle of the tensor veli palatini: Anatomic consideration of the dilating mechanism of the Eustachian tube

Publication date: Available online 16 June 2017
Source:Auris Nasus Larynx
Author(s): Ryuhei Okada, Satoru Muro, Kohtaro Eguchi, Kohei Yagi, Hisayo Nasu, Kumiko Yamaguchi, Koh Miwa, Keiichi Akita
ObjectiveThe aim of this study was to analyze the topographical structures of the muscles surrounding the Eustachian tube.Materials and methodsWe conducted macroscopic and histological studies of 24 halves of 12 heads from Japanese cadavers.ResultsThe main findings were as follows: 1) the infero-lateral muscle bundles of the tensor veli palatini didn't turn medially at the pterygoid hamulus but were distributed laterally and continuous with the buccinator; 2) the tensor veli palatini attached laterally to the membranous part of the Eustachian tube; 3) the superior pharyngeal constrictor was not only adjacent to the buccinator at the pterygomandibular raphe but also had muscular continuation with it laterally and 4) some bundles of the superior pharyngeal constrictor adhered with the palatine aponeurosis.ConclusionWe believe that the cooperation of the muscles contributes to the dilating mechanism of the Eustachian tube, due to the complex topographical structures of the surrounding muscles: the tensor veli palatini, the levator veli palatini, the superior pharyngeal constrictor and the buccinator.



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Acute pediatric neck infections: Outcomes in a seven-year series

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Filipa Camacho Côrte, João Firmino-Machado, Carla Pinto Moura, Jorge Spratley, Margarida Santos
ObjectivesThe aim of this study was to analyse the epidemiology, clinical presentation, diagnostic clues, as biochemical parameters and imaging studies, of children with acute neck infections (ANI) to identify possible independent prognostic factors leading to complications and prolonged hospitalization. Methods: Records of children admitted to a tertiary university hospital from January 2008 to December 2014 with a diagnosis of ANIs were reviewed retrospectively. Diseases were categorized according to the site of infection and patients were divided into two groups: children (aged<10 years) and adolescents (aged 10–18 years).ResultsA total of 102 patients belonged to the children's group and 57 were adolescents. Forty-nine patients (27.2%) received antibiotics prior to presentation. The most frequent ANI was peritonsillar abscess (n = 72). Four peritonsillar abscesses progressed to parapharyngeal and retropharyngeal abscesses (n = 2 respectively). An association between age and type of abscess was found, with most of the retropharyngeal abscesses occurring in children (p = 0.05), and the submandibular abscesses in adolescents (p < 0.001). The most frequent symptoms/signs were fever (63.9%) and odynophagia (50.6%). Upon admission, all patients received intravenous antibiotics and 86.8% underwent drainage of the abscess. Cultures were harvested in 87 abscesses and the most frequent pathogen isolated was Streptococcus pyogenes. Signs of airway obstruction occurred in two patients with submandibular abscess, one with peritonsillar and one with parapharyngeal abscess. There were no cases of death or severe sequelae. Recurrent ANIs were observed in eight patients including two infected branchial cysts. Children, presence of multiple abscesses and palpable cervical mass on admission, absence of odynophagia and pharyngeal bulging, surgery with general anaesthesia and surgery after 24 h, were associated with prolonged hospitalization. Presence of toothache and neck pain on admission were identified as predictors of complications.ConclusionsThe present study found, that often, the diagnosis and treatment of neck abscesses in paediatric patients is not straightforward, but can achieve a favourable outcome. The primary location of the ANI appears to vary in different paediatric age groups. Younger age, presence of multiple abscesses or a palpable cervical mass on admission, were associated with prolonged hospitalization. Presence of toothache and neck pain on admission was identified as possible predictors of complications.



