The objective of this study was to analyze the potential of using low-dose, volumetric computed tomography (CT) during different phases of respiration for identifying patients likely to have severe obstructive sleep apnea (OSA) defined as having a respiratory disturbance index (RDI) of more than 30.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jco8TV
via IFTTT
Παρασκευή 8 Δεκεμβρίου 2017
Upper Airway Areas, Volumes and Linear Measurements Determined on CT during Different Phases of Respiration Predict the Presence of Severe Obstructive Sleep Apnea
“Ferrule Comes First. Post Is Second!” Fake News and Alternative Facts? A Systematic Review
Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A4GbP1
via IFTTT
Effect of Low–surface Tension EDTA Solutions on the Bond Strength of Resin-based Sealer to Young and Old Root Canal Dentin
The purpose of this study was to evaluate the effect of low–surface tension EDTA solutions on the push-out bond strength of resin-based sealer to young and old root canal dentin.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AHN4XD
via IFTTT
Impact of Cone-beam Computed Tomography on Treatment Planning for External Cervical Resorption and a Novel Axial Slice–based Classification System
The aim of this study was to compare treatment plans for external cervical resorption (ECR) developed from periapical (PA) radiographs and cone-beam computed tomographic (CBCT) imaging. The secondary aim of this study was to test a new classification system for ECR based on CBCT axial slice analysis.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A4pL9o
via IFTTT
Regenerative Endodontic Procedures among Endodontists: A Web-based Survey
The protocols that endodontists implement for regenerative endodontic procedures (REPs) are unknown. The aim of this study was to examine current REP protocols among practicing endodontists in the United States.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AHMZ6h
via IFTTT
Evaluation of 3 Different Retreatment Techniques in Maxillary Molar Teeth by Using Micro–computed Tomography
Nonsurgical retreatment procedure involves the complete removal of the previous filling material to allow thorough instrumentation, disinfection, and refilling of root canal system. We aimed to determine the residuals of the root-filling material by using 3 different retreatment techniques with the aid of micro–computed tomography.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A6Uqmh
via IFTTT
The Effects of Irrigants on the Survival of Human Stem Cells of the Apical Papilla, Including Endocyn
Endocyn, a pH-neutral solution of hypochlorous acid and hypochlorite has been developed for use as an endodontic irrigant. The purpose of this study was to evaluate the effect of Endocyn on human periodontal ligament (PDL) fibroblasts, rat osteosarcoma cells (UMR-106), and stem cells of the apical papilla (SCAP) compared with other commonly used endodontic irrigants.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AGlx96
via IFTTT
Survival Rates of Teeth with Primary Endodontic Treatment after Core/Post and Crown Placement
The objective of this study was to determine the effect of delayed placement of the core/post and crown on the outcomes of nonsurgical root canal therapy (NSRCT).
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A8uIOp
via IFTTT
Efficacy of Ultrasound Doppler Flowmetry in Assessing Pulp Vitality of Traumatized Teeth: A Propensity Score Matching Analysis
This retrospective study aimed to evaluate and compare the efficacy of ultrasound Doppler flowmetry (UDF) with that of electric pulp testing (EPT) in assessing pulp vitality in traumatized teeth.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AEXmrj
via IFTTT
Model-Driven Treatment of Childhood Apraxia of Speech: Positive Effects of the Speech Motor Learning Approach
Purpose
The aim of the study was to propose the speech motor learning approach (Van der Merwe, 2011) as a treatment for childhood apraxia of speech and to determine if it will effect positive change in the ability of a 33-month-old child to produce untreated nonwords and words containing treated age-appropriate consonants (Set 1 sounds), untreated age-appropriate consonants (Set 2), and untreated age-inappropriate consonants (Set 3) and also to determine the nature and number of segmental speech errors before and after treatment. Method
An A-B design with multiple target measures and follow-up was implemented to assess the effects of treatment of Set 1. Effect sizes for whole-word accuracy were determined, and two criterion lines were generated following the conservative dual criterion method. Speech errors were judged perceptually. Results
Conservative dual criterion analyses indicated no reliable treatment effect due to rising baseline scores. Effect sizes showed significant improvement in whole-word accuracy of untreated nonwords and real words containing age-appropriate treated sounds and real words containing age-appropriate untreated sounds. The number of errors for all three sound sets declined. Sound distortion was the most frequent error type. Conclusions
Preliminary evidence suggests potentially positive treatment effects. However, rising baseline scores limit causal inference. Replication with more children of different ages is necessary. Supplemental Materials
http://ift.tt/2ApICzWfrom ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nKz5NO
via IFTTT
Orbital volume and shape in Treacher Collins syndrome
Orbito-palpebral reconstruction is a challenge in Treacher Collins syndrome (TCS). This study investigates orbital phenotypes in TCS using cephalometry and orbital shape analysis.Eighteen TCS and 52 control patients were included in this study, using the Dr Warehouse database. Orbital cephalometry was based on 20 landmarks, 10 planes, 16 angles, and 22 distances. Orbits were segmented. Registration-based, age-specific mean models were generated using semi-automatic segmentation, and aligned and compared using color-coded distance maps – maximum absolute distance (MAD), Hausdorff distance (HD), and Dice similarly coefficient (DSC).
