Setton International Foods, Inc. of Commack, NY, is voluntarily recalling select dark chocolate almonds and dark chocolate raisins products. All these products contain undeclared Milk. People with an allergy or severe sensitivity to milk run the risk of a serious or life threatening allergic reaction if they consume these products.
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Παρασκευή 3 Νοεμβρίου 2017
Setton International Foods Issues Allergy Alert for Undeclared Milk in Select Dark Chocolate Almonds and Dark Chocolate Raisins Products Received from our Supplier GKI Foods LLC
Sociodemographic patterns in pharmacy dispensing of medications for erectile dysfunction in Sweden
Abstract
Purpose
The purpose of this study is to investigate the relationship between sociodemographic factors and pharmacy dispensing of medications for erectile dysfunction (ED) in the general population of middle-aged and elderly men. By considering a number of medical conditions that could promote or contraindicate use of ED medication, the analysis could help capture prescription patterns that might not be explained by medical needs.
Methods
Individual-level pharmacy dispensing data from 2006 for a population-based cohort of 216,148 men aged 45–79 years in the county Scania, Sweden, were analysed. Multiple logistic regression was applied, and area under the receiver operating characteristic curve (AUC) was calculated to quantify the discriminatory accuracy (DA) of the associations. National trends in pharmacy dispensing of ED medication between 2006 and 2016 were also analysed.
Results
Pharmacy dispensing of ED medication increased between 2006 and 2016, particularly among men aged 65–79 years (from 6.8 to 9.2%). Dispensing of ED medication was positively associated with higher socioeconomic position, and divorced and widowed men were more likely to fill a prescription with ED medication than married men. These associations remained after adjusting for medical conditions. The DA of the associations was, however, rather low (AUC = 0.69 among 45–64 year olds and AUC = 0.65 among 65–79 year olds).
Conclusions
Pharmacy dispensing of ED medication seem linked to the individuals socioeconomic position, age and marital status suggesting sociodemographic disparities in the pharmacy dispensing targeting sexual function. However, the low DA of the associations shows the limited capacity of these factors to predict ED medication use at the individual level.
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'End the scandal of our children's rotten teeth'
CHILDREN from Blackburn with Darwen have the worst teeth in the country and those of five-year-olds in Burnley, Hyndburn, and Pendle are almost as bad. The problem is highlighted in a new report which identifies a North-South divide on the issue and a consistent gap between the teeth of the rich and poor in England.
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Avian Influenza (H7N9) Viruses Co-circulating among Chickens, Southern China
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Beyond the Laboratory, Into the Clinic: What Dogs with Disk Disease Have Taught Us About Photobiomodulation for Spinal Cord Injury
Photomedicine and Laser Surgery Nov 2017, Vol. 35, No. 11: 589-594.
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Pre-Exercise Infrared Photobiomodulation Therapy (810 nm) in Skeletal Muscle Performance and Postexercise Recovery in Humans: What Is the Optimal Power Output?
Photomedicine and Laser Surgery Nov 2017, Vol. 35, No. 11: 595-603.
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Photobiomodulation in Neuroscience: A Summary of Personal Experience
Photomedicine and Laser Surgery Nov 2017, Vol. 35, No. 11: 604-615.
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Er,Cr:YSGG Laser Energy Delivery: Pulse and Power Effects on Enamel Surface and Erosive Resistance
Photomedicine and Laser Surgery Nov 2017, Vol. 35, No. 11: 639-646.
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Oral pregabalin for acute pain relief after cervicofacial surgery: a systematic review
Abstract
Objective
The objectives of this systematic review were to unify criteria on the effectiveness of oral pregabalin to treat acute post-operative pain after cervicofacial surgery, to establish the most effective dose regimens, and to determine its effect on rescue medicine consumption and its association with adverse effects.
Materials and methods
PubMed/Medline (National Library of Medicine, Washington, DC), Scopus, Web of Science, and Cochrane databases were searched for studies in any language published between January 2000 and September 2016. The following question was posed, in accordance with PRISMA guidelines: Is oral pregabalin effective and safe for the relief of acute pain after cervicofacial surgery? The critical reading of the literature utilized a list of questions prepared by the CASPe Network, applying the Jadad scale for evaluation of the methodological quality of trials.
Results
Eleven randomized controlled clinical trials were selected. The 11 trials obtained a score ≥ 3, considered as Ib evidence level and high quality. A single oral dose of 75-mg pregabalin before or after cervicofacial surgery alleviates pain and lessens the need for rescue analgesia consumption, while the statistical significance of these effects is higher with a single dose of 150-mg pregabalin, either before or after the surgery.
Conclusion
Oral pregabalin appears to significantly alleviate post-operative pain and reduce rescue analgesia consumption, with no severe adverse effects. However, the ideal dose and most effective administration regimen remain controversial issues that need to be addressed in further high-quality clinical trials.
Clinical relevance
These findings suggest that pregabalin may be useful for acute pain relief after cervicofacial surgery.
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$10 sensor chip and 3D printed holders help produce 3D ultrasound images
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Distribution and determinants of tuberculosis in the Kingdom of Saudi Arabia from 2005 to 2012
Publication date: Available online 2 November 2017
Source:Journal of Epidemiology and Global Health
Author(s): Fahad M. Almutairi, Tamara Tayeb, Raffat Alhakeem, Abdulaziz bin Saeed, Abdullah Assiri, Scott J.N. McNabb
Tuberculosis (TB) remains a public health threat in the Kingdom of Saudi Arabia (KSA) with many challenges that limit its prevention and control. To understand how to meet these challenges, this study calculated the TB incidence rates (IRs) in KSA from 2005 to 2012, which were stratified by nationality, sex, and administrative regions. Furthermore, laboratory capabilities were assessed by determining the proportion of laboratory-confirmed TB cases. The overall TB IRs decreased from 15.80/100,000 population in 2005 [95% confidence interval (CI)=15.29–16.31] to 13.16/100,000 population in 2012 (95% CI=12.74–13.58). The IRs were greater for males than for females from 2009 to 2012. The IRs of non-Saudis were approximately two times those of Saudis during the study period. Mecca had greater IR during the study period compared with other regions [25.13/100,000 (95% CI=24.7–25.56)]. Among non-Saudis, those from Indonesia and Yemen had the greatest proportion of TB cases (15.4% and 12.9%, respectively). Individuals <15years of age comprised 14.2% of the TB cases. Employed non-Saudis had the greatest proportion of TB (32%), followed by unemployed Saudis (22.38%). The proportion of laboratory-confirmed cases of reported TB was 57% from 2005 to 2012. For effective prevention and control, TB screening should be implemented for non-Saudi workers at ports of entry and laboratory-screening capacity for TB should be evaluated.