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Saliva Testing for HPV in Oropharyngeal Squamous Cell Carcinoma (OPSCC): A Diagnostic Accuracy Study

Abstract

Background

New cases of oropharyngeal squamous cell carcinoma (OPSCC) are routinely tested for HPV. HPV in saliva can be detected with PCR, but its clinical applicability in the context of OPSCC remains unknown.

Methods

Forty-six consecutive patients diagnosed with OPSCC had pre-treatment saliva specimens collected. PCR for HPV on saliva was compared to p16 IHC and HPV DNA in-situ hybridisation (ISH) on surgical biopsies.

Results

The sensitivity and specificity of saliva testing when compared to the reference test of p16 IHC and HPV DNA ISH was 72.2% and 90% and positive and negative predictive values were 96.3% and 47.4%. There were no adverse events. Time from last meal, smoking, alcohol drinking and physical exercise did not impact on results.

Conclusions

Saliva testing is a promising test to detect HPV in patients with OPSCC. A positive result could avoid the need for surgical biopsies, thereby reducing costs, patient morbidity, and expedite treatment.

This article is protected by copyright. All rights reserved.

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Does gene expression in laryngeal sub-sites differ between patients with laryngopharyngeal reflux and controls?

Abstract

Objective

to identify laryngeal mRNA gene changes in patients with laryngopharyngeal reflux (LPR).

Method

Laryngeal biopsies from non-smoking LPR patients (n=10; Reflux Symptom Index (RSI) >12 and a Reflux Finding Score (RFS) >6) and controls (n=9; RSI <12 and RFS <6) were collected from 4 sub-sites (true vocal cord, false vocal cord, medial arytenoid, posterior commissure) of the larynx. qRT-PCR analyses were conducted on 20 reflux and inflammation related genes, including interleukin 6 and 8, cytokeratin 8 and 14, mucin genes MUC 1, 2, 3B, 4, 5B, 6 & 7, and carbonic anhydrase III. Statistical analysis (Mann Whitney U test) compared gene expression levels between LPR and control groups at each sub-site.

Results

Site-specific differences in squamous metaplasia and gene expression were noted in LPR patients, with the majority present in the medial arytenoid region. Significant differences were noted in genes related to mucosal defense and inflammation, including CRNN, CD1d, TGFβ-1, MUC2, MUC5B, CDH1.

Conclusion

Whilst the posterior commissure is commonly identified as the area demonstrating the most significant macroscopic change in LPR, the histological changes and genes assessed here showed more pronounced LPR associated differences in the medial arytenoid. We identified differences in expression of mucin genes, cytokeratin 14 and molecular markers of inflammation. Whilst some of these changes may be metaplasia-related, further evaluation of the mRNA expression of these genes may provide a useful biomarker panel for diagnosis and therapeutic monitoring of LPR.

This article is protected by copyright. All rights reserved.

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The validity of nasal endoscopy in patients with chronic rhinosinusitis – an interrater agreement study

Abstract

Objectives

Nasal endoscopy is a cornerstone in diagnosing sinonasal disease but different raters might generate different results using the technique. Our study aims to evaluate the agreement between multiple raters to assess the validity of nasal endoscopy.

Design/Participants

Three independent and blinded raters evaluated 28 patients (56 nasal cavities) diagnosed with chronic rhinosinusitis according to the European Position Paper on Rhinosinusitis and Nasal Polyps. The ratings were compared using unweighted Fleiss' kappa coefficients (K_f) for each objective parameter.

Setting

The department of Otorhinolaryngology, Odense University Hospital, Denmark.

Main outcome measures

The ratings were quantified in a modified Lund-Kennedy endoscopy score and focused on the objective parameters specified in the diagnostic criteria: polyps, oedema, and discharge.

Results

The raters agreed on the findings concerning polyps and discharge but not regarding oedema with the interrater agreement for the different parameters being: Polyps K_f = 0.66 (standard error (SE) 0.07, p<0.001), oedema K_f = 0.05 (SE 0.07, p=0.21), discharge K_f = 0.35 (SE 0.08, p<0.001), oedema exclusively in middle meatus K_f = -0.07 (SE 0.04, p = 0.8), and discharge exclusively in middle meatus K_f = 0.16 (SE 0.07, p = 0.01).