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kGu0oI
via IFTTT
Outcome and complications after treatment of facial fractures at different times in polytrauma patients
Finding the correct point of time for operative treatment of facial fractures in multiply injured people remains one of the most important challenges in modern emergency medicine. Findings relating to pathophysiological mechanisms after severe trauma argue against the early operative treatment of non-life-threatening injuries. Our retrospective analysis investigated the effects on complications and outcome of different time points for operative treatment of maxillofacial fractures in multiply injured patients.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Bj04pz
via IFTTT
Orthodontic Class II:1 treatment—efficiency and outcome quality of Herbst-multibracket appliance therapy
Abstract
Objectives
The aim of this retrospective investigation was to assess the efficiency and outcome quality of Class II:1 treatment (Tx).
Material and methods
The investigation is based on the evaluation of all Class II:1 patients that ever (1986–2014) started Tx with a Herbst appliance and subsequently a multibracket appliance (MBA) at the study center. Study casts from before Tx, after Herbst-MBA Tx, and (if available) after ≥ 24 months of retention were evaluated using the Peer Assessment Rating (PAR) index, the Ahlgren scale, and standard occlusal variables.
Results
In total, 526 Class II:1 patients with a mean pre-Tx age of 14.4 years (range 9.8–44.4) had received Herbst-MBA Tx; 18 patients discontinued Tx before completion. For 240 patients, data from ≥ 24 months of retention were available. The pre-Tx PAR score of 32.4 ± 8.83 was reduced to 8.0 ± 4.51 during Tx. A slight increase to 8.8 ± 5.11 occurred during retention. The percentage of patients which could be assigned to the category "greatly improved" was 62% after Tx and 57% after retention; only 2–3% had to be assigned to the category "worse/no different." The outcome ratings according to the Ahlgren scale revealed 17% excellent, 35% good, 45% satisfactory, and 3% unsuccessful results.
Conclusions
Class II:1 Tx using Herbst-MBA is an efficient approach in orthodontic care. During a mean active Tx period of 2 years, high-quality results can be obtained in the majority of patients.