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An estimation of the burden of sports injuries among African adolescents
Publication date: Available online 2 November 2017
Source:Journal of Epidemiology and Global Health
Author(s): Drake G. LeBrun, Julius del Rosario, John D. Kelly, Sherry M. Wren, David A. Spiegel, Nyengo Mkandawire, Richard A. Gosselin, Adam L. Kushner
The extent to which sports injuries contribute to the burden of injury among adolescents in low- and middle-income countries (LMICs) is unknown. The goal of this study was to estimate the incidence of sports injuries among adolescents in Africa. Data from the World Health Organization Global School-Based Student Health surveys were used to estimate the annual number of African adolescents sustaining sports injuries. Gender-stratified injury rates were calculated and applied to every African country's adolescent population to estimate country-specific and continent-wide injury totals. A total of 21,858 males and 24,691 females from 14 countries were included in the analysis. Country-specific annual sports injury rates ranged from 13.5% to 38.1% in males and 5.2% to 20.2% in females. Weighted average sports injury rates for males and females were 23.7% (95% CI 23.1%–24.2%) and 12.5% (95% CI 12.1%–12.9%), respectively. When these rates were extrapolated to the adolescent populations of the African continent, an estimated 15,477,798 (95% CI 15,085,955–15,804,333) males and 7,943,625 (95% CI 7,689,429–8,197,821) females sustained sports injuries. Our findings suggest that over 23 million African adolescents sustained sports injuries annually. Further work will help to more precisely define the burden of sports injuries in LMICs and the role that surgery can play in mitigating this burden.
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Psychosocial predictors of breast self-examination behavior among female students: an application of the health belief model using logistic regression
Breast cancer is a life-threatening condition affecting women around the world. The early detection of breast lumps using a breast self-examination (BSE) is important for the prevention and control of this dis...
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No Shots No Drill Dentistry
Dr Schefdore is one of the first dentists in illinois using a new laser technology that allows him to do fillings and treatment of gum disease comfortably with no shots ,drills, or stitches.Recently, Dr Schefdore had a all day live patient seminar at his office training dentists from Indiana, New York, Ohio, and Texas on this new laser technology. Even the dentists were surprised that None of the patients required Novocaine shots, drills, or stitches Also people with sensitive teeth or that experience painful dental cleaning due to sensitive teeth can get relief by getting a 30 minute comfortable laser sensitivity treatment.
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Clogged arteries may be down to bacteria, not diet
An analysis of the chemical signatures of fatty deposits in clogged arteries found that they matched lipids produced by mouth and gut bacteria.
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Next generation sequencing: clinical applications in solid tumours
Summary
Next generation sequencing (NGS) has unravelled the genetic alterations that underlie the pathogenesis of cancer. It is now becoming integrated into routine clinical diagnostics of malignant tumours. NGS supports diagnosis, identifies therapeutic targets, reveals resistance mechanisms and facilitates disease monitoring. It takes a central function in the implementation of cancer therapies adapted to the molecular alterations of tumours.
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A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test
Annals of Otology, Rhinology &Laryngology, Ahead of Print.
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A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test
Annals of Otology, Rhinology &Laryngology, Ahead of Print.
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Thermodynamic modeling of the V-Si-B system
Publication date: December 2017
Source:Calphad, Volume 59
Author(s): Antonio Augusto Araujo Pinto da Silva, Nabil Chaia, Flavio Ferreira, Gilberto Carvalho Coelho, Jean-Marc Fiorani, Nicolas David, Michel Vilasi, Carlos Angelo Nunes
In the present work, the V-Si-B ternary system was thermodynamically modeled using the CALPHAD method. The thermodynamic descriptions of the V-Si and B-Si binary systems were taken from literature while the parameters of binary V-B were re-evaluated, based on new experimental information. The ternary thermodynamic description was based on experimental data of isothermal section and liquidus projection. The binary compounds V3B2, VB, V5B6, V3B4, V2B3 and VB2 were modeled as stoichiometric phases; the terminal solid solutions BCC and β-Rhomb were modeled using the sublattice models (V,Si)1(B,va)3 and (B)93(B, Si)12; the ternary phases D88 and T2 were modeled as (V)0.5556(B,Si)0.3333(B,va)0.1111 and (V)0.625(B,Si)0.375, respectively. A set of thermodynamic parameters is proposed and the results showed a good agreement with available experimental information from the literature.
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Transversal changes, space closure, and efficiency of conventional and self-ligating appliances
Abstract
Objective
Self-ligating brackets (SLBs) were compared to conventional brackets (CBs) regarding their effectiveness on transversal changes and space closure, as well as the efficiency of alignment and treatment time.
Methods
All previously published randomized controlled clinical trials (RCTs) dealing with SLBs and CBs were searched via electronic databases, e.g., MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Registry Platform, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, relevant journals were searched manually. Data extraction was performed independently by two reviewers and assessment of the risk of bias was executed using Cochrane Collaboration's tool. Discrepancies were resolved by discussion with a third reviewer. Meta-analyses were conducted using Review Manager (version 5.3).
Results
A total of 976 patients in 17 RCTs were included in the study, of which 11 could be produced quantitatively and 2 showed a low risk of bias. Meta-analyses were found to favor CB for mandibular intercanine width expansion, while passive SLBs were more effective in posterior expansion. Moreover, CBs had an apparent advantage during short treatment periods. However, SLBs and CBs did not differ in closing spaces.
Conclusions
Based on current clinical evidence obtained from RCTs, SLBs do not show clinical superiority compared to CBs in expanding transversal dimensions, space closure, or orthodontic efficiency. Further high-level studies involving randomized, controlled, clinical trials are warranted to confirm these results.
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Transversal changes, space closure, and efficiency of conventional and self-ligating appliances
Abstract
Objective
Self-ligating brackets (SLBs) were compared to conventional brackets (CBs) regarding their effectiveness on transversal changes and space closure, as well as the efficiency of alignment and treatment time.
Methods
All previously published randomized controlled clinical trials (RCTs) dealing with SLBs and CBs were searched via electronic databases, e.g., MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, World Health Organization International Clinical Trials Registry Platform, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, relevant journals were searched manually. Data extraction was performed independently by two reviewers and assessment of the risk of bias was executed using Cochrane Collaboration's tool. Discrepancies were resolved by discussion with a third reviewer. Meta-analyses were conducted using Review Manager (version 5.3).
