New American Food Products, LLC of Methuen, MA is voluntarily recalling various packaged goods because they contain undeclared milk. People who have an allergy or severe sensitivity to milk run the risk of serious or life-threatening allergic reaction if they consume this product.
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Πέμπτη 2 Νοεμβρίου 2017
New American Food Products LLC Issues Allergy Alert on Undeclared Milk in Packaged Goods Received From Our Supplier GKI Foods.
Long-term management and outcomes after repair of cerebrospinal fluid rhinorrhea related to idiopathic intracranial hypertension.
Purpose of review: To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH). Recent findings: Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder. Recent data also support the use of acetazolamide and dural venous sinus stenting as adjuncts for reducing ICP. Summary: Spontaneous CSF rhinorrhea associated with IIH represents a challenging clinical entity, with an increased risk of recurrence compared to CSF leaks because of other causes. Adjunct therapies intended to reduce ICP likely improve outcomes after surgical repair, but further research is necessary to better characterize the effects of these treatment modalities. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Updates in the management of sinonasal mucosal melanoma.
Purpose of review: Sinonasal mucosal melanoma (SNMM) is an aggressive cancer with a poor prognosis. Although there is significant study surrounding the treatment of sinonasal malignancies and cutaneous melanomas, the rarity of this tumor has largely precluded robust outcomes analyses. The authors of this review seek to provide an overview of the recent literature related to the treatment of SNMM with added context from our institutional experience with this disease. Recent findings: In the surgical management of sinonasal malignancies and SNMM specifically, resection via endoscopic endonasal technique appears to offer comparable oncologic outcomes versus an open approach. The role of adjuvant therapy continues to be debated, but there is strong evidence for improved rates of local control with radiotherapy after complete resection. In the last few years, significant developments have been made in the study of systemic therapies for cutaneous melanoma. The identification of genetic mutations common to mucosal melanoma has allowed for early trials of targeted therapies, but study is ongoing. Summary: Although the study of SNMM is largely limited to small retrospective case series, treatment continues to evolve. Until effective systemic therapies can be identified, endoscopic resection with adjuvant radiotherapy may offer the best disease-free survival with acceptably low morbidity. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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The role of frontal sinus drillouts in nasal polyposis.
Purpose of review: Historically, the common frontal sinusotomy has been reserved only for salvage frontal sinus surgery in patients with severely recalcitrant inflammatory sinus disease. By understanding the pathophysiology of inflammatory sinus disease and the long-term role of topical medication in their treatment, the indications for Draf3 have expanded. Recent findings: A major therapeutic impact from endoscopic sinus surgery for inflammatory sinus disease is imparted by allowing sinus access to topical therapies to work. Although traditionally, the Draf3 frontal sinus procedure has been reserved for revision surgery in severe cases, advancements in technology, instrumentation, and techniques has allowed the Draf3 to evolve to efficient and safe procedure, often applied primarily in select patients. There is evidence to support the indication for Draf3 in primary surgery for severe cases. Summary: In inflammatory sinus disease, the goal of endoscopic sinus surgery is to convert the complex and limited frontal sinus outflow tracts into a simple common cavity. This allows for local, topical anti-inflammatory treatments to control the disease. When patients have broader inflammatory airway disease and asthma, the Draf3, as part of a neo-sinus cavity, is commonly applied early in surgical care. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Local allergic rhinitis: evolution of concepts
The discovery of an exclusive local production of IgE antibodies dates back to the 1970s, but only recently the pathophysiology of such phenomenon was deeply investigated, leading to the concept of local aller...
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Glomangiomyoma of the neck in a child in Nepal: a rare case report and literature review
Glomangiomyoma is a rare histological variant of glomus tumour. Clinically, it mimicks as a haemangioma and is challenging to diagnose. Its occurrence in the neck of a child has not been previously described.
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Synovial fluid multiplex PCR is superior to culture for detection of low-virulent pathogens causing periprosthetic joint infection
Publication date: Available online 2 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Christian Morgenstern, Sabrina Cabric, Carsten Perka, Andrej Trampuz, Nora Renz
IntroductionAnalysis of joint aspirate is the standard preoperative investigation for diagnosis of periprosthetic joint infection (PJI). We compared the diagnostic performance of culture and multiplex polymerase chain reaction (PCR) of synovial fluid for diagnosis of PJI.Patients and methodsPatients in whom aspiration of the prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included. The performance of synovial fluid culture and multiplex PCR was compared by McNemar's chi squared test.ResultsA total of 142 patients were included, 82 with knee and 60 with hip prosthesis. PJI was diagnosed in 77 patients (54%) and aseptic failure in 65 patients (46%). The sensitivity of synovial fluid culture and PCR was 52% and 60%, respectively, showing concordant results in 116 patients (82%). In patients with PJI, PCR missed 6 high-virulent pathogens (S. aureus, streptococci, E. faecalis, E. coli) which grew in synovial fluid culture, whereas synovial fluid culture missed 12 pathogens detected by multiplex PCR, predominantly low-virulent pathogens (Cutibacterium acnes and coagulase-negative staphylococci). In patients with aseptic failure addition, PCR detected 6 low-virulent organisms (predominantly C. acnes).ConclusionWhile the overall performance of synovial fluid PCR was comparable to culture, PCR was superior for detection of low-virulent bacteria such as Cutibacterium spp. and coagulase-negative staphylococci. In addition, synovial fluid culture required several days for growth, whereas multiplex PCR provided results within 5hours in an automated manner.
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Wildlife as Source of Human Escherichia coli O157 Infection
B. Crook and H. Senior
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Unexpected Infection with Armillifer Parasites
I. Potters et al.
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Diagnostic Accuracy of Parameters for Zika and Dengue Virus Infections, Singapore
H. J. Ho et al.
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Distribution of Usutu Virus in Germany and Its Effect on Breeding Bird Populations
R. Lühken et al.
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Tool for Eliminating Dog-Mediated Human Rabies through Mass Dog Vaccination Campaigns
E. A. Undurraga et al.
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Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy
Purpose
Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens. Method
This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation. Results
The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games. Conclusions
A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://article/doi/10.1044/2017_AJSLP-17-0040/2661757/Flow-and-Grit-by-Design-Exploring-Gamification-in
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Dentist hosts candy drive for girl with cancer
But very rarely is a 5-year-old diagnosed with Diffuse Intrinsic Pontine Glioma, known as DIPG - a highly aggressive and difficult-to-treat brain cancer. Too much candy around your house? Tonight a dentist is willing to buy it from you to help a metro girl.