Clinical relevance
The present investigation is the first to investigate a large unselected cohort of consecutive Herbst-MBA patients to determine representative data on the efficiency and the outcome quality of this Tx approach.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2C0MzYP
via IFTTT
“Omics” in oral cancer: New approaches for biomarker discovery
Source:Archives of Oral Biology
Author(s): Vertika Rai, Rashmi Mukherjee, Ananta K. Ghosh, Aurobinda Routray, Chandan Chakraborty
ObjectivesIn this review paper, we explored the application of "omics" approaches in the study of oral cancer (OC). It will provide a better understanding of how "omics" approaches may lead to novel biomarker molecules or molecular signatures with potential value in clinical practice. A future direction of "omics"-driven research in OC is also discussed.MethodsStudies on "omics"-based approaches [genomics/proteomics/transcriptomics/metabolomics] were investigated for differentiating oral squamous cell carcinoma,oral sub-mucous fibrosis, oral leukoplakia, oral lichen planus, oral erythroplakia from normal cases. Electronic databases viz., PubMed, Springer, and Google Scholar were searched.ResultsOne eighty-one studies were included in this review. The review shows that the fields of genomics, transcriptomics, proteomics, and metabolomics-based marker identification have implemented advanced tools to screen early changes in DNA, RNA, protein, and metabolite expression in OC population.ConclusionsIt may be concluded that despite advances in OC therapy, symptomatic presentation occurs at an advanced stage, where various curative treatment options become very limited. A molecular level study is essential for detecting an OC biomarker at an early stage. Modern "Omics" strategies can potentially make a major contribution to meet this need.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nIVET6
via IFTTT
Genetic markers of nasolabial morphology
Source:Archives of Oral Biology
Author(s): Tarek El-Bialy
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Ao7IiH
via IFTTT
Gongylonema pulchrum infection in the human oral cavity – a case report and literature review
Gongylonema infection is a zoonotic disease occurring throughout the world and is mainly caused by consumption of contaminated water and raw food. Adult Gongylonema worms can exist as parasites in the human body for up to 10 years and cause symptoms of local irritation in the oral cavity, oesophagus, and pharynx. Herein, we report a rare case in which live Gongylonema pulchrum was detected and extracted from the oral cavity of a woman. The pathogen was confirmed as G. pulchrum on the basis of microscopic examination and morphological analysis.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BXHIb3
via IFTTT
Quality and readability of internet-based information on halitosis
To evaluate quality and readability of Internet-based information on halitosis.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BO375o
via IFTTT
Minnesota mom details daughter's death in dentist's office
'Please don't kill me': Cop is cleared of murder after shooting dead sobbing father, 26, as he crawled along a hotel corridor in shocking footage which his family insists shows a 'cold-blooded execution' Muslim 'day of rage' turns deadly as Palestinian is shot dead by Israeli soldiers during violent clashes over Trump's decision to recognize Jerusalem as the capital 14 UN peacekeepers are killed and more than 50 wounded in 'worst attack on United Nations troops in recent history' in Congo Trump heads to Florida town fewer than FIFTEEN miles from Alabama to boost Roy Moore's bid for senate despite his slew of teen harassment and sexual assault allegations Bitcoin plunges 15 per cent to below $14,500 in wild trading after a roller-coaster week that saw the currency hit record highs and fears it is on course to create 'largest financial bubble ever' Nine fraternity brothers are arrested in ... (more)
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jc3K50
via IFTTT
Clinical validation study of dried blood spot for determining everolimus concentration in patients with cancer
Abstract
Purpose
Everolimus treatment is seriously hampered by its toxicity profile. As a relationship between everolimus exposure and effectiveness and toxicity has been established, early and ongoing concentration measurement can be key to individualize the dose and optimize treatment outcomes. Dried blood spot (DBS) facilitates sampling at a patients' home and thereby eases dose individualization. The aim of this study is to determine the agreement and predictive performance of DBS compared to whole blood (WB) to measure everolimus concentrations in cancer patients.
Methods
Paired DBS and WB samples were collected in 22 cancer patients treated with everolimus and analyzed using UPLC-MS/MS. Bland-Altman and Passing-Bablok analysis were used to determine method agreement. Limits of clinical relevance were set at a difference of ± 25%, as this would lead to a different dosing advice. Using DBS concentration and Passing-Bablok regression analysis, WB concentrations were predicted.
Results
Samples of 20 patients were suitable for analysis. Bland-Altman analysis showed a mean ratio of everolimus WB to DBS concentrations of 0.90, with 95% of data points within limits of clinical relevance. Passing-Bablok regression of DBS compared to WB revealed no constant bias (intercept 0.02; 95% CI 0.93–1.35) and a small proportional bias (slope 0.89; 95% CI 0.76–0.99). Predicted concentrations showed low bias and imprecision and 90% of samples had an absolute percentage prediction error of < 20%.
Conclusions
DBS is a valid method to determine everolimus concentrations in cancer patients. This can especially be of value for early recognition of over- or underexposure to enable dose adaptations.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nIXF1I
via IFTTT
ASBA/SGS First Sleep Coordinator Boot Camp an Overwhelming Success!