Results
A total of 976 patients in 17 RCTs were included in the study, of which 11 could be produced quantitatively and 2 showed a low risk of bias. Meta-analyses were found to favor CB for mandibular intercanine width expansion, while passive SLBs were more effective in posterior expansion. Moreover, CBs had an apparent advantage during short treatment periods. However, SLBs and CBs did not differ in closing spaces.
Conclusions
Based on current clinical evidence obtained from RCTs, SLBs do not show clinical superiority compared to CBs in expanding transversal dimensions, space closure, or orthodontic efficiency. Further high-level studies involving randomized, controlled, clinical trials are warranted to confirm these results.
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Thickness evaluation of articulating papers and foils
Abstract
Articulation and occlusion test materials are tools used in daily prosthodontic and restorative procedures that aid the clinicians in the evaluation of adjacent and opposing natural and/or artificial tooth contacts. A precision micrometer (Series 293, Mitutoyo, Japan) with a resolution of 0.001 mm was used to measure the thickness of five articulating papers and six articulation foils. Four of the articulating foils tested presented thicknesses inferior or equal to 21 μm, confirming their adequacy for the evaluation of natural dentitions. Clinicians and researchers should be aware that some labeled and actual papers/foils thicknesses are not in accordance.
Clinical Significance
The thickness of articulating papers and foils reported by some manufacturers is not accurate. The information provided in this article may aid clinicians and researchers to better select the most appropriate materials for the evaluation of static and dynamic occlusion.
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Pro-angiogenic gene expression is associated with better outcome on sunitinib in metastatic clear-cell renal cell carcinoma
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District MPs demand action as some people resort to 'DIY dentistry' due to dental care crisis
Last year, a damning report by Keighley-based Healthwatch Bradford and District revealed that some people had resorted to 'DIY dentistry' or ended up in A&E because they could not access a dentist. Speaking in a Commons debate on children's oral health, Keighley Labour MP John Grogan highlighted that in many areas of the country - including his constituency - there was "no advertising at all of dentists who are available to take on new children as patients".
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Copyright-Page
Elsevier (Source: Otolaryngologic clinics of North America)
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Allergy as Part of the Unified Otolaryngologic Practice
The management of allergic disorders is an integral part of the specialty of otolaryngology –head and neck surgery. Its importance in the comprehensive management of the ENT patient has become more and more apparent over time. In 1985, 58% of Otolaryngology residency programs offered no formal training in allergy. That situation had improved by 2006, when 62% of programs had active aller gy programs, and the remainder were adding them.1,2 (Source: Otolaryngologic clinics of North America)
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Clinical Applications of Sublingual Immunotherapy
Sublingual immunotherapy (SLIT) is effective for the treatment of allergic rhinitis and allergic asthma in adults and children. In a limited number of studies, SLIT efficacy has been demonstrated for the treatment of food allergy. SLIT has a higher safety profile versus subcutaneous immunotherapy, although some systemic reactions have been reported. Appropriate patient selection, meticulous patient education, and routine follow-up are key for the safe and effective administration of SLIT. With organization and attention to detail, adding SLIT to one 's practice can provide a highly valued patient service. (Source: Otolaryngologic clinics of North America)
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Allergy for the Otolaryngologist
The diagnosis and treatment of allergic disease is an integral part of otolaryngology practice, where care for inflammatory disorders of the nose, sinuses, and upper airway is common. This issue of Otolaryngologic Clinics of North America is designed to bring the practicing otolaryngologist up to date by focusing on where developments have occurred. (Source: Otolaryngologic clinics of North America)
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Management of Anaphylaxis
Anaphylaxis is a severe systemic reaction that can be managed appropriately with expedient diagnosis and treatment. Intramuscular epinephrine continues to be the mainstay of treatment of anaphylaxis; however, it is still underused in the community and in the medical setting. Further education and counseling of patients and health care providers is required to prevent and manage anaphylaxis successfully. In-office management of anaphylaxis includes training of staff, preparedness with the necessary supplies and medication, and an effective action plan. (Source: Otolaryngologic clinics of North America)
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Allergy for the Otolaryngologist
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA (Source: Otolaryngologic clinics of North America)
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Contributors
SUJANA S. CHANDRASEKHAR, MD (Source: Otolaryngologic clinics of North America)
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Forthcoming Issues
Congenital Vascular Lesions of the Head and Neck (Source: Otolaryngologic clinics of North America)
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Rational Approach to Allergy Testing
Allergy testing is commonly used when symptoms of allergic rhinitis are refractory to symptoms and there is potential for treatment with institution of avoidance measures or immunotherapy. Once the decision for testing has been made, the method of testing by either in vivo skin testing by prick/puncture or intradermal testing or in vitro testing of serum-specific IgE is dictated by factors in the clinical history and an informed decision by the patient. Because there is no perfect testing method, understanding the benefits and limitations of each method is imp ortant in selecting the best testing option for each patient. (Source: Otolaryngologic clinics of North America)
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CME Accreditation Page
(Source: Otolaryngologic clinics of North America)
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Discourse measurement in aphasia research
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Compared with Ethel: analyzing the singing styles of Reba McEntire and Bernadette Peters with Ethel Merman in Annie Get Your Gun
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Vocal traditions: Fitzmaurice Voicework
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Metabolic effects of Lactobacillus reuteri DSM 17938 in people with type 2 diabetes: A randomized controlled trial.
 | Related Articles |
Metabolic effects of Lactobacillus reuteri DSM 17938 in people with type 2 diabetes: A randomized controlled trial.
Diabetes Obes Metab. 2017 Apr;19(4):579-589
Authors: Mobini R, Tremaroli V, Ståhlman M, Karlsson F, Levin M, Ljungberg M, Sohlin M, Bertéus Forslund H, Perkins R, Bäckhed F, Jansson PA
Abstract
AIMS: To investigate the metabolic effects of 12-week oral supplementation with Lactobacillus reuteri DSM 17938 in patients with type 2 diabetes on insulin therapy.
MATERIALS AND METHODS: In a double-blind trial, we randomized 46 people with type 2 diabetes to placebo or a low (10(8) CFU/d) or high dose (10(10) CFU/d) of L. reuteri DSM 17938 for 12 weeks. The primary endpoint was the effect of supplementation on glycated haemoglobin (HbA1c). Secondary endpoints were insulin sensitivity (assessed by glucose clamp), liver fat content, body composition, body fat distribution, faecal microbiota composition and serum bile acids.