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miRNA Expression Profile of Mucoepidermoid Carcinoma
Abstract
Objectives
MicroRNAs (miRNAs) are single-stranded RNAs that have been implicated in cancer initiation and progression and act as tumour suppressors or oncogenes. In this study, miRNA profiling was conducted on the most frequent malignancy of salivary glands, mucoepidermoid carcinoma (MEC), with comparison to normal tissues.
Materials and Methods
The TaqMan Human miRNA Cards Array was used for the miRNA profiling of MEC and normal tissues. To validate the differentially expressed miRNAs in MEC, we used real-time PCR (qRT-PCR).
Results
miR-302a was the most significantly increased miRNA in cancer tissues (p < 0.05). Here, we demonstrate that the up-regulation of miR-302a expression in SGT cell lines induced cancer cell invasion in vitro.
Conclusions
These promising results suggest the need for further studies to establish mir-302a as a marker of invasion and aggressiveness in MEC.
This article is protected by copyright. All rights reserved.
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“Active Team” a social and gamified app-based physical activity intervention: randomised controlled trial study protocol
Physical inactivity is a leading preventable cause of chronic disease and premature death globally, yet over half of the adult Australian population is inactive. To address this, web-based physical activity in...
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Effect of prohibiting the use of Paraquat on pesticide-associated mortality
Paraquat is associated with a high rate of fatalities in acute poisoning. This study aimed to examine the association between the national public health policy that banned the use of paraquat and the incidence...
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Adult normative data for phonatory aerodynamics in connected speech
ConclusionsThis study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 2017 (Source: The Laryngoscope)
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Risk factors of pediatric tinnitus: Systematic review and meta ‐analysis
ConclusionsOlder‐aged adolescents, as well as those who are females and those with hearing loss may have a higher risk of tinnitus. Noise exposure in the general pediatric population and smoking in adolescents may represent especially important risk factors in pediatric tinnitus. Laryngoscope, 2017 (Source: The Laryngoscope)
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Comparing perilymph proteomes across species
ConclusionsPerilymph proteomes were compared across three species. The degree of crossover of proteins of both guinea pig and cat with human indicate that these animals suitable models for the human cochlea, albeit the cat perilymph is a closer match. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)
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Process of tight junction recovery in the injured vocal fold epithelium: Morphological and paracellular permeability analysis
ConclusionsIt was strongly suggested that TJs in the vocal fold epithelium exist at the junctional regions of the first layer of stratified squamous epithelium. TJ‐based paracellular diffusion barrier following vocal fold injury is recovered by 14 days postinjury, and this period corresponds with the time course of structural changes in the regenerating epithelium layer. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)
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A matched comparison of human papillomavirus –induced squamous cancer of unknown primary with early oropharynx cancer
ConclusionsPatients with T0N+M0 HPV‐induced CUP have similar survival outcomes to matched patients with T1‐2N+M0 HPV+ OPX. These patients can reasonably be included in clinical trials investigating the role of treatment deintensification and risk stratified similar to patients with early‐stage known primary OPX cancer. Level of Evidence4. Laryngoscope, 2017 (Source: The Laryngoscope)
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MRSA chronic bacterial laryngitis: A growing problem
ConclusionMRSA infection was documented in 30% of patients overall with chronic bacterial laryngitis. Based on the results of the study, a treatment algorithm for management of this unusual patient population is suggested. Level of Evidence4. Laryngoscope, 2017 (Source: The Laryngoscope)
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Feasibility of preservation of chorda tympani nerve during noninflammatory ear surgery: A systematic review
ConclusionPatients with a stretched chorda tympani were slightly more symptomatic compared to patients with a sacrificed chorda tympani. Therefore, in cases for which the chorda tympani greatly hinders a proper view of the surgical field, sacrificing the nerve could be considered to maximize surgical performance and have a satisfactory postoperative result. Laryngoscope, 2017 (Source: The Laryngoscope)
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Oropharyngeal squamous cell carcinoma incidence and mortality trends in the United States, 1973 –2013
ConclusionOropharyngeal squamous cell carcinoma incidence rates increased in a nonlinear fashion from 1973 to 2013, whereas mortality rates declined. This, along with variation in trends by demographic and tumor factors, suggest that human papilloma virus is the main driver of the recent rise in incidence. Level of Evidence2b. Laryngoscope, 2017 (Source: The Laryngoscope)
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Utility of intraoperative imaging in cochlear implantation: A systematic review
ConclusionIntraoperative imaging detects unsatisfactory placement of electrodes during CI surgery at a low, but not negligible, rate. The current literature is not conclusive regarding the utility of routine imaging, but it appears to be most useful with abnormal cochlear anatomy or when the surgeon questions placement. Level of EvidenceNA. Laryngoscope, 2017 (Source: The Laryngoscope)
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Selective recurrent laryngeal nerve stimulation using a penetrating electrode array in the feline model
ConclusionsWe demonstrated the ability of a penetrating MEA to selectively stimulate restricted fiber populations within the feline RLN and selectively elicit contractions of discrete LMs in both acute and injury‐model experiments, suggesting a potential role for intraneural MEA implantation in VFP management. Level of EvidenceNA Laryngoscope, 2017 (Source: The Laryngoscope)
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Upper airway stimulation therapy and prior airway surgery for obstructive sleep apnea
ConclusionOverall, patients had significant improvement following implantation with hypoglossal nerve stimulator. Prior airway surgery had no statistically significant effect on postoperative AHI or NOS. Level of Evidence4. Laryngoscope, 2017 (Source: The Laryngoscope)
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Survival benefit of tamoxifen and aromatase inhibitor in male and female breast cancer
Abstract
Background
Our goal was to compare the survival advantage of tamoxifen (TAM) and aromatase inhibitor (AI) in female (FBC) and male breast cancer (MBC).