Conclusion

Using nasal endoscopy, the evaluation of polyps by multiple raters showed sufficient reliability indicating an acceptable objective evaluation. The evaluation of discharge achieved a fair level of agreement while the assessment of oedema could not achieve a sufficient reliability questioning the inclusion of oedema in the criteria for diagnosing sinonasal disease.

This article is protected by copyright. All rights reserved.

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Assault at the workplace in 147 patients resulting in Cochleovestibular dysfunction

Abstract

Assault and violence at the workplace although uncommon are occupational health and safety hazards. Although there is no paucity of literature on cochleovestibular dysfunction after head injuries, there is little published on cochleovestibular dysfunction as a consequence of assault at the workplace.

This article is protected by copyright. All rights reserved.

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A novel management of streptococcal pharyngotonsillar infections by laser-activated silver nanoparticles and methylene blue conjugate, in vitro study

Species of Streptococcus are classified based on their hemolytic properties ‏ into alpha and beta types. And, since antimicrobial drug resistance is an increasingly problematic issue, the efforts to develop modalities that would overcome this obstacle and avoid antibiotic side effects is an ongoing challenge.

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Auditory, visual and auditory-visual memory and sequencing performance in typically developing children

The study evaluated whether there exists a difference/relation in the way four different memory skills (memory score, sequencing score, memory span, & sequencing span) are processed through the auditory modality, visual modality and combined modalities.

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Exome sequencing identifies a novel missense mutation of WFS1 as the cause of non-syndromic low-frequency hearing loss in a Chinese family

Autosomal dominant non-syndromic low-frequency sensorineural hearing loss (LFSNHL) DFNA6/14/38 is an uncommon type of hearing loss that classically affects low frequencies of 2000 Hz and below, demonstrating an ascending configuration. The current study aimed to investigate the cause of LFSNHL in a five-generation Chinese family.

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Functional endoscopic sinus surgery improves the quality of life in children suffering from chronic rhinosinusitis with nasal polyps

To evaluate the impact of FESS in children with chronic rhinosinusitis with nasal polyps, regarding their overall postoperative quality-of-life (QoL) and constituent QoL domains. Potential differences between cystic fibrosis (CF) sufferers and non-sufferers, or cases with recurrent sinonasal polyposis versus single-operations were also explored.

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Absence of KCNQ4 mutation in Bengali families with ADNSHL originated from West Bengal, India

Autosomal Dominant Non-Syndromic Hearing Loss (ADNSHL) is extremely heterogeneous in nature. More than 60 loci with 30 different genes have been identified linked to ADNSHL. Mutation in KCNQ4 is considered as one of the most common causative factor responsible for ADNSHL. No study focused on the genetic alteration of KCNQ4 gene among hearing loss patients in India. The present study for the first time was carried out to determine the mutation spectrum of KCNQ4 gene in ADNSHL patients of West Bengal state, India.

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Bilateral congenital cholesteatoma: Surgical treatment and considerations

To describe a multicenter study regarding surgical management of bilateral congenital cholesteatoma (BCC) and underline the importance of endoscopes in the management of this condition. In BCC, hearing preservation is more crucial than in unilateral cases. The endoscopic approach allows complete removal of cholesteatoma via a minimally invasive technique offering low residual disease rates while preserving the normal physiology of the middle ear and possibly the ossicular chain.

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Study of the effects of hearing on static and dynamic postural function in children using cochlear implants

The present study aimed to evaluate the postural control perturbations by the center of pressure parameters in two main approaches, cochlear implant turned "on" and "off".

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Pediatric head and neck bone sarcomas: An analysis of 204 cases

To analyze the demographics, survival, and treatment efficacy of pediatric sarcomas of the facial skeleton and skull.