RESULTS: Supplementation with L. reuteri DSM 17938 for 12 weeks did not affect HbA1c, liver steatosis, adiposity or microbiota composition. Participants who received the highest dose of L. reuteri exhibited increases in insulin sensitivity index (ISI) and serum levels of the secondary bile acid deoxycholic acid (DCA) compared with baseline, but these differences were not significant in the between-group analyses. Post hoc analysis showed that participants who responded with increased ISI after L. reuteri supplementation had higher microbial diversity at baseline, and increased serum levels of DCA after supplementation. In addition, increases in DCA levels correlated with improvement in insulin sensitivity in the probiotic recipients.
CONCLUSIONS: Intake of L. reuteri DSM 17938 for 12 weeks did not affect HbA1c in people with type 2 diabetes on insulin therapy; however, L. reuteri improved insulin sensitivity in a subset of participants and we propose that high diversity of the gut microbiota at baseline may be important.
PMID: 28009106 [PubMed - indexed for MEDLINE]
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Actinomyces infection as a complication of a post-radiotherapy rectal ulcer.
| Related Articles |
Actinomyces infection as a complication of a post-radiotherapy rectal ulcer.
Rev Esp Enferm Dig. 2016 Sep;108(9):580-1
Authors: Martos Plasencia C, Olivencia Palomar P, Patón Arenas R, Verdejo Gil C, Salmoral Luque R, Peña Gómez M, De la Santa Belda E, López Viedma B, Olmedo Camacho J
Abstract
INTRODUCTION: Pelvic radiotherapy is associated with early and late local complication. Actinomyces bacterium is part of the saprophyte flora, although some infection underlying factors are known , the pathophysiology of the disease is still unexplained. Frequently it is involved in oral, gastrointestinal and respiratory infections.
CASE REPORT: We present the description of a clinical case supported with images. So that we have developed a bibliographical research in Pubmed data base including the following key words: Ulcer, rectum, brachitherapy and Actinomyces. The most recent original articles published in the last teen years, related with the pathology observed in the patient of the case, were selected.
DISCUSSION: Brachitherapy over pelvic beds ( prostate, cervix and uterus) could be associated with digestive complications specially in the rectum. Those complications might oscillate from mild inflammatory changes in the mucosa to serious damages as ulcers and lack of tissue. This situation increase the risk of opportunistic infections which could endanger the clinical improve of our patients. We suggest to remember those germen in the diagnosis process in other to achieve an early diagnosis and to use a targeted treatment.
PMID: 27615019 [PubMed - indexed for MEDLINE]
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Whipple's disease under the vision of capsule endoscopy.
| Related Articles |
Whipple's disease under the vision of capsule endoscopy.
Rev Esp Enferm Dig. 2016 Sep;108(9):606
Authors: Juanmartiñena Fernández JF, Oyón Lara D, Rázquin Lizarraga S, Fernández Urien I
Abstract
We read with great interest the paper by Martínez-Sánchez et al. entitled Diagnóstico atípico mediante cápsula endoscópica: enfermedad de Whipple and we support their conclusions.
PMID: 27128447 [PubMed - indexed for MEDLINE]
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Retention force of removable partial dentures with different double crowns
Abstract
Objectives
The aim of the study was to compare the retentive behaviors of double crowns with different designs and material compositions before and after artificial aging.
Materials and methods
Six pairs of double crowns were fabricated: telescopic crowns 0° made of high-noble metal (group A) or non-precious metal (group B), telescopic zirconia copings with secondary crowns made of electroplated gold 2° (group C), crowns with friction pins 2° made of non-precious metal (group D) or zirconia (group E), and conical crowns 6° made of high-noble metal (group F). Retention forces were assessed before and after artificial aging, and after axial and non-axial loading.
Results
Initially, specimens in group D (13.9 N), B (12.5 N), and E (12.2 N) exhibited the highest retention forces. Retention forces in groups A (9.6 N), C (7.4 N), and F (6.0 N) were statistically significantly lower than those of the other groups (p < 0.05). After artificial aging, double crowns with additional retention elements exhibited the highest retention forces. The largest retention force losses were evident in groups A (70%), B (64%), C (39%), and F (47%).
Conclusions
Double crowns with different designs and made of different materials exhibited different retention forces and different long-term retentive behavior. The highest retention force losses were evident in double crowns with more extended surface contact, such as telescopic crowns.
Clinical significance
Telescopic crowns with additional retention elements were more resistant to wearing than double crowns without additional retention elements. An additional clinical benefit might be the quick and easy possibility of enhancing retention.
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Association between XRCC1 single-nucleotide polymorphism and acute radiation reaction in patients with nasopharyngeal carcinoma: A cohort study.
Association between XRCC1 single-nucleotide polymorphism and acute radiation reaction in patients with nasopharyngeal carcinoma: A cohort study.
Medicine (Baltimore). 2017 Nov;96(44):e8202
Authors: Chen H, Wu M, Li G, Hua L, Chen S, Huang H
Abstract
To explore the association of the X-ray repair cross-complementing gene 1 (XRCC1) codon 399 single-nucleotide polymorphism (SNP) with acute radiation dermatitis and oral mucositis in nasopharyngeal carcinoma (NPC) patients treated by intensity-modulated radiation therapy (IMRT).Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the SNP of the XRCC1 codon 399 in 114 NPC patients before radiotherapy.The risk of patients with the Arg/Arg genotype suffering from acute radiation dermatitis Grade ≥2 was higher than the other 2 genotypes (P = .014, 95% CI: 1.182-4.582). No significant difference was observed in the degree of acute radiation oral mucositis injury among the patients with different genotypes (P = .449, 95% CI: 0.691-2.304). Multivariate analysis showed that N stage and genotype were significantly associated with acute radiation dermatitis of Grade ≥2 (OR = 3.221, P < .001, 95% CI: 1.669-6.216, OR = 2.860, P = .006, 95% CI: 1.354-6.043). T stage and smoking status were significantly associated with acute radiation oral mucositis with Grade ≥2 (OR = 2.508, P = .001, 95% CI: 1.427-4.408, OR = 6.355, P < .001, 95% CI: 2.533-15.841).The XRCC1 codon 399 genotype in NPC could be an important predicting factor in the risk of acute radiation dermatitis during IMRT.
PMID: 29095251 [PubMed - in process]
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Evidence-based dentistry: Challenges and possibilities.
Evidence-based dentistry: Challenges and possibilities.