Patients and methods
We performed a retrospective study of 2785 FBC and 257 MBC patients treated with hormonal therapy.
Results
The median follow-up was 106 months (range 3–151 months) and 42 months (range 2–115 months) for FBC and MBC, respectively. The patients were divided into two groups according to the hormonal therapy used: TAM-treated and AI-treated. MBC was characterized by older age, advanced tumor stage, and higher rate of lymph node metastases, in comparison with FBC. Matching analysis was performed using six prognostic criteria: patient age, tumor stage, tumor grade, lymph node status, human epidermal growth factor receptor (HER2) status, and administration of chemotherapy. The female and male patients were matched 2:1. In this analysis, 316 women and 158 men treated with TAM, and 60 women and 30 men treated with AI, were included. The overall survival (OS) was estimated by the Kaplan–Meier method and was compared between FBC and MBC. TAM-treated FBC and MBC patients had similar 5-year OS, 85.1 and 89.2%, respectively (p = 0.972). Notably, FBC patients treated with AI had significantly greater 5-year OS (85.0%) in comparison with AI-treated MBC patients (5-year OS of 73.3%; p = 0.028).
Conclusions
The OS of TAM-treated patients with MBC was similar to the OS of TAM-treated FBC patients, whereas AI treatment is associated with poorer survival of MBC patients.
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Bioabsorbable Steroid-Releasing Implant in the Frontal Sinus After Endoscopic Sinus Surgery
This randomized clinical trial assess the safety and efficacy of an hourglass-shaped, bioabsorbable, steroid-releasing sinus implant in improving postoperative outcomes when placed in the frontal sinus ostia following endoscopic sinus surgery in patients with chronic rhinosinusitis.
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Association of Treatment at High-Volume Facilities With Survival in Nasopharyngeal Cancer
Using the National Cancer Database, this study examines the association of treatment at high-volume facilities with survival in patients receiving chemotherapy for nasopharyngeal cancer.
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Frontal Sinus Drug-Eluting Implants—Effective, but for Which Patients and at What Cost?
Surgical intervention for chronic rhinosinusitis (CRS) is an important treatment option for patients refractory to medical therapy. Despite advances in surgical techniques and operative technology, revision endoscopic sinus surgery (ESS) is necessary in 6% to 19% of patients. Reasons for revision surgery include scarring and adhesion formation, recurrent polyposis, and persistent inflammation. These issues are especially problematic in the frontal recess given the narrow anatomic boundaries that limit the size of the surgical sinusotomy that can be created. Long-term patency rates are reported in the range of 67% to 92%. Attempts to improve the success of frontal sinus surgery by decreasing scarring and inflammation have been long standing and a variety of stenting options exist. Recent advancements in bioabsorbable and drug-eluting stents provide a new possibility for improving postoperative sinus surgery outcomes.
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Hypoglossal Nerve Stimulation for Children With Down Syndrome and Sleep Apnea
This case series examines whether hypoglossal nerve stimulation is safe and effective in children with Down syndrome and obstructive sleep apnea.
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Adjuvant External Beam Radiotherapy in Differentiated Thyroid Cancer
This cohort study investigates the role of adjuvant external beam radiotherapy in locally advanced differentiated thyroid cancer.
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Intraoral Observation of the Mentalis and Incisivus Labii Inferioris Muscles
Abstract: The mentalis (MT) and the incisivus labii inferioris (ILI), which are accessory muscles of the orbicularis oris (OO) muscle, form an intertwined and three-dimensionally related complex. The purpose of this study is to clarify the relationship between the MT, ILI, and OO muscles via intraoral dissection. Twenty-two sides from 11 fresh adult Caucasian cadaveric heads were used, and the MT, ILI, and OO dissected under the surgical microscope. Next, measurements of the bony attachment were carried out on another 12 sides. The fibers of the MT were separated into 2 parts: a superior and an inferior part with the former coursing anteromedially and joining the inferior part of the OO. The latter coursed anteroinferiorly to the skin of the chin. The ILI traveled anterolaterally and joined the inferior part of the OO. Inferior labial branches of the mental nerves ran on the OO. There was a significant difference (P = 0.0001) between specimens that were edentulous or had severe periodontitis with regard to the distance from the alveolar ridge to the upper side of the quadrangle when compared with specimens with mild periodontitis. However, there was no significant difference (P > 0.05) between specimens that were edentulous or had severe periodontitis specimens with mild periodontitis with regard to the distance from the inferior border of the mandible to the lower side of the quadrangle. We believe that the observations of this study could help surgeons better understand the anatomy of the chin and minimize complications following surgical and other invasive procedures in this area.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2iqn8XB
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Inflammatory Myofibroblastic Tumor: Rare Manifestation in Face
Abstract: Inflammatory myofibroblastic tumor, also known as inflammatory pseudotumor and plasma cell granuloma, is a tumor that occurs most often in the lungs, abdomen, skin, soft tissue, genital system, and mediastinal. Before surgery, the diagnosis is difficult to establish because of its diverse manifestations. In the head and neck, manifestation is rare and may occur in the upper respiratory tract, soft tissues, orbits, and skull base. This article aims to report a rare manifestation of the disease in the face, highlighting the importance of a correct diagnosis to determine the most appropriate form of treatment, in male patient, leucoderma, 22 years old, with complain of a painless unilateral growth in the left cheek, beginning 2 months before and with progressive growth.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ioZ3Rb
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“Brighter Hours Will Come: ” The Signet Ring of Florence Nightingale
No abstract availablefrom ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ioK5L4
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A Novel Dissector and Needle Holder Within One Tool
No abstract availablefrom ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zcOZoa
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Head Shape Configuration Over The Centuries
No abstract availablefrom ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zdXkYP
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Bilateral Submental Flap: An Innovative Modification