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Update on the supraclavicular flap.

Purpose of review: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. Recent findings: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer. Summary: The supraclavicular flap has shown dependability in reconstruction of defects in the head and neck, and it warrants consideration among reconstructive surgeons, especially for circumstances in which free tissue or other pedicled flaps are less than ideal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: a retrospective case -control study

Eustachian tube (ET) dysfunction can be very difficult to diagnose accurately. Our aim is to determine whether a newly developed sonotubometric test using clicks can reliably detect ET opening during swallowin...

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Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: a retrospective case -control study

Eustachian tube (ET) dysfunction can be very difficult to diagnose accurately. Our aim is to determine whether a newly developed sonotubometric test using clicks can reliably detect ET opening during swallowin...

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Clinical performance validation of PITX2 DNA methylation as prognostic biomarker in patients with head and neck squamous cell carcinoma

by Verena Sailer, Heidrun Gevensleben, Joern Dietrich, Diane Goltz, Glen Kristiansen, Friedrich Bootz, Dimo Dietrich

Background

Despite advances in combined modality therapy, outcomes in head and neck squamous cell cancer (HNSCC) remain dismal with five-year overall survival rates of less than 50%. Prognostic biomarkers are urgently needed to identify patients with a high risk of death after initial curative treatment. Methylation status of the paired-like homeodomain transcription factor 2 (PITX2) has recently emerged as a powerful prognostic biomarker in various cancers. In the present study, the clinical performance of PITX2 methylation was validated in a HNSCC cohort by means of an independent analytical platform (Infinium HumanMethylation450 BeadChip, Illumina, Inc.).

Methods

A total of 528 HNSCC patients from The Cancer Genome Atlas (TCGA) were included in the study. Death was defined as primary endpoint. PITX2 methylation was correlated with overall survival and clinicopathological parameters.

Results

PITX2 methylation was significantly associated with sex, tumor site, p16 status, and grade. In univariate Cox proportional hazards analysis, PITX2 hypermethylation analyzed as continuous and dichotomized variable was significantly associated with prolonged overall survival of HNSCC patients (continuous: hazard ratio (HR) = 0.19 [95%CI: 0.04–0.88], p = 0.034; dichotomized: HR = 0.52 [95%CI: 0.33–0.84], p = 0.007). In multivariate Cox analysis including established clinicopathological parameters, PITX2 promoter methylation was confirmed as prognostic factor (HR = 0.28 [95%CI: 0.09–0.84], p = 0.023).

Conclusion

Using an independent analytical platform, PITX2 methylation was validated as a prognostic biomarker in HNSCC patients, identifying patients that potentially benefit from intensified surveillance and/or administration of adjuvant/neodjuvant treatment, i.e. immunotherapy.

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Low-Dose Childhood Radiation Effects to the Thyroid Follow a Linear Dose–Response Trend and Persist Even 45+ Years After Exposure

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 235-236.


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Persistent Hyperthyroidism Is Associated with Increased Mortality

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 214-217.


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Patients with Toxic Nodular Goiter and Graves’ Disease Are at Increased Risk for All-Cause and Cardiovascular Mortality

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 218-220.


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Delaying Surgery by More Than 1 Year for Selected Patients with Papillary Thyroid Microcarcinoma Does Not Compromise Outcomes

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 241-243.


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Thyroid Cancer Incidence and Mortality Are Increasing

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 221-223.


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Does Core Needle Biopsy Have A Role in the Evaluation of Thyroid Nodules with Indeterminate Cytology?

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 232-234.


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Levothyroxine Does Not Lower Hypothyroidism Symptoms in Older Adults with Mild Subclinical Hypothyroidism

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 224-228.


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Thyroid Hormone Receptor Alpha Resistance Causes Variability in the Severity but Not the Nature of Clinical Features

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 237-240.