J Oral Pathol Med. 2017 Nov;46(10):857-858
Authors: Martins-Júnior PA, Gomez RS, Brennan PA, Abreu LG
PMID: 29095537 [PubMed - in process]
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Emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae
Source:The Lancet Infectious Diseases
Author(s): Marcus Ho Yin Wong, Hoi-Ping Shum, Jonathan Hon Kwan Chen, Man-Yee Man, Alan Wu, Edward Wai-Chi Chan, Kwok-Yung Yuen, Sheng Chen
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Emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae
Source:The Lancet Infectious Diseases
Author(s): Hong Yao, Shangshang Qin, Sheng Chen, Jianzhong Shen, Xiang-Dang Du
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Persistent carbapenem-resistant Klebsiella pneumoniae: a Trojan horse
Source:The Lancet Infectious Diseases
Author(s): Zhi-Qiang Yang, Yong-Lu Huang, Hong-Wei Zhou, Rong Zhang, Kui Zhu
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Emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae
Source:The Lancet Infectious Diseases
Author(s): Pengcheng Du, Yuanyuan Zhang, Chen Chen
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Editorial Board
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
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Table of Contents
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
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Society Page
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
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Information for Readers
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
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Can we keep the MD program within reach of OMS?
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
Author(s): Mark Engelstad
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Hyperbaric oxygen treatment did not significantly affect radiation injury in the mandibular area of rats.
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Tonje Sønstevold, Anne Christine Johannessen, Rolf K. Reed, Gerd S. Salvesen, Linda Stuhr
ObjectiveHyperbaric oxygen therapy (HBOT) has been used to enhance the microcirculation and thereby the oxygen tension in tissues. The present study aimed to investigate the effect of HBOT on radiation injury in the mandibular area of rats.Study designThe left mandible of rats were irradiated by external radiotherapy (15 Gy every other week for a total of 75Gy). Four HBOT strategies were used; two prophylactic groups receiving HBOT either between each radiation treatment or immediately following terminated radiation treatment, and two therapeutic groups receiving HBOT after the latent period of 6 weeks post irradiation either every day (standard HBOT protocol) or three days a week for 6 weeks. Tissue samples of the irradiated area were taken from skin, salivary gland and mandible. All tissues were H&E stained for morphological examination. Furthermore, the skin samples were stained with CD31 for blood vessel analysis.Results.There was no change in blood vessel density, or morphology between controls or HBOT tissues post radiation. Two of 5 HBOT rats had either normalization of dentin or the dentin was not affected by irradiation.Conclusions.HBOT did not affect radiation injury of the mandibular area in rats within 12 weeks post irradiation.
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Osteoradionecrosis: a review of pathophysiology, prevention and pharmacologic management using pentoxifylline, α-tocopherol, and clodronate
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
Author(s): Jose Antonio Rivero, Omar Shamji, Antonia Kolokythas
A significant complication of radiotherapy to the head and neck for cancer treatment is osteoradionecrosis (ORN) of the jaws. The management of ORN can be complex and often requires a multimodality approach. Nonsurgical treatments with or without adjunct measures and surgical interventions have all been employed on the basis of staging of the disease process. New theories on the pathophysiology of ORN have led to the identification of novel treatment modalities, including pharmacologic management using pentoxifylline, tocopherol, and clodronate (together referred to as "Pentoclo"). In this review article, we discuss the definition and staging of ORN, its etiology and pathophysiology, and traditional treatment options and present the available information on pentoxifylline, tocopherol, and clodronate and their use in combined therapy for ORN. Limited studies to date have demonstrated the effective pharmacologic use of Pentoclo in treating ORN and radiation-induced injury at other body sites. Further research is necessary to elucidate any potential role for the use of Pentoclo in the management of this debilitating disease process.
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Axitinib-related osteonecrosis of the jaw
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
Author(s): Vinod Patel, Chris Sproat, Jerry Kwok, Nikki Tanna
Tyrosine kinase inhibitors (TKIs) are oral chemotherapy drugs used primarily to treat leukemias, renal cell carcinomas, gastrointestinal stromal tumors, and neuroendocrine tumors. Within this group, a number of drugs have already been implicated in jaw necrosis. Axitinib (Inlyta) is a novel TKI currently licensed for the treatment of renal cell carcinoma. We report the first case, to our knowledge, of jaw necrosis solely related to this medication and review the literature surrounding TKIs and their implication in osteonecrosis of the jaw.
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Clinicopathologic significance of in vivo antinuclear autoantibodies in oral mucosal biopsies
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
Author(s): Rana Alshagroud, Mirdza Neiders, Jill M. Kramer, Lakshmanan Suresh
ObjectiveAlthough antinuclear autoantibody (ANA) staining of oral biopsy specimens is indicative of chronic ulcerative stomatitis, it is not known whether this staining is characteristic of other autoimmune diseases. Our study was undertaken to characterize the various in vivo ANA patterns detected in the oral mucosa by direct immunofluorescence to describe the associated hematoxylin and eosin findings, and determine whether patients with these findings had a coexisting systemic connective tissue disease.Study DesignThis was a retrospective analysis of oral biopsy specimens submitted from 2013 to 2016.ResultsIn vivo ANA staining was present in 72 of the 2019 cases examined. Immunoglobulin G was the most common immunoreactant (71 of 72 cases), and speckled nuclear staining was the most frequent in vivo ANA pattern (52 of 72). In most cases, hematoxylin and eosin staining of biopsy specimens showed mucositis (24 of 34). Detailed clinical information was available for 10 patients, and all of them had an autoimmune disease.ConclusionsWe found similar prevalence of ANA staining with direct immunofluorescence in oral epithelial biopsy specimens as reported for those of skin. In vivo ANA in the oral epithelium may indicate the presence of an immune-mediated disease. Patients who show ANA deposits in oral mucosal biopsy specimens should be investigated for systemic connective tissue disease as well as for chronic ulcerative stomatitis.
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Contrast-enhanced ultrasound for diagnosis of an enlarged cervical lymph node in a patient with oropharyngeal cancer: a case report
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 5
Author(s): Shalva R. Gvetadze, Ping Xiong, Jiang Li, Mingming Lv, Jun Li, Xin Yang, Konstantin D. Ilkaev, Jian Sun
In oral and oropharyngeal cancer, the presence of regional neck metastasis strongly influences treatment planning and survival prognosis. A number of imaging techniques can be utilized in the clinic for diagnosis and staging. A patient with oropharyngeal cancer was staged T2 cN1 after clinical examination, computed tomography, and 18F-fluorodeoxyglucose positron emission tomography with computed tomography. Contrast-enhanced microbubble imaging was applied for diagnosis of a lymph node suspected of harboring a metastasis. The result of the microbubble procedure showed the suspicious node to be tumor negative, and this was later confirmed by frozen section and serial step section of the harvested node. Contrast-enhanced ultrasonography with introduction of intravenous microbubble contrast may be of benefit in staging oropharyngeal cancer in patients with enlarged neck lymph nodes.