Rebecca Layhe brought energy and excitement to the course as she presented to over 40 dental team members. She has worked in the medical field for over 20 years. She has experience in dental and medical practice management, as well as in medical billing, coding, transcription, and is a medical language specialist.
The Sleep Group Solutions/ASBA Boot Camp is built around supporting dental team members involved in DSM screening and treatment. The program provides a two-day, hands-on training dedicated to their particular roles in snoring and sleep apnea screening and treatment, as well as oral appliance therapy. The two-day program focuses on patient care, team coordination, case creation and presentation, marketing, insurance billing and collections. For only $295, sending your staff to this course is a no-brainer; the amount of productivity it will bring to your office is priceless. To find out more or how you can register for the next ASBA/Sleep Group Solutions Sleep Coordinator Boot Camp, email skylar@myasba.com.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BiWzPY
via IFTTT
Peak Airflow Measurement in Patients With Glottic Insufficiency After Vocal Fold Augmentation
This case series study evaluates changes in peak airflow after vocal fold augmentation among patients with glottic insufficiency.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo8JT
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo8JT
via IFTTT
Implementing Quality Improvement and Patient Safety in Residency Education
This Viewpoint discusses practical strategies for implementing successful resident-led patient safety and quality improvement initiatives in otolaryngology–head and neck surgery residency education.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOge0
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOge0
via IFTTT
Anesthesia Exposure and Neurotoxicity in Children
This Viewpoint discusses the implications for otolaryngologists of a recent US Food and Drug Administration warning about the association between anesthesia exposure and neurocognitive deficits in children.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOdik
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOdik
via IFTTT
Survival Outcomes for T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx
This cohort study defines outcomes in patients with clinical T3N0M0 glottic laryngeal cancer treated with definitive surgical and radiotherapy-based approaches.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzBLkW
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzBLkW
via IFTTT
Reporting of Effect Size and Confidence Intervals
This study evaluates the frequency of reporting effect sizes and confidence intervals in the results of analytical studies from JAMA Otolaryngology–Head & Neck Surgery.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLfotE
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLfotE
via IFTTT
Error in Byline
In the Observation titled "Double Parathyroid Adenomas in Monozygotic Twins," published online September 28, 2017, there was an error in the byline. Where it previously read Brendan R. Stack, it now correctly reads Brendan C. Stack Jr. This article was corrected online.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo1hr
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo1hr
via IFTTT
Measuring Institutional Quality in Head and Neck Surgery Using Hospital-Level Data
Using data from the National Cancer Database, this study examines the association of negative margin rate and lymph node yield with survival in patients with head and neck squamous cell carcinomas at the hospital level.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzJLCi
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzJLCi
via IFTTT
Prognosis of 5-Year Survival of Chemoradiotherapy-Treated Patients With Nasopharyngeal Carcinoma
This cohort study evaluates outcomes data and the American Joint Committee on Cancer staging system to improve the accuracy of the 5-year survival prognosis for patients with nasopharyngeal carcinoma who underwent chemoradiotherapy.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwnSdT
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwnSdT
via IFTTT
Nationwide Variation in Rates of Thyroidectomy Among US Medicare Beneficiaries
This cross-sectional analysis of Medicaid data examines variability across US regions for rates of thyroid surgery among Medicaid beneficiaries.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQk9gS
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQk9gS
via IFTTT
Extracapsular Dissection vs Superficial Parotidectomy
This study reviews all parotidectomies at a single institution conducted by head and neck surgeons to compare extracapsular dissection with superficial parotidectomy for benign parotid tumors with respect to surgical outcomes and cost-effectiveness.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwyk55