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High-Intensity Focused Ultrasound Is Useful in the Treatment of Symptomatic Benign Thyroid Nodules

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 229-231.


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Thyroid Tumor Board: The Pathologic Criteria of Poorly Differentiated Thyroid Cancer Can Be Difficult to Distinguish From Differentiated Thyroid Carcinoma

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 244-246.


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Adjuvant Human Papillomavirus Vaccination for Secondary Prevention

This systematic review evaluates literature regarding human papillomavirus vaccination for secondary disease prevention after treatment of virus-related clinical disease.

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Support for the Diagnosis of CHARGE Syndrome—Reply

In Reply We appreciate the comments by Martin et al regarding our work and wish to respond to the excellent points that they raised.

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The 10 Commandments of Management for Acute Upper Airway Obstruction

This Viewpoint recommends 10 commandments or rules to follow when managing an acute upper airway obstruction in an infant or child.

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Slowly Enlarging Neck Mass

A man had an enlarging, nontender, neck mass at the angle of the mandible; computed tomography showed a heterogeneous mass adjacent to the tail of the left parotid, and pathologic findings revealed an encapsulated soft nodule within the specimen. What is your diagnosis?

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Learning Curves for Transoral Robotic Surgery for Oropharynx Carcinoma

This study assesses learning curves for 3 oncologic transoral robotic surgery specialists and assesses the number of cases needed to identify the learning phase.

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With Experience Comes Wisdom

What a pleasure it is to be able to comment on the Viewpoint by Grundfast et al, "The 10 Commandments of Management for Acute Upper Airway Obstruction in Infants and Children." Having just finished Michael Lewis's book The Undoing Project, which tells the story of Daniel Kahneman, Amos Tversky, and the birth of a new form of behavioral psychology and decision analysis, I am, of course, concerned about the inherent biases in trusting at face value the words of a senior statesman just because he looks and acts the part. Do we hold with heuristic beliefs that with an author's age and experience comes wisdom? I am now "trained" not to ask "who the author is" but "what has he or she actually done" before I trust the narrator that speaks to me.

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Otolaryngology Resident Duty Hour Restrictions and Outcomes

This study analyses the association of otolaryngology duty hour restrictions with surgery-specific outcomes, including complications following thyroid and parathyroid procedures performed before and after duty hour reform.

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Slow-Growing Infiltrative Sinonasal Mass

A man in his 50s was seen for a 6-month history of swelling involving the nasal bridge and right eye and intermittent ipsilateral epistaxis; endoscopy demonstrated a right-sided exophytic mass visible between the middle turbinate and nasal septum. What is your diagnosis?

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Definition of Close Surgical Margins in SCC of the Oral Tongue

This study evaluates specimens of squamous cell carcinoma of the oral tongue and compares close resection margins of less than 5.0 mm vs less than or equal to 2.2 mm for determination of risk for local recurrence as a positive margin.

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Conservative Treatment of Isolated Cricoid Cartilage Fractures From Blunt Trauma

This case series examines the conservative treatment of laryngotracheal traumas.

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Lingual Tonsillectomy for Treatment of Pediatric Obstructive Sleep Apnea

This meta-analysis evaluates the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric obstructive sleep apnea.

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June 2017 Issue Highlights

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Traumatic Facial Injuries Among Elderly Nursing Home Residents

This population-based study estimates the incidence of facial trauma among elderly nursing home residents and details mechanisms of injury, injury characteristics, and patient demographic data.

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Inaugural Symposium on Advanced Surgical Techniques in Adult Airway Reconstruction

This report communicates the findings of the North American Airway Collaborative Symposium on Advanced Surgical Techniques in Adult Airway Reconstruction.

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Association of Body Mass Index in Head and Neck Reconstructive Surgery

This cohort study examines whether elevated body mass index is an independent risk factor for perioperative and postoperative infections after free tissue transfer in patients undergoing head and neck reconstructive surgery.