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IV Brazilian Consensus on Rhinitis: 2017 update
Publication date: Available online 2 November 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Eulalia Sakano, Emanuel S.C. Sarinho, Alvaro A. Cruz, Antonio C. Patorino, Edwin Tamashiro, Fábio Kuschnir, Fábio F.M. Castro, Fabrizio R. Romano, Gustavo F. Wandalsen, Herberto J. Chong-Neto, João F. de Mello, Luciana R. Silva, Maria Cândida Rizzo, Mônica A.M. Miyake, Nelson A. Rosário Filho, Norma de Paula M. Rubini, Olavo Mion, Paulo A. Camargos, Renato Roithmann, Ricardo N. Godinho, Shirley Shizue N. Pignatari, Tania Sih, Wilma T. Anselmo-Lima, Dirceu Solé
IntroductionThe guidelines on allergic rhinitis aim to update knowledge about the disease and care for affected patients. The initiative called "Allergic Rhinitis and its Impact on Asthma", initially published in 2001 and updated in 2008 and 2010, has been very successful in disseminating information and evidence, as well as providing a classification of severity and proposing a systemized treatment protocol. In order to include the participation of other medical professionals in the treatment of allergic rhinitis, it is important to develop algorithms that accurately indicate what should and can be done regionally.ObjectiveTo update the III Brazilian Consensus on Rhinitis – 2012, with the creation of an algorithm for allergic rhinitis management.MethodsWe invited 24 experts nominated by the Brazilian Association of Allergy and Immunology, Brazilian Association of Otorhinolaryngology and Head and Neck Surgery and Brazilian Society of Pediatrics to update the 2012 document.ResultsThe update of the last Brazilian Consensus on Rhinitis incorporated and adapted the relevant information published in all "Allergic Rhinitis and its Impact on Asthma" Initiative documents to the Brazilian scenario, bringing new concepts such as local allergic rhinitis, new drugs and treatment evaluation methods.ConclusionA flowchart for allergic rhinitis treatment has been proposed.
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Button battery ingestion in children
Purpose of review: As the demand for small electronics continues to grow so does the risk of oesophageal ingestion of button batteries. These small but powerful sources of energy are ubiquitous in every household and when swallowed, especially in small children, have been shown to create significant injury in a short amount of time leading to long-term morbidity and possible death. This review highlights the latest findings regarding epidemiology, pathophysiology, diagnosis and management of ingested button batteries. Recent findings: Updated epidemiology from the National Capital Poison Center, new bench research looking at injury patterns and possible mitigation strategies, updated ideas on management algorithms including the use of a trauma protocol, close-look second endoscopy and management of button batteries in the lower gastrointestinal tract are reviewed in this paper. Summary: Despite advances in the understanding of injury mechanics and innovations leading to early diagnosis and improved management of button battery ingestion, parental and provider education remain the most important tools to keep children well tolerated from the sequelae of these potentially fatal events. Collaboration between healthcare experts, public health and industry is essential to find a safe answer to this ongoing threat.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2h7hj4V
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Otolaryngologic management of Down syndrome patients: what is new?
Purpose of review: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. Recent findings: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea–Hypopnea Index, up to 80% may have persistent OSA. Surgical techniques involving reduction of the base of tongue are effective for those who fail adenotonsillectomy, and it is expected that drug-induced sleep endoscopy may improve outcomes. New technology is also on the horizon that can assist with diagnosis and treatment including computational modelling and upper airway stimulation. Children with Down syndrome may not respond to medical management of eustachian tube dysfunction as well as normally developing children. In addition, there is a high prevalence of inner ear anomalies, increasing the risk for sensorineural hearing loss. Summary: Questions remain pertinent to the otolaryngologist regarding the ideal management of children with Down syndrome. Additional studies are necessary, to optimize understanding and treatment of this complex population, in particular as opportunities develop with technological advances.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2h8EmMI
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Role of reinnervation in the management of recurrent laryngeal nerve injury: current state and advances
Purpose of review: To present the current state of knowledge concerning different laryngeal reinnervation procedures for unilateral and bilateral vocal palsy. Recent findings: Recent reports show positive outcomes on both unilateral and bilateral reinnervations. The phrenic nerve is the most commonly used donor for bilateral vocal palsy, but use of the superior laryngeal nerve has also been suggested. Summary: Reinnervation of the larynx is a complex undertaking that can be performed by ENT surgeons with skills in microsurgery. Advances in this this field represent a paradigm shift in laryngeal rehabilitation and a prerequisite for laryngeal transplantation. Advances in basic understanding of nerve regeneration and in particular the need to surgically manage competitive reinnervation make the results of laryngeal reinnervation more predictable.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zbp3Kg
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Emerging techniques in assessment and treatment of muscle tension dysphonia
Purpose of review: The purpose of this review is to summarize current evidence regarding treatment for muscle tension dysphonia (MTD) and to present recent advances in evaluation and management. Recent findings: It is generally accepted that voice therapy for MTD is effective, but current systematic reviews report limited evaluation specific to MTD patients with moderate evidence, at best, available to support voice therapy techniques. Individual studies are difficult to compare because of heterogeneity. Considerable work is underway to identify most important metrics to include in assessment, and to advance and define direct voice therapy approaches. Summary: Further standardization of assessment and treatment protocols for MTD will improve future research. Novel therapeutic techniques are under investigation. In small studies, these have found value in improving voice outcomes and measures compared with pretreatment values but have not met success greater than existing therapeutic methods.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zaDA8Q
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Management of Type I and Type II laryngeal clefts: controversies and evidence
Purpose of review: To summarize the pediatric Type I and Type II laryngeal cleft literature, paying special attention to recent trends, including evolution of surgical techniques, standardization of outcome assessments, and utilization of management algorithms. Recent findings: There are a variety of options to choose from whenever considering Type I and Type II cleft repair, including endoscopic repair, transoral robotic surgery, and injection laryngoplasty. Conservative management including feeding therapy and treatment of comorbid medical conditions is recommended prior to repair. Validated outcome measures have arisen for swallow study interpretation and timing, as well as caregiver quality-of-life assessment. In addition, a series of medical algorithms have been proposed, which provide specific recommendations for diagnosis, treatment, and follow-up. Summary: For clefts that fail conservative management, endoscopic repair has become the gold standard. In addition, injection laryngoplasty appears to provide both a diagnostic and therapeutic option in the management of these patients. Transoral robotic-assisted endoscopic repair appears well tolerated and feasible, although broader implementation of this technology remains limited. The development and refinement of best practice algorithms can help standardize management and improve decision-making. Furthermore, incorporating validated outcome measures, recorded and followed over time, will improve both patient care and research efforts moving forward.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zbp156
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Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment