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwyk55
via IFTTT
Interferon-γ Treatment of Human Laryngotracheal Stenosis–Derived Fibroblasts
This in vitro controlled study assesses whether the helper T cell 1 cytokine interferon-γ inhibits laryngotracheal stenosis–derived fibroblast function in patients undergoing surgical subglottic and tracheal dilation.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zO6s4M
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zO6s4M
via IFTTT
Double Parathyroid Adenomas in Monozygotic Twins
This is a report of a case of primary hyperparathyroidism in a pair of genetically identical individuals.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQjYSX
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQjYSX
via IFTTT
JAMA Otolaryngology–Head & Neck Surgery
Mission Statement:JAMA Otolaryngology–Head & Neck Surgery provides timely information for physicians and scientists concerned with diseases of the head and neck. Given the diversity of structure and function based in this anatomic region, JAMA Otolaryngology–Head & Neck Surgery publishes clinical, translational, and population health research from an array of disciplines. We place a high priority on strong study designs that accurately identify etiologies, evaluate diagnostic strategies, and distinguish among treatment options and outcomes. Our objectives are to (1) publish original contributions that will enhance the clinician's understanding of otolaryngologic disorders, benefit the care of our patients, and stimulate research in our field; (2) forecast important advances within otolaryngology—head and neck surgery, particularly as they relate to the prevention, diagnosis, and treatment of disease through clinical and translational research, including that of the human genome and novel imaging techniques; (3) address questions of clinical outcomes and cost-effectiveness that result from clinical intervention, which grow in importance as health care providers are increasingly challenged to provide evidence of enhanced survival and quality of life; (4) provide expert reviews of topics that keep our readers current with true advances and also to provide a valuable educational resource for trainees in the several disciplines that treat patients with diseases of the head and neck; (5) serve as a forum for the concerns of otolaryngologists such as socioeconomic, legal, ethical, and medical issues; (6) provide helpful critiques that enable contributing authors to improve their submissions. We encourage a concise presentation of information and employ an abstract format that efficiently assesses validity and relevance from a clinical perspective. This approach promotes succinct yet complete presentation for our readers and electronic information resources. We believe this approach typifies the commitment of JAMA Otolaryngology–Head & Neck Surgery to providing important information that is easily interpreted by its diverse readership.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zNPX8N
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zNPX8N
via IFTTT
What is the appropriate timing for endoscopic and radiographic surveillance following treatment for sinonasal malignancies?
(Source: The Laryngoscope)
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kEUd77
via IFTTT
Mendelian randomization: a novel approach for the prediction of adverse drug events and drug repurposing opportunities
Abstract
Identification of unintended drug effects, specifically drug repurposing opportunities and adverse drug events, maximizes the benefit of a drug and protects the health of patients. However, current observational research methods are subject to several biases. These include confounding by indication, reverse causality and missing data. We propose that Mendelian randomization (MR) offers a novel approach for the prediction of unintended drug effects. In particular, we advocate the synthesis of evidence from this method and other approaches, in the spirit of triangulation, to improve causal inferences concerning drug effects. MR addresses some of the limitations associated with the existing methods in this field. Furthermore, it can be applied either before or after approval of the drug, and could therefore prevent the potentially harmful exposure of patients in clinical trials and beyond. The potential of MR as a pharmacovigilance and drug repurposing tool is yet to be realized, and could both help prevent adverse drug events and identify novel indications for existing drugs in the future.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8IpLc
via IFTTT
Association between exposure to second-hand smoke and telomere length: cross-sectional study of 1303 non-smokers
Abstract
Background