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A Young Man With Proptosis Causing Decreased Visual Acuity

A teenage boy had deteriorating vision and swelling in his right eye, right ear pain, and forehead tenderness; endoscopy revealed a fleshy, red soft-tissue mass in the superior nasal cavity. What is your diagnosis?

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Transoral Robotic Surgery and Long-term Outcomes and Costs

This cross-sectional analysis investigates the association of transoral robotic surgery with short- and long-term outcomes and costs in surgically treated patients with oropharyngeal cancer.

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Trismus and Swelling on the Side of the Face

A woman presented with mild to moderate trismus and swelling on the left side of the face of a few months' duration; physical examination was remarkable for left-sided facial swelling, and no deficits of the facial or trigeminal nerves were detected. What is your diagnosis?

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Long-term Surveillance Following Intralesional Steroid Injection for Benign Vocal Fold Lesions

This cohort study reports the findings of a long-term surveillance following intralesional steroid injection for benign vocal fold lesions.

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Head and Neck Squamous Cell Carcinoma Therapy With a WEE1 Inhibitor

This study maps the cellular response to the WEE1 inhibitor and explores the contributions of p53 to its effect.

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Bacterial colonization of resin composite cements: influence of material composition and surface roughness

So-called secondary caries may develop in the cement gap between the tooth and the bonded restoration. Cement materials with a low susceptibility to biofilm formation are therefore desirable. In the present study, the adhesion of Strepococcus mutans onto three adhesive (Multilink Automix, RelyX Ultimate, and Panavia V5) and three self-adhesive (Multilink Speed Cem, RelyX Unicem 2 Automix, and Panavia SA plus) resin composite cements was evaluated. Previous studies have failed to evaluate concomitantly the effect of both the composition of the cements and their surface roughness on biofilm formation. The presence of S. mutans on cement surfaces with differing degrees of roughness was therefore recorded using fluorescence microscopy and crystal violet staining, and the composition of the cements was analyzed using energy-dispersive X-ray spectroscopy mapping. Biofilm formation on resin composite cements was found to be higher on rougher surfaces, implying that adequate polishing of the cement gap is essential. The use of copper-containing cements (Multilink Automix, Panavia V5, and Panavia SA plus) significantly reduced biofilm formation.

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The outcomes of endoscopic management in young children with subglottic stenosis

Subglottic stenosis (SGS) is a common cause of obstructed airway in children, and the treatment of pediatric SGS, especially congenital SGS, remains a challenge for the otolaryngologist.

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Pediatric Langerhans cell histiocytosis of the lateral skull base

Describe the presentation, imaging characteristics, management, and outcomes of pediatric patients with Langerhans cell histiocytosis (LCH) of the temporal bone.

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Vocal palsy increases the risk of lower respiratory tract infection in low-risk low-morbidity patients undergoing thyroidectomy for benign disease: a big data analysis

Abstract

Objectives

Thyroidectomy is the commonest and most rapidly-growing operation which places normally-functioning laryngeal nerves at risk of injury. Laryngeal palsy is a major risk-factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure.

Design

An N=near-all analysis of the English administrative dataset using a previously-validated informatics algorithm to identify young and otherwise low-risk patients undergoing thyroidectomy for benign disease. Information about age, sex, morbidities, social deprivation, and postoperative and late complications were derived.

Main Outcome Measures

Between 2004 and 2012, 43,515 patients between the ages of 20 and 69 who had no history of cancer, neurological, or respiratory disease underwent first-time elective total or hemithyroidectomy without concomitant or late neck dissection, parathyroidectomy, or laryngotracheal surgery for benign thyroid disease. Information about age, sex, morbidities, and in-hospital and late complications was recorded.