Purpose of review: The management of benign vocal fold lesions (BVFLs) continues to evolve. This article will review the recent literature surrounding the nomenclature, cause, diagnosis, and treatment of BVFLs, including polyps, nodules, cysts, and reactive lesions. Recent findings: The taxonomy of vocal fold lesions has been refined, and it serves as a common descriptive language for diagnosis, treatment algorithms, and reporting of outcomes. Though these lesions are known to be the result of phonotrauma, investigation into inflammatory mediators, apoptosis, and laryngopharyngeal reflux provide further elucidation of their underlying pathophysiology. The future of diagnosis, for which direct fiberoptic visualization and stroboscopy are the current gold standard, may utilize narrow-band imaging and videokymography; the clinical utility of ultrasound and optical coherence tomography is more remote. Angiolytic laser therapy and intralesional steroid injection are acceptable options for treatment of BVFLs. Voice therapy and microsurgical excision are mainstays of treatment. Summary: Recent clinical and basic science research has expanded upon an extensive literature surrounding the nomenclature, cause, diagnosis, and treatment of benign subepithelial vocal fold lesions. There remains a strong need for the advancement of rigorous diagnostic principles, evaluation of therapeutic interventions, and development of best practices guidelines.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zbp012
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Editorial introductions
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Voice rest after laryngeal surgery: what's the evidence?
Purpose of review: This article aims to review previous research reports and to summarize current strategies for the optimal duration of voice rest and the effect of phonatory stimulation after phonomicrosurgery. Recent findings: Voice rest is commonly recommended after laryngeal surgery to prevent worsening of vocal fold injuries. However, there are no established standard protocol for voice rest, and the type and duration of voice rest vary among clinicians. The most effective duration of voice rest is unknown. Recently, early vocal stimulation was recommended as a means to improve wound healing, on the basis of the basic and clinical researches. Summary: It seems that early vocal stimulation may enhance the wound healing process in the vocal fold. More basic and clinical researches are warranted to investigate appropriate timing of initiation of stimulation, as well as the type and amount of stimulation that are available for human.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboX5m
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Update on pediatric sinus surgery: indications and outcomes
Purpose of review: To review the recent literature of pediatric endoscopic sinus surgery (ESS). Recent findings: Sinus balloon catheter dilation is an important addition to the surgical treatment tools for pediatric chronic rhinosinusitis (PCRS). ESS is a safe and effective therapeutic modality for uncomplicated PCRS. For PCRS complicated by comorbidities including cystic fibrosis and primary ciliary dyskinesia, ESS and adjuvant medical therapy confers significant sinus, pulmonary, and quality of life benefits to pediatric patients. Summary: ESS is a safe and effective treatment modality in the management of pediatric acute and chronic sinus disorders.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboVKM
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Vocal fold leukoplakia: incidence, management, and prevention
Purpose of review: The purpose of this article is to provide an update on English-language literature evaluating the current understanding of incidence, management, and prevention of vocal fold leukoplakia focusing on premalignancy. Recent findings: Recent studies have continued to try to elucidate factors influencing recurrence and progression of dysplastic disease, though results vary. Although advanced diagnostic techniques have attempted to predict disease behavior, tissue diagnosis continues to be essential. Studies reinforce the necessity of removal of disease as the primary treatment, whereas use of photoangiolytic lasers via the ablative technique has increased, as has transition of some patients into the office-based settings for treatment. Although genetic and molecular testing may hold promise for predictive purposes, further study is necessary, and chemotherapy for recalcitrant disease continues to be an area of study with few case studies being reported. Summary: Management of vocal fold leukoplakia continues to progress in terms of identification and treatment. Although many work to advance our knowledge in the field and push treatment strategies toward newer avenues, pathologic diagnosis, eradiation of disease on the basis of experience and skill, and close surveillance continue to be paramount.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboT5C
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Postoperative care after tonsillectomy: what's the evidence?
Purpose of review: The purpose of this review is to evaluate the current literature regarding postoperative management after tonsillectomy in children. Recent findings: Controversy remains regarding the ideal medication regimen to manage pain after tonsillectomy. Acetaminophen and ibuprofen are routinely used, although concerns of more severe postoperative hemorrhage with ibuprofen remain. Narcotics are prescribed commonly, but with extreme caution in children with severe obstructive sleep apnea. Although not always utilized by the authors, additional adjunctive medications such as perioperative dexamethasone, ketamine, and local infiltration of lidocaine into tonsillar pillars may decrease postoperative pain. Systematic reviews have shown that dexamethasone does not increase risk of posttonsillectomy bleeding. Summary: Adenotonsillectomy is one of the most common procedures performed on children and may have significant morbidity from postoperative pain and bleeding. Managing pain remains challenging and the optimal treatment regimen has not been definitively identified. Many medications and alternative therapies have been studied and suggest possible benefit.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboQXu
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Pharyngolaryngeal symptoms associated with thyroid disease
Purpose of review: The current review summarizes previous reports on laryngopharyngeal symptoms associated with thyroid disease. This review also includes pharyngolaryngeal symptoms caused by thyroidectomy. However, we focus on pharyngolaryngeal symptoms following uncomplicated thyroidectomy, as this is an important issue in the fields of otolaryngology. Recent findings: An enlarged thyroid gland, as in thyroiditis, multinodular goiter, or large nodules, can cause compressive symptoms. Malignant nodules invading the recurrent laryngeal nerve and benign nodules compressing the nerve can cause vocal cord paralysis and hoarseness. Pharyngolaryngeal symptoms are known to develop after a thyroidectomy, generally as a result of injury to the superior or recurrent laryngeal nerve. However, recent studies have shown that various pharyngolaryngeal symptoms, such as globus symptoms and voice changes, occur after thyroidectomy in the absence of laryngeal nerve injury. These symptoms are known collectively as postthyroidectomy syndrome. Several possible explanations have been proposed and evaluated for postthyroidectomy syndrome. Summary: Several thyroid disorders can cause compressive symptoms and hoarseness. Superior and/or recurrent laryngeal nerve injury during thyroidectomy is the main cause of various pharyngolaryngeal symptoms. However, other pharyngolaryngeal symptoms that arise following thyroidectomy in the absence of nerve injury, a condition known as postthyroidectomy syndrome, are becoming more common.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zaJ2IT
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Binaural integration: a challenge to overcome for children with hearing loss
Purpose of review: Access to bilateral hearing can be provided to children with hearing loss by fitting appropriate hearing devices to each affected ear. It is not clear, however, that bilateral input is properly integrated through hearing devices to promote binaural hearing. In the present review, we examine evidence indicating that abnormal binaural hearing continues to be a challenge for children with hearing loss despite early access to bilateral input. Recent findings: Behavioral responses and electrophysiological data in children, combined with data from developing animal models, reveal that deafness in early life disrupts binaural hearing and that present hearing devices are unable to reverse these changes and/or promote expected development. Possible limitations of hearing devices include mismatches in binaural place, level, and timing of stimulation. Such mismatches could be common in children with hearing loss. One potential solution is to modify present device fitting beyond providing audibility to each ear by implementing binaural fitting targets. Summary: Efforts to better integrate bilateral input could improve spatial hearing in children with hearing loss.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboMac
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Vocal tremor: where are we at?