Both active smoking and second-hand smoke (SHS) are important risk factors for many age-related diseases. Active smoking is associated with shortened telomere length. However, whether SHS accelerates telomere attrition with age is uncertain. The aim of this study was to examine the association between SHS exposure and shortening by age of leukocyte telomere length among adult non-smokers. Methods
We undertook a cross-sectional study of the association between self-reported levels of SHS exposure and telomere length shortening per annum on a subgroup of participants from the Scottish Family Health Study. Inclusion was restricted to non-smokers aged ≥ 18 years, who had provided self-reported overall usual SHS exposure (total hours per week) and blood samples for telomere analysis. Linear regression models were used to compare the ratio of telomere repeat copy number to single copy gene number (T/S)by age according to SHS exposure. Results
Of the 1303 eligible participants, 779 (59.8%) reported no SHS exposure, 495 (38.0%) low exposure (1–19 h per week) and 29 (2.2%) high exposure (≥20 h per week). In the univariate linear regression analyses, relative T/S ratio declined with increasing age in all exposure groups. Telomere length decreased more rapidly with increasing age among those with high exposure to SHS [adjusted coefficient −0.019, 95% confidence interval (CI) −0.031- −0.007) when compared with both those with no exposure to SHS (adjusted coefficient −0.006, 95% CI −0.008- −0.004) (high vs no SHS: P = 0.010) and those with low exposure to SHS (adjusted coefficient −0.005, 95% CI −0.007- −0.003) (high vs low SHS: P = 0.005). Conclusions
Our findings suggest that high SHS exposure may accelerate normal biological ageing, and support efforts to protect the public from SHS exposure. Further studies on relevant mechanisms should be conducted.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yPoa9e
via IFTTT
Body mass index and breast cancer survival: a Mendelian randomization analysis
Abstract
Background
There is increasing evidence that elevated body mass index (BMI) is associated with reduced survival for women with breast cancer. However, the underlying reasons remain unclear. We conducted a Mendelian randomization analysis to investigate a possible causal role of BMI in survival from breast cancer. Methods
We used individual-level data from six large breast cancer case-cohorts including a total of 36 210 individuals (2475 events) of European ancestry. We created a BMI genetic risk score (GRS) based on genotypes at 94 known BMI-associated genetic variants. Association between the BMI genetic score and breast cancer survival was analysed by Cox regression for each study separately. Study-specific hazard ratios were pooled using fixed-effect meta-analysis. Results
BMI genetic score was found to be associated with reduced breast cancer-specific survival for estrogen receptor (ER)-positive cases [hazard ratio (HR) = 1.11, per one-unit increment of GRS, 95% confidence interval (CI) 1.01–1.22, P = 0.03). We observed no association for ER-negative cases (HR = 1.00, per one-unit increment of GRS, 95% CI 0.89–1.13, P = 0.95). Conclusions
Our findings suggest a causal effect of increased BMI on reduced breast cancer survival for ER-positive breast cancer. There is no evidence of a causal effect of higher BMI on survival for ER-negative breast cancer cases.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y9nGXS
via IFTTT
A dose-response meta-analysis of chronic arsenic exposure and incident cardiovascular disease
Abstract
Background
Consistent evidence at high levels of water arsenic (≥100 µg/l), and growing evidence at low-moderate levels (<100 µg/l), support a link with cardiovascular disease (CVD). The shape of the dose-response across low-moderate and high levels of arsenic in drinking water is uncertain and critical for risk assessment. Methods
We conducted a systematic review of general population epidemiological studies of arsenic and incident clinical CVD (all CVD, coronary heart disease (CHD) and stroke) with three or more exposure categories. In a dose-response meta-analysis, we estimated the pooled association between log-transformed water arsenic (log-linear) and restricted cubic splines of log-transformed water arsenic (non-linear) and the relative risk of each CVD endpoint. Results
Twelve studies (pooled N = 408 945) conducted at high (N = 7) and low-moderate (N = 5) levels of water arsenic met inclusion criteria, and 11 studies were included in the meta-analysis. Compared with 10 µg/l, the estimated pooled relative risks [95% confidence interval (CI)] for 20 µg/l water arsenic, based on a log-linear model, were 1.09 (1.03, 1.14) (N = 2) for CVD incidence, 1.07 (1.01, 1.14) (N = 6) for CVD mortality, 1.11 (1.05, 1.17) (N = 4) for CHD incidence, 1.16 (1.07, 1.26) (N = 6) for CHD mortality, 1.08 (0.99, 1.17) (N = 2) for stroke incidence and 1.06 (0.93, 1.20) (N = 6) for stroke mortality. We found no evidence of non-linearity, although these tests had low statistical power. Conclusions