Abstract: Early management of premalignant lesions like oral submucous fibrosis cannot be underestimated in context of prevention and control of oral malignancies. Soft tissue reconstruction of the oral cavity and face is a complex undertaking. Several flaps local and distant as well as microvascular are available, each with their pros and cons. Microvascular free flaps lay a considerable burden on resources, expertise, increased operating time, and logistics. Simple and technically reproducible alternatives are needed to tackle these issues, more so in developing countries like ours. Submental flap is based on a large branch of the facial artery and was initially described in 1993 by Martin et al as an excellent option in head and neck reconstruction. We describe innovative modification of the submental flap based on concept of bilateral presence of facial and submental vasculature and thus can be used for bilateral cheek reconstruction. We use pedicled bilateral submental flap (BSF) by dividing the oval skin paddle obliquely, maintaining needed length. The best use of the BSF is in reconstruction of cheek defect, after surgical release of grade IV oral submucous fibrosis, a debilitating affliction commonly affecting young productive adults and seen in Indian subcontinent. The technique was used successfully in 20cases with minor complications.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zcORFc
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Long-Term Follow-Up of Osseointegrated Orbital Prosthetic Reconstruction
Background: Osseointegrated implants have been used for craniofacial prosthetic reconstruction since 1979. The authors sought to review long-term outcomes of osseointegrated orbital reconstruction at the Institute for Reconstructive Sciences in Medicine (iRSM). Methods: Twenty-six patients have undergone osseointegrated orbital prosthetic (OOP) reconstruction at iRSM since 1991. A retrospective chart review was performed and patient satisfaction assessed through a questionnaire used in previous osseointegration studies. Multivariate binary logistic regression analysis was performed to assess the relationship between smoking, age, sex, and previous radiation treatment with the occurrence of skin reactions and implant failures. A χ2 test was used to assess the relationship between implant position within the orbit and development of a skin reaction or implant failure. Results: Patients received an average of 5.8 implants during the course of treatment. Follow-up ranged from 6 months to 24 years (mean = 10.6 years). A statistically significant correlation was found between skin reaction and age (P = 0.022), with younger patients more likely to develop a reaction. No variables in our model were significant for predicting implant failure. Overall, there were 39 failures of 155 osseointegrated implants, for a success rate of 74.8%. There was no relationship between skin reaction and implant failure compared to implant position within the orbit. Survey responses were received from 11 of 19 patients (58% response rate). Ninety-one percent of patients were overall satisfied with their prosthesis. Conclusions: There are minimal contraindications for consideration of OOP reconstruction. Patients find their prosthesis comfortable, report increased self-confidence, and are happy to have undergone reconstruction.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zcOMBo
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A Study on the Effects of the Use of Propofol in Experimental Model Inferior Epigastric Island Flap on Ischemia-Reperfusion Injury
Abstract: Problems concerning vascular blood flow are the most frequently encountered ones after flap applications. The flap tissue starts to develop ischemia in patients with a vascular blood flow insufficiency. And reperfusion starts in those patients in whom the ischemia is temporary, triggering an ischemia-reperfusion injury depending on the duration of the ischemia. The aim of this study was to evaluate the effect of propofol, which is an anesthetic agent known to have an antioxidant effect and a free radical scavenging feature on the ischemia-reperfusion injury created on an experimental epigastric island flap. Thirty Sprague–Dawley rats were used in the study. The rats were divided into 3 groups of 10 rats each. Inferior epigastric artery-based abdominal flaps were prepared in all the groups. In group 1 (sham), the flap was elevated but no ischemia was applied. In groups 2 (control) and 3 (propofol), the flap was exposed to ischemia for 2 hours after it was elevated. All the rats were sacrificed and biochemical and histopathological assessments were made on the tissue samples taken on the 14th day. As a result of a comparison between the groups, the flap viability rates and the superoxide dismutase, total antioxidant capacity, and catalase values were found to be significantly higher (P from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zcOKcK
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Does Fat Grafting Influence Postoperative Edema in Orthognathic Surgery?
Purpose: Autologous fat grafting is a useful adjunctive procedure to orthognathic surgery and may also confer anti-inflammatory properties. The purpose of this study is to answer the clinical question: among patients undergoing orthognathic operations, what are the effects of fat grafting on facial edema (magnitude, duration, and rate of decrease)? Methods: A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from preoperative and a series of postprocedure time-points were analyzed. The data set was divided into a fat-grafted cohort and a non-fat-grafted cohort and later analyzed using paired and unpaired t tests and linear regressions to determine significant correlations. Results: One hundred sixteen pre- and postoperative three-dimensional photo data sets were included. The sample included 29 subjects. The facial volume was analyzed both overall and comparing each subgroup (orthognathic vs. orthognathic + fat grafting group). Postoperative facial volume increase averaged 23.7% for the entire cohort (FG and nFG). By week 12, the swelling decreased about 62% from baseline. In all patients, there was a statistically significant decrease in facial volume with time. In the fat-grafted group, despite adding volume, the facial volume was equal to the non-fat-grafted group at week 1, yet the rate of decrease was faster through week 12. Conclusion: The majority of postoperative facial edema decreases by 12 weeks following orthognathic surgery. In this cohort of patients, despite the addition of volume, concurrent fat grafting lessened postoperative edema, and led to a greater magnitude and speed of resolution.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zeK06s
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Immediate Dental Implant Placement After Removal of Complex Odontoma
Abstract: The aim of the authors was to report a clinical case about immediate implant placement after the removal of complex odontoma. A 35-year-old female patient presented to private service complaining about absence of lower right first premolar. The computed tomographic showed radiopaque attenuation, surrounded by a narrow radiolucency in the area of dental absence, suggesting a mineralized lesion. The surgical removal of lesion was performed by intraoral access with general anesthesia and the implant of 3.75 × 10 mm (Neodent) was placed with the aid of a surgical guide, following the drill sequence established by the manufacturer. No complications were observed after 1 year with the prosthetic rehabilitation.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zdX2RJ