Results

Mean age at surgery was 46±12. There was a strong female preponderance (85%) and most patients (89%) had no recorded Charlson morbidities. Most patients (65%) underwent hemithyroidectomy. Late vocal palsy was recorded in 449 (1.03%) patients and its occurrence was an independent risk factor for emergency hospital readmission (n=7113; Hazard Ratio 1.52; 95% Confidence interval 1.21-1.91), hospitalisation for lower respiratory tract infection (n=944; HR 2.04; 95% CI 1.07-3.75), dysphagia (n=564; HR 3.47; 95% CI 1.57-7.65) and gastrostomy/tracheostomy placement (n=80; HR 20.8; 95% CI 2.5-171.2). Independent risk-factors for late vocal palsy were age, burden of morbidities, total thyroidectomy, and postoperative bleeding. Female sex and annual surgeon volume >30 were independently protective.

Conclusions

There is a significant association between post-thyroidectomy vocal palsy and long-term risks of hospital readmission, dysphagia, pneumonia, and gastrostomy/tracheostomy tube placement. This adds weight to the need, from a thyroid surgical perspective, to undertake universal post-thyroidectomy laryngeal surveillance with a focus on postoperative dysphagia and aspiration, and from a medical/respiratory perspective, to initiate investigations to identify occult vocal palsy in patients who present with pneumonia, who have a history of thyroid surgery.

This article is protected by copyright. All rights reserved.

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Long-term outcomes of central neck dissection for cN0 papillary thyroid carcinoma

Publication date: Available online 14 June 2017
Source:American Journal of Otolaryngology
Author(s): Davide Giordano, Andrea Frasoldati, Enrico Gabrielli, Carmine Pernice, Michele Zini, Andrea Castellucci, Simonetta Piana, Alessia Ciarrocchi, Silvio Cavuto, Verter Barbieri
Objective.The risk-benefit ratio of central neck dissection (CND) in patients affected by papillary thyroid carcinoma (PTC) without clinical or ultrasonographic (US) evidence of neck lymph node metastasis (cN0) is currently debated. The aim of this study was to evaluate long-term outcome of CND on locoregional recurrence, distant metastasis, survival, and postoperative complications in a large series of patients with cN0-PTC.Study Design.Observational retrospective controlled study.MethodsClinical records of patients (n=610) surgically treated for cN0-PTC at the Otolaryngology Unit of the Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy, from January 1984 to December 2008, were retrospectively reviewed. Study population was divided into three groups according to surgical treatment: Group A, total thyroidectomy (n=205); Group B, total thyroidectomy and elective ipsilateral CND (n=281); Group C, total thyroidectomy and bilateral CND (n=124).ResultsOf a total of 610 patients, 305 (50%) were classified as low-risk, 278 (45.57%) as intermediate-risk, and 27 (4.43%) as high-risk. Response to initial therapy was excellent in 567 patients (92.95%), acceptable in 21 (3.44%), and incomplete in 22 (3.61%), with no significant differences among groups. Locoregional recurrence was detected in 32 (5.2%) out of 610 patients. Distant metastasis was found in 15 patients (2.5%). Statistical analysis showed no significant differences in the rates of locoregional recurrence (p=0.890) or distant metastasis (p=0.538) among groups. Disease-specific mortality and overall survival did not significantly differ among groups (p=0.248 and 0.223, respectively). Rate of permanent hypoparathyroidism was significantly higher in Group C patients compared to those in Groups A and B.ConclusionCND does not confer any clear advantage in the treatment of low-risk patients, regardless of surgical procedure. Instead, bilateral CND may be effective in limiting disease relapse and/or progression in patients at higher prognostic risk. Our data indicate that elective CND does not confer any clear advantage in terms of locoregional recurrence and long-term survival, as demonstrated by outcomes of the study Groups, regardless of their different prognostic risk. Elective CND allows a more accurate pathologic staging of central neck lymph nodes, despite its increasing the risk of permanent hypoparathyroidism. Intraoperative pathologic staging is a valuable tool to assess the risk of controlateral lymph node metastasis in the central neck compartment and to limit more aggressive surgery only to cases, otherwise understaged, with lymph node metastasis.