Although limited by the small number of studies, this analysis supports quantitatively including CVD in inorganic arsenic risk assessment, and strengthens the evidence for an association between arsenic and CVD across low-moderate to high levels.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yPnSza
via IFTTT
Alcohol consumption in 0.5 million people from 10 diverse regions of China: prevalence, patterns and socio-demographic and health-related correlates
First published online: 1 August 2013, Int J Epidemiol, 2013, doi: http://ift.tt/2yPqHzW
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8jg3x
via IFTTT
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8jg3x
via IFTTT
HDL-cholesterol levels and risk of age-related macular degeneration: a multiethnic genetic study using Mendelian randomization
Abstract
Background
Dyslipidemia, particularly high-density lipoprotein cholesterol (HDL-C), has recently been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of vision loss. However, epidemiological studies have yielded conflicting results. Methods
We investigated the causal role of plasma lipid levels in AMD in multiethnic populations comprising 16 144 advanced AMD cases and 17 832 controls of European descent, together with 2219 cases and 5275 controls of Asian descent, using Mendelian randomization in three models. Model 1 is a conventional meta-analysis which does not account for pleiotropy of instrumental variable (IV) effects. Model 2 is a univariate, inverse variance weighted regression analysis that accounts for potential unbalanced pleiotropy using MR-Egger method. Finally, Model 3 is a multivariate regression analysis that addresses pleiotropy by MR-Egger method and by adjusting for effects on other lipid traits. Results
A 1 standard deviation (SD) higher HDL-cholesterol level was associated with an odds ratio (OR) for AMD of 1.17 (95% confidence interval: 1.07–1.29) in Europeans (P = 6.88 × 10–4) and of 1.58 (1.24–2.00) in Asians (P = 2.92 × 10–4) in Model 3. The corresponding OR estimates were 1.30 (1.09–1.55) in Europeans (P = 3.18 × 10–3) and 1.42 (1.11—1.80) in Asians (P = 4.42 × 10–3) in Model 1, and 1.21 (1.11–1.31) in Europeans (P = 3.12 × 10–5) and 1.51 (1.20–1.91) in Asians (P = 7.61 × 10–4) in Model 2. Conversely, neither LDL-C (Europeans: OR = 0.96, P = 0.272; Asians: OR = 1.02, P = 0.874; Model 3) nor triglyceride levels (Europeans: OR = 0.91, P = 0.102; Asians: OR = 1.06, P = 0.613) were associated with AMD. We also assessed the association between lipid levels and polypoidal choroidal vasculopathy (PCV) in Asians, a subtype of AMD, and found a similar trend for association of PCV with HDL-C levels. Conclusions
Our study shows that high levels of plasma HDL-C are causally associated with an increased risk for advanced AMD in European and Asian populations, implying that strategies reducing HDL-C levels may be useful to prevent and treat AMD.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8SY10
via IFTTT
Exposure to perchlorate, nitrate and thiocyanate, and prevalence of diabetes mellitus
Abstract
Background
It is known that perchlorate, nitrate and thiocyanate have the property of inhibiting sodium iodide symporter. Animal studies have suggested that these compounds, especially perchlorate, might also interfere with insulin secretion. However, the association between their exposure and diabetes risk is largely unknown in humans. Methods
Among 11 443 participants (mean age 42.3 years) from the National Health and Nutritional Examination Survey 2001–14, urinary perchlorate, nitrate and thiocyanate were measured by using ion chromatography coupled with electrospray tandem mass spectrometry. Diabetes was defined as self-reported doctor diagnosis, use of oral hypoglycaemic medication or insulin, fasting plasma glucose ≥ 126 mg/dl or glycated haemoglobin A1c (HbA1c) ≥ 6.5%. Results
The median (interquartile range) levels of urinary perchlorate, nitrate and thiocyanate were 3.32 (1.84, 5.70) μg/l, 46.4 (27.9, 72.0) mg/l and 1.23 (0.59, 2.78) mg/l, respectively. Higher levels of urinary perchlorate were associated with elevated levels of fasting glucose, HbA1c, insulin and homeostatic model assessment of insulin resistance (all Ptrend < 0.001). After multivariate adjustment including urinary creatinine, smoking status and body mass index (BMI), higher urinary perchlorate, but not nitrate or thiocyanate, was associated with an increased prevalence of diabetes mellitus. Comparing extreme quintiles, the odds ratio (95% confidence interval) of diabetes was 1.53 (1.21, 1.93; Ptrend < 0.001) for perchlorate, 1.01 (0.77, 1.32; Ptrend = 0.44) for nitrate and 0.98 (0.73, 1.31; Ptrend = 0.64) for thiocyanate. When urinary perchlorate, nitrate and thiocyanate were further mutually adjusted, the results did not materially change. Similar results were observed when analyses were stratified by smoking status, as well as by age, gender, kidney function and BMI. Conclusions