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The Americleft Project: A Modification of Asher-McDade Method for Rating Nasolabial Esthetics in Patients With Unilateral Cleft Lip and Palate Using Q-sort
Abstract: The purpose of this study was to investigate ways to improve rater reliability and satisfaction in nasolabial esthetic evaluations of patients with complete unilateral cleft lip and palate (UCLP), by modifying the Asher-McDade method with use of Q-sort methodology. Blinded ratings of cropped photographs of one hundred forty-nine 5- to 7-year-old consecutively treated patients with complete UCLP from 4 different centers were used in a rating of frontal and profile nasolabial esthetic outcomes by 6 judges involved in the Americleft Project's intercenter outcome comparisons. Four judges rated in previous studies using the original Asher-McDade approach. For the Q-sort modification, rather than projection of images, each judge had cards with frontal and profile photographs of each patient and rated them on a scale of 1 to 5 for vermillion border, nasolabial frontal, and profile, using the Q-sort method with placement of cards into categories 1 to 5. Inter- and intrarater reliabilities were calculated using the Weighted Kappa (95% confidence interval). For 4 raters, the reliabilities were compared with those in previous studies. There was no significant improvement in inter-rater reliabilities using the new method. Intrarater reliability consistently improved. All raters preferred the Q-sort method with rating cards rather than a PowerPoint of photos, which improved internal consistency in rating compared to previous studies using the original Asher-McDade method. All raters preferred this method because of the ability to continuously compare photos and adjust relative ratings between patients.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zdhEtf
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Multiple (Concomitant) Traumatic Pseudoaneurysms of the Superficial Temporal Artery
Abstract: The authors present a case with a 22-year-old man suffering from a 2 pseudoaneurysms at the temporal region following trauma. The second pseudoaneurysm was diagnosed through an astute use of digital subtraction angiography along with ultrasound to the right external carotid artery which was preferred due to the presence of a vascular pathology at the region of the trauma. During surgery, the distal and proximal ends of both aneurysms were ligated and resected. The concomitant pseudoaneurysms and the use of digital subtraction angiography should be kept in mind in such trauma patients to prevent additional surgical interventions.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2iob9de
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Cleft Lip and Palate Repair
Introduction: Cleft lip and palate is the most frequent congenital craniofacial deformity. In this article, the authors describe their experience with cleft lip and palate repair. Methods: Data regarding patients presenting with primary diagnosis of cleft lip and/or palate, between 2009 and 2015, were reviewed. Details including demographics, type of cleft, presence of known risk factors, surgical details, and follow-up visits were collected. Documented complications were reported. Caregivers' satisfaction was assessed with a survey. The survey used to assess satisfaction with cleft-related features was based on the cleft evaluation profile (CEP). In addition, 4 assessors used visual analog scale (VAS) to assess the aesthetic satisfaction. Results: Seven hundred fifty-two patients with primary diagnosis of cleft lip and/or palate underwent surgical correction at "S. Chiara" Hospital, 432 (57.45%) male and 320 (42.55%) female. The most common cleft types in our study were incomplete cleft palate (152 patients) and left unilateral complete cleft lip and palate (152 patients). Associated syndromes were found in 46 patients (6.12%). Cleft lip was repaired using a modified Tennison–Randall technique when the defect was unilateral, whereas a modified Mulliken technique was used for bilateral cleft lip. Cleft palate was repaired using the Bardach technique or Von Langenbeck technique at 5 to 6 months of age. Cleft lip and palate was repaired in several surgical steps. In total, complications were reported in 81 of 752 patients (14.16%). Average fathers' satisfaction score assessed using CEP was 4.5 (lip), 4.8 (nose), 4.7 (teeth), 4.8 (bite), 4.2 (breathing), 4.6 (profile). Average mothers' satisfaction score assessed using CEP was 4.3 (lip), 4.6 (nose), 4.4 (teeth), 4.5 (bite), 4.1 (breathing), 4.4 (profile). Average level of aesthetic satisfaction, assessed using VAS, was 8.7 (fathers), 8.1 (mothers), 7.9 (lay person), and 8.0 (senior cleft surgeon). Conclusion: The multidisciplinary management of children with oral cleft determinated good results, in terms of satisfaction and aesthetic appearance. From our experience, periosteoplasty and lip-adhesion are key surgical techniques.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2iobPPL
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Research and its Impact on Education and Information in the Global Arena
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Role of Negative Orbit Vector in Orbital Blow-Out Fractures
Background: Negative orbit vector is defined as the most anterior globe portion protrudes past the malar eminence. The aim of the study was to evaluate the relationship between negative orbit vector and blow-out fracture location analyzing the distance between the anterior corneal surface and orbital bone with facial soft tissue in medial and orbital floor blow out fractures using orbital computed tomography (CT). Methods: Seventy-seven patients diagnosed with blow-out fractures involving the medial or orbital floor were included. Distances from the anterior cornea to lower lid fat, inferior orbital wall, inferior orbital rim, and anterior cheek mass were measured using orbital CT scans. The proportion of negative orbit vector and measured distanced were compared between medial wall fracture and orbital floor fracture. Medical records including age, sex, concomitant ophthalmic diagnosis, and nature of injury were retrospectively reviewed. Results: Forty-three eyes from 43 patients diagnosed with medial wall fracture and 34 eyes from 34 patients diagnosed with orbital floor fracture were included. There was no significant difference in the distance from the anterior cornea to lower lid fat (P = 0.574), inferior orbital wall (P = 0.494), or orbital rim (P = 0.685). The distance from anterior cornea to anterior cheek mass was significantly different in medial wall fracture (−0.19 ± 3.49 mm) compared with orbital floor fracture (−1.69 ± 3.70 mm), P = 0.05. Negative orbit vector was significantly higher in orbital floor fracture patients (24 among 34 patients, 70.6%) compared with those with medial wall fractures (19 among 43 patients, 44.2%) (P = 0.04). Conclusions: Patients presenting with a negative orbit vector relationship when the most anterior portion of globe protruded past the anterior cheek mass and malar eminence were more likely to develop orbital floor fracture than medial wall fracture.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2gY6Kxr
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Effects of Local Low-Dose Alendronate Injections Into the Distraction Gap on New Bone Formation and Distraction Rate on Distraction Osteogenesis