Purpose of review: Vocal tremor in movement disorders is often overlooked, although it has a significant impact on quality of life. Careful observation of tremor phenomenology allows for accurate diagnosis and tailored treatment. Recent findings: The central pathways associated with various vocal tremor-associated diseases have been further elucidated. Summary: Patients are likely to benefit from a combination of medical and interventional treatments delivered within a multidisciplinary settingfrom ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zboLmE
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Current opinion in otolaryngology: update on vascular injuries in craniomaxillofacial fractures
Purpose of review: The primary purpose of this chapter is to define current recommendations for vascular work-up of patients with craniomaxillofacial (CMF) trauma with emphasis on imaging to include intraoperative fluorescence, angiography, and surgical exploration. The second goal is to review current management recommendations for observation versus surgical exploration based on the neck zones of injury. Recent findings: Over the past two decades, endovascular techniques are increasingly utilized, particularly in zones I and III of the neck. Additionally, modern advances in radiographic technology have allowed for selective exploration of penetrating zone II injuries. A high suspicion for blunt cerebrovascular injury should be maintained for patients with high-speed deceleration mechanisms of injury, with a majority of patients managed with medical therapy or conservative monitoring over surgical intervention. Summary: CMF fractures are associated with vascular injuries to the intracranial carotid system, extracranial carotid system, or vertebral artery system. A thorough understanding of at risk patients, optimal work-up, and timely treatment algorithms is imperative given the devastating sequellae of stroke and death.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AevkCi
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Prosthodontic Management of a Patient with Moebius Syndrome: A Clinical Report
Abstract
Moebius/Mӧbius Syndrome (MS) is an extremely rare congenital disorder characterized by uni- or bilateral palsy of the abducens (VI) and the facial (VII) nerves, causing facial paralysis. Dysfunction of cranial nerves III through XII is common, most often the glossopharyngeal (IX) and hypoglossus (XII). Afflicted individuals seeking prosthodontic care, particularly removable prosthetics, present multiple challenges related to inherent facial and tongue muscle weakness and microstomia. Other extraoral anomalies may include congenital multiple arthrogryposis and malformations of the upper and lower limbs. This clinical report describes the rehabilitation of a patient with Moebius Syndrome using a maxillary 2-implant retained overdenture and mandibular partial removable denture prosthesis.
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Πέμπτη 2 Νοεμβρίου 2017
Boy (12) attacked and bitten on the face by neighbour's dog awarded a 32k
A 15-year-old schoolboy, who was attacked and bitten in the face by a neighbour's dog, was today in the Circuit Civil Court awarded a 32,000 damages for personal injuries. http://ift.tt/2iTT5vy A 15-year-old schoolboy, who was attacked and bitten in the face by a neighbour's dog, was today in the Circuit Civil Court awarded a 32,000 damages for personal injuries.
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Children and adolescents with intellectual disabilities: oral health status
This review of oral health status in people with intellectual disabilities included 39 studies. Higher level of dental plaque, worse gingival status, and fewer decayed and filled permanent teeth were seen than in patients without intellectual disabilities.
The post Children and adolescents with intellectual disabilities: oral health status appeared first on National Elf Service.
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Rational Approach to Allergy Testing
Allergy testing is commonly used when symptoms of allergic rhinitis are refractory to symptoms and there is potential for treatment with institution of avoidance measures or immunotherapy. Once the decision for testing has been made, the method of testing by either in vivo skin testing by prick/puncture or intradermal testing or in vitro testing of serum-specific IgE is dictated by factors in the clinical history and an informed decision by the patient. Because there is no perfect testing method, understanding the benefits and limitations of each method is important in selecting the best testing option for each patient.
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Clinical Applications of Sublingual Immunotherapy
Sublingual immunotherapy (SLIT) is effective for the treatment of allergic rhinitis and allergic asthma in adults and children. In a limited number of studies, SLIT efficacy has been demonstrated for the treatment of food allergy. SLIT has a higher safety profile versus subcutaneous immunotherapy, although some systemic reactions have been reported. Appropriate patient selection, meticulous patient education, and routine follow-up are key for the safe and effective administration of SLIT. With organization and attention to detail, adding SLIT to one's practice can provide a highly valued patient service.
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Management of Anaphylaxis
Anaphylaxis is a severe systemic reaction that can be managed appropriately with expedient diagnosis and treatment. Intramuscular epinephrine continues to be the mainstay of treatment of anaphylaxis; however, it is still underused in the community and in the medical setting. Further education and counseling of patients and health care providers is required to prevent and manage anaphylaxis successfully. In-office management of anaphylaxis includes training of staff, preparedness with the necessary supplies and medication, and an effective action plan.
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Copyright-Page
Elsevier
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Allergy for the Otolaryngologist
The diagnosis and treatment of allergic disease is an integral part of otolaryngology practice, where care for inflammatory disorders of the nose, sinuses, and upper airway is common. This issue of Otolaryngologic Clinics of North America is designed to bring the practicing otolaryngologist up to date by focusing on where developments have occurred.
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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...