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Neck dissection for unknown cancer of the head and neck in the era of chemoradiation

Publication date: Available online 14 June 2017
Source:American Journal of Otolaryngology
Author(s): Mark J. Amsbaugh, Mehran Yusuf, Jeremy Gaskins, Craig Silverman, Kevin Potts, Jeffrey Bumpous, Rebecca Redman, Cesar Perez, Neal Dunlap
PurposeTo report outcomes for patients with cervical lymph node metastases from an unknown primary site of the head and neck treated with either non-operative therapy or neck dissection followed by adjuvant therapy.Materials and MethodsAll patients with squamous cell carcinoma of an unknown primary site of the head or neck seen between 2003 and 2013 were reviewed. The Kaplan-Meier method was used to estimate overall survival, local recurrence free survival, loco-regional recurrence free survival, and progression free survival. The log-rank test and proportional hazards regression were used to analyze factors influencing outcomes.ResultsOf 2258 patients with a new diagnosis of head and neck cancer, no primary site was identified in 66 patients. Twenty-nine patients were treated with definitive non-operative therapy (15 with chemoradiation and 14 with radiation alone). Thirty-seven patients received an upfront neck dissection followed by adjuvant radiation or chemoradiation. Three-year loco-regional recurrence free survival, progression free survival, and overall survival were 55.9%, 55.4%, and 69.4% respectively. Patients treated with preoperative neck dissection had improved local recurrence free survival (96.7% vs 54.1%, p=0.003) and loco-regional recurrence free survival (82.2% vs 46.4%, p=0.068) compared to patients treated with definitive chemoradiation with no difference in overall survival (p=0.641).ConclusionsNeck dissection improved local and regional control but not overall survival in patients with unknown primary squamous cell carcinoma of the head and neck over non-operative therapy alone.



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Temporal bone computed tomography findings associated with feasibility of endoscopic ear surgery

Publication date: Available online 14 June 2017
Source:American Journal of Otolaryngology
Author(s): Dunia Abdul-Aziz, Elliott D. Kozin, Brian M. Lin, Kevin Wong, Parth V. Shah, Aaron K. Remenschneider, Lukas D. Landegger, Amy F. Juliano, Michael S. Cohen, Daniel J. Lee
PurposeThere are no formal radiologic criteria to stratify patients for transcanal (TEES) or transmastoid endoscopic ear surgery for resection of cholesteatoma. We aim to determine 1) whether standard preoperative computed tomography (CT) findings are associated with the need for conversion to a transmastoid approach and 2) the amount of time added for conversion from TEES to transmastoid techniques.Materials and methodsRetrospective chart review of consecutive pediatric and adult cases of TEES for primary cholesteatoma from 2013 through 2015 (n=52). TEES cases were defined as endoscope-only procedures that did not require a transmastoid approach (n=33). Conversion cases were defined as procedures that began as TEES however, required conversion to a transmastoid approach due to the inability to complete cholesteatoma removal (n=19). Preoperative CT findings and total operating room (OR) times of TEES and conversion cases were compared.ResultsPreoperative CT scan characteristics that were associated with conversion included tegmen erosion (p=0.026), malleus erosion (p<0.001), incus erosion (p=0.009), mastoid opacification (p=0.009), soft tissue opacification extending into the aditus ad antrum (p=0.009) and into antrum (p=0.006). Total OR time for TEES cases was significantly shorter than conversion cases (median 143min versus 217min, p<0.001).ConclusionsPreoperative CT findings, notably extension of soft tissue in the aditus ad antrum, antrum and mastoid, are associated with need for conversion to transmastoid technique to achieve removal of cholesteatoma. Endoscope-only cases were significantly faster than cases that required conversion to a transmastoid approach.



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