Abstract: Bisphosphonates that constrain bone resorption have a direct effect on osteoclast function. In this experimental study, the effects of low-dose local alendronate injections on the distraction gap (DG) in rabbit mandible at 2 different rates were evaluated. The experimental study was conducted on 20 male, New Zealand white rabbits. The animals were divided into 3 experimental groups and 1 control group. Group 1 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative local low-dose alendronate local injections into the DG. Group 2 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.75 μg/kg of alendronate local injections into the DG. Group 3 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. Group 4 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. All the injections were performed immediately postoperatively and for all groups at 1, 2, 3, and 4 weeks following surgery. The distraction zones were evaluated using dual-energy X-ray absorptiometry and histological analysis. Histologically, bone healing was found to be significantly accelerated in Groups 1 and 4 compared with Groups 2 and 3 (P from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2gW8C9P
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Impact of Septoplasty on Eustachian Tube Functions
Objective: To evaluate the impact of nasal septum deviation (NSD) and septoplasty on eustachian tube (ET) functions. Material and Methods: The study was designed as a prospective controlled study and conducted in a tertiary referral center. A study group of 25 patients who were scheduled for septoplasty for NSD; and a control group of 25 healthy individuals having no ear or nose symptoms were formed. Tympanometric analysis of ET function, subjective and objective analysis of nasal functions with acoustic rhinometry and rhinomanometry were performed. Patients in study group underwent nasal surgery and tests were repeated at postoperative 1st and 3rd months. Results: Eustachian tube functions of study group were significantly worse than the control group (P = 0.032). ET functions were found to be poorer as the nasal airway resistances increase which was found to be close to significance (P = 0.056). One and 3 months after corrective surgery, both nasal airway functions and ET functions improved significantly reaching to the level of control group. Conclusions: Nasal septum deviation was associated with higher rates of ET dysfunction, which could be improved by the nasal surgery. However, in some patients, nasal surgery itself caused ET dysfunction in the early postoperative period.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2gY6jTP
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Review of “Reporting of Randomized Controlled Trials With Statistically Nonsignificant Primary Outcomes Published in High-Impact Surgical Journals” by Arunachalam L, Hunter IA, Killeen S in Ann Surg 265: 1141–1145, 2017
No abstract available
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Oral Behaviors and Parafunctions: Comparison of Temporomandibular Dysfunction Patients and Controls
Abstract: The aim of this study is to evaluate the frequency of oral behaviors in patients with temporomandibular disorders (TMD) and a control group without TMD. In this baseline case–control study, 260 controls and 260 subjects with TMD completed the oral behaviors checklist defined as a "self-report scale for identifying and quantifying the frequency of jaw overuse behavior" and underwent clinical examinations using the DC/TMJ international examination form (version May 12, 2013). Relationships of oral parafunctions' frequencies between groups were examined. The statistical analysis was performed with IBM SPSS Statistics 23 software. Age and gender distribution in the study groups did not reveal statistical differences (P > 0.05). Multivariate logistic regression analysis was conducted to establish system of independent oral behaviors for prognosis TMD. The stepwise regression analysis demonstrated that very frequent expression of holding, tightening, or tense muscles is associated with 10.83 times (P from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ipL2Tp
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A Three-Dimensional Study of Midfacial Changes Following Le Fort II Distraction With Zygomatic Repositioning in Syndromic Patients
Abstract: Le Fort II distraction with zygomatic repositioning introduced the ability to restore central midfacial height and convexity independent of changes in orbital morphology. This study analyzes midfacial and orbital morphology before and after Le Fort II distraction with zygomatic repositioning. All patients who underwent Le Fort II Distraction with zygomatic repositioning between 2013 and 2015 were included. Two- and 3-dimensional measurements were made using 3dMD Vultus software to assess canthal tilt, nasolabial angle, ratio of midfacial to lower facial height, and absolute change in nasal length. Presence of an open bite and Angle classification were assessed before and after surgery. Four patients underwent segmental midface advancement using Le Fort II distraction with zygomatic repositioning. Associated diagnoses included Apert syndrome, Goldenhar syndrome, and achondroplasia. Changes in facial dimensions included: 3.19° improvement in canthal tilt (range −4.7° to 8.4°), 9° change in nasolabial angle (range −1.0° to 19°), and 0.69 cm increase in absolute nasal length (range 0.2–0.94 cm). Mean ratio of midfacial to lower facial height was 0.79 preoperatively and 0.89 postoperatively. Preoperatively, all patients demonstrated Angle class III with 3 of 4 patients demonstrating anterior open bite. All achieved closure of open bite and demonstrated class I or II occlusion. No complications were observed. Le Fort II distraction with zygomatic repositioning resulted in normalization of midfacial soft tissue landmarks. This form of advancement demonstrates the ability to selectively improve midfacial height and canthal tilt while restoring normal occlusion.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ioQLsr
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Deaths among Wild Birds during Highly Pathogenic Avian Influenza A(H5N8) Virus Outbreak, the Netherlands
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Multiple Reassorted Viruses as Cause of Highly Pathogenic Avian Influenza A(H5N8) Virus Epidemic, the Netherlands, 2016
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Angiostrongylus cantonensis DNA in Cerebrospinal Fluid of Persons with Eosinophilic Meningitis, Laos
D. Ming et al.
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Moku Virus in Invasive Asian Hornets, Belgium, 2016
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Lack of Secondary Transmission of Ebola Virus from Healthcare Worker to 238 Contacts, United Kingdom, December 2014
P. Crook et al.
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Is your kid willing to trade Halloween candy for cash? Some dentists buy back sweets
If your child can spare a pound or two, they can trade in their candy for a few bucks at two Fresno dental offices Wednesday through Friday. The dentists are among many nationwide who buy candy from children and donate it to nonprofit organizations that then send the sweets to first responders and U. S. soldiers overseas.
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Comparing perilymph proteomes across species
Objectives/Hypothesis
Biological components of perilymph affect the electrical performance of cochlear implants. Understanding the perilymph composition of common animal models will improve the understanding of this impact and improve the interpretation of results from animal studies and how it relates to humans.
Study Design
Analysis and comparison of the proteomes of human, guinea pig, and cat perilymph.
Methods
Multiple perilymph samples from both guinea pigs and cats were analysed via liquid chromatography with tandem mass spectrometry. Proteins were identified using the Mascot database. Human data were obtained from a published dataset. Proteins identified were refined to form a proteome for each species.
Results
Over 200 different proteins were found per species. There were 81, 39, and 64 proteins in the final human, guinea pig, and cat proteomes, respectively. Twenty-one proteins were common to all three species. Fifty-two percent of the cat proteome was found in the human proteome, and 31% of the guinea pig was common to human. The cat proteome had similar complexity to the human proteome in three protein classes, whereas the guinea pig had a similar complexity in two. The presence of albumin was significantly higher in human perilymph than in the other two species. Immunoglobulins were more abundant in the human than in the cat proteome.
Conclusions
Perilymph proteomes were compared across three species. The degree of crossover of proteins of both guinea pig and cat with human indicate that these animals suitable models for the human cochlea, albeit the cat perilymph is a closer match.
Level of Evidence
NA Laryngoscope, 2017
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The tipping point: are we nearly there yet?
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Cover
The cover image, by Stefan P. Bienz et al., is based on the Original Research Volumetric changes and peri-implant health at implant sites with or without soft tissue grafting in the esthetic zone, a retrospective case–control study with a 5-year follow-up , DOI: 10.1111/clr.13013.
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Practical management of adverse events associated with cabozantinib treatment in patients with renal-cell carcinoma.
| Related Articles |
Practical management of adverse events associated with cabozantinib treatment in patients with renal-cell carcinoma.
Onco Targets Ther. 2017;10:5053-5064
Authors: Gerendash BS, Creel PA
Abstract
Cabozantinib is an oral tyrosine-kinase inhibitor whose targets include VEGFR, MET, and AXL. Cabozantinib is approved for the treatment of patients with advanced clear-cell renal-cell carcinoma (RCC) who have received prior antiangiogenic therapy. In the pivotal Phase III trial of second-line RCC, cabozantinib was associated with a significant improvement in overall survival, progression-free survival, and antitumor response compared with everolimus. Adverse events (AEs) were common for patients receiving cabozantinib, but were effectively managed with supportive care and dose modifications, as discontinuations of cabozantinib due to an AE were infrequent. This article reviews the management of the more common AEs associated with cabozantinib based on findings from the pivotal study, clinical practice guidelines, and the authors' real-world clinical experience, with support from published literature. We focus on hypertension, palmar-plantar erythrodysesthesia, diarrhea, nausea, vomiting, decreased appetite, fatigue, and stomatitis. Effective management of these AEs involves a multimodal strategy that includes patient education, prophylactic and supportive care, and dose modifications. Effective AE management can allow patients to maintain antitumor activity with cabozantinib while mitigating the impact on quality of life.
PMID: 29089775 [PubMed]
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Carer preferences for home support services in later stage dementia
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Carer preferences for home support services in later stage dementia
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Spillover effects in epidemiology: parameters, study designs and methodological considerations
Abstract
Many public health interventions provide benefits that extend beyond their direct recipients and impact people in close physical or social proximity who did not directly receive the intervention themselves. A classic example of this phenomenon is the herd protection provided by many vaccines. If these 'spillover effects' (i.e. 'herd effects') are present in the same direction as the effects on the intended recipients, studies that only estimate direct effects on recipients will likely underestimate the full public health benefits of the intervention. Causal inference assumptions for spillover parameters have been articulated in the vaccine literature, but many studies measuring spillovers of other types of public health interventions have not drawn upon that literature. In conjunction with a systematic review we conducted of spillovers of public health interventions delivered in low- and middle-income countries, we classified the most widely used spillover parameters reported in the empirical literature into a standard notation. General classes of spillover parameters include: cluster-level spillovers; spillovers conditional on treatment or outcome density, distance or the number of treated social network links; and vaccine efficacy parameters related to spillovers. We draw on high quality empirical examples to illustrate each of these parameters. We describe study designs to estimate spillovers and assumptions required to make causal inferences about spillovers. We aim to advance and encourage methods for spillover estimation and reporting by standardizing spillover parameter nomenclature and articulating the causal inference assumptions required to estimate spillovers.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z7FQh2
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Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: Effect of applying BMI adjustments standardizing for ethnic differences in BMI-body fatness associations
Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: Effect of applying BMI adjustments standardizing for ethnic differences in BMI-body fatness associations
Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: Effect of applying BMI adjustments standardizing for ethnic differences in BMI-body fatness associations, Published online: 02 November 2017; doi:10.1038/ijo.2017.272
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Rutter's Child and Adolescent Psychiatry, 6th Edition
 |  | Rutter's Child and Adolescent Psychiatry is the leading textbook in its field. Both interdisciplinary and international, it provides a coherent appraisal of the current state of the field to help researchers, trainees and practicing clinicians in their daily work. Integrating science and clinical practice, it is a comprehensive reference for all aspects of child and adolescent psychiatry. New to this full color edition are expanded coverage on classification Read More... |
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Inflammation: From Molecular and Cellular Mechanisms to the Clinic, 4 Volume Set
 | | The leading reference on this topic of increasing medical relevance is unique in offering unparalleled coverage. The editors are among the most respected researchers in inflammation worldwide and here have put together a prestigious team of contributors. Starting with the molecular basis of inflammation, from cytokines via the innate immune system to the different kinds of inflammatory cells, they continue with the function of inflammation in infectious Read More... |
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Endoscopy in Liver Disease
 | | Liver disease is an increasingly common cause of mortality, and its management is often complex and challenging. Endoscopy has in recent times undergone a period of rapid progress, with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. As the technology in endoscopy expands, both as a diagnostic and interventional procedure, so does the role of the Read More... |
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Microbial Functional Foods and Nutraceuticals
 | | Showcases the recent advances in microbial functional food applications across food science, microbiology, biotechnology, and chemical engineering Microbial technology plays a key role in the improvement of biotechnology, cosmeceuticals, and biopharmaceutical applications. It has turned into a subject of expanding significance because new microbes and their related biomolecules are distinguished for their biological activity and health benefits. Encompassing Read More... |
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Infrared Thermal Imaging: Fundamentals, Research and Applications, 2nd Edition
 | | This new up-to-date edition of the successful handbook and ready reference retains the proven concept of the first, covering basic and advanced methods and applications in infrared imaging from two leading expert authors in the field. All chapters have been completely revised and expanded and a new chapter has been added to reflect recent developments in the field and report on the progress made within the last decade. In addition there is now an even Read More... |
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Woman sees unlicensed dentist, suffers 8-hour surgery, extreme...
A San Antonio man has been arrested, charged with practicing dentistry without a license. His arrest came after a woman accused him of doing an 8-hour surgery on her that ended with what is being considered "extreme damage" to her mouth.
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Severe dermatophytosis in solid organ transplant recipients: A French retrospective series and literature review
Abstract
Objective
Severe dermatophytosis is described in immunocompromised patients with defective cellular immunity. We report here a large series and a literature review of severe dermatophytosis in solid organ transplant (SOT) recipients.
Method
The data main source was a national French retrospective study of severe dermatophytosis in SOT recipients between 2010 and 2016. Inclusion criteria were the presence of dermatophytes in skin culture and one severity criteria: dermal invasion by dermatophytes (invasive dermatophytosis) or involvement of at least two body sites or >10% of body surface area (extensive dermatophytosis)
Results
Twelve patients were included (8 men, median age of 56 years [range: 33-71]). Ten were kidney transplant. The median time from transplantation to severe dermatophytosis diagnosis was 16 months [range: 2-94]. Clinical signs of superficial dermatophytosis were present in 8/12 patients before the emergence of severe dermatophytosis. Nine patients had invasive forms and three extensive ones and nodules of the lower extremities were found in eight. Trichophyton rubrum was isolated in 11 cases. First line treatment was terbinafine (7/12), posaconazole (3/12) or topical treatment alone (2/12). Immunosuppressive therapy was reduced in three patients because of associated infections. Complete response was obtained for 3/3 and 5/9 patients with extensive or invasive forms, respectively after a median treatment's duration of 2.5 [range: 1.5-5] months and 7.5 months [range: 4-12]. Unrelated deaths (n = 2) and graft function impairment (n = 3) occurred.
Conclusion
Severe dermatophytosis is a late complication in SOT recipients presenting with lower limb nodules, which might be prevented by prompt treatment of superficial dermatophytosis.
This article is protected by copyright. All rights reserved.
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Adult onset Kawasaki disease presenting with acute epiglottitis findings
Publication date: Available online 5 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Daichi Murakami, Gen Sugita, Mehmet Gunduz, Tomohiro Suenaga, Takashi Takeuchi, Hiroyuki Suzuki, Muneki Hotomi
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Current Scope and Challenges in Phenome-Wide Association Studies
Abstract
Purpose of Review
Over many decades, researchers have been designing studies to investigate the relationship between genotypes and phenotypes to gain an understanding about the effect of genetics on disease. Recently, a high-throughput approach called phenome-wide associations studies (PheWAS) have been extensively used to identify associations between genetic variants and many diseases and traits simultaneously. In this review, we describe the value of PheWAS along with methodological issues and challenges in interpretation for current applications of PheWAS.
Recent Findings
PheWAS have uncovered a paradigm to identify new associations for genetic loci across many diseases. The application of PheWAS has been effective with phenotype data from electronic health records, epidemiological studies, and clinical trials data.
Summary
The key strength of PheWAS is to identify the association of one or more genetic variants with multiple phenotypes, which can showcase interconnections among the phenotypes due to shared genetic associations. While the PheWAS approach appears promising, there are a number of challenges that need to be addressed to provide additional robustness to PheWAS findings.
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Τετάρτη 1 Νοεμβρίου 2017
Risk factors of pediatric tinnitus: Systematic review and meta-analysis
Objectives/Hypothesis
Medications for pediatric tinnitus are not widely used due to a lack of evidence-based information. The modification of risk factors is essential in pediatric tinnitus; however, there is a lack of systematic reviews despite several reports on risk factors. This study performed a systematic review and meta-analysis of available literature to evaluate risk factors of pediatric tinnitus.
Methods
Studies reporting the risk factors of pediatric tinnitus were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2016. The selected articles included clinical or epidemiological studies conducted with at least 50 subjects and at least one risk factor, including age, gender, hearing loss, noise exposure, or smoking.
Results
Eleven studies involving a total of 28,358 individuals were identified. Increased age was not a significant risk factor with a standardized median difference of 0.16 (95% confidence interval [CI]: −0.01 to 0.33). However, there was a significant correlation between increased age and tinnitus in the adolescent population. The odds ratio (OR) was 1.37 for female gender (95% CI: 1.17 to 1.60), 2.39 for hearing loss (95% CI: 1.48 to 3.87), and 11.35 for noise exposure (95% CI: 1.87 to 68.77). Two studies in adolescents showed statistical significance for smoking as a risk factor in developing tinnitus (OR: 6.05, 95% CI: 1.81 to 20.21).
Conclusions
Older-aged adolescents, as well as those who are females and those with hearing loss may have a higher risk of tinnitus. Noise exposure in the general pediatric population and smoking in adolescents may represent especially important risk factors in pediatric tinnitus. Laryngoscope, 2017
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Summary Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering com...
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Abstract Purpose Clinicians must balance the risks from hypotension with the potential adverse effects of vasopressors. Experts have rec...
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Does CBD Oil Lower Blood Pressure? This article was originally published at SundayScaries." Madeline Taylor POSTED ON January 13, 20...