Higher urinary perchlorate levels are associated with an increased prevalence of diabetes mellitus, independent of traditional risk factors. Future prospective studies are needed to confirm these findings.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8lgZE
via IFTTT
Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort
Abstract
Background
There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods
We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results
High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions
Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8kP1g
via IFTTT
Impact of adding hand-washing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial
Abstract
Background
Information on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization. Methods
Ninety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households. Results
A total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3–10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3–11.1); control: 9.7 (95% CI: 8.3–11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations. Conclusions
Neither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yPyePB
via IFTTT
Declining exposures to lead and cadmium contribute to explaining the reduction of cardiovascular mortality in the US population, 1988–2004
Abstract
Background
Lead and cadmium exposures have markedly declined in the USA following the implementation of large-scale public health policies and could have contributed to the unexplained decline in cardiovascular mortality in US adults. We evaluated the potential contribution of lead and cadmium exposure reductions to explain decreasing cardiovascular mortality trends occurring in the USA from 1988–94 to 1999–2004. Methods
Prospective study in 15 421 adults ≥40 years old who had participated in the National Health and Nutrition Examination Survey 1988–94 or 1999–2004. We estimated the amount of change in cardiovascular mortality over time that can be independently attributed to the intermediate pathway of changes in blood lead and urine cadmium concentrations. Results
There was a 42.0% decrease in blood lead and a 31.0% decrease in urine cadmium concentrations. The cardiovascular mortality rate ratio [95% confidence intervals (CIs)] associated with a doubling of metal levels was 1.19 (1.07, 1.31) for blood lead and 1.20 (1.09, 1.32) for urine cadmium. The absolute reduction in cardiovascular deaths comparing 1999–2004 to 1988–94 was 230.7 deaths/100 000 person-years, in models adjusted for traditional cardiovascular risk factors. Among these avoided deaths, 52.0 (95% CI 8.4, 96.7) and 19.4 (4.3, 36.4) deaths/100 000 person-years were attributable to changes in lead and cadmium, respectively. Conclusions
Environmental declines in lead and cadmium exposures were associated with reductions in cardiovascular mortality in US adults. Given the fact that lead and cadmium remain associated with cardiovascular disease at relatively low levels of exposure, prevention strategies that further minimize exposure to lead and cadmium may be needed.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2y8Bjqi
via IFTTT
Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis
Abstract
Background
Physical activity is associated with reduced risk of colorectal cancer, but most epidemiological studies have focused on occupational and recreational physical activity. The evidence for other domains of activity, and for sedentary behaviour, is limited. Methods
Medline, Embase and Web of Science were searched from inception to December 2015 for studies examining domain-specific physical activity or sedentary behaviour and the risk of colon and/or rectal cancer. We extracted maximally adjusted relative risks (RRs) except when RRs not adjusted for body mass index, were also presented. We used random-effects meta-analysis to compute pooled RRs comparing the highest versus the lowest level of exposure. We used meta-regression to assess sources of heterogeneity in estimates. Results
We identified 17 cohort and 21 case-control studies, of which 17 had occupational data, 23 had recreational data, three each had data on transport and household physical activity domains, and 6 studies had data on occupational sedentary behaviour. The pooled relative risks (RRs) for colon cancer were 0.74 (95% confidence interval (CI): 0.67, 0.82) for occupational activity, 0.80 (95% CI: 0.71, 0.89) for recreational activity, 0.66 (95% CI: 0.45, 0.98) for transport-related physical activity, 0.85 (95% CI: 0.71, 1.02) for household physical activity, and 1.44 (95% CI: 1.28, 1.62) for occupational sedentary behaviour. For rectal cancer, the pooled RRs were 0.88 (95% CI: 0.79, 0.98) for occupational activity, 0.87 (95% CI: 0.75, 1.01) for recreational activity, 0.88 (95% CI: 0.70, 1.12) for transport-related physical activity, 1.01 (95% CI: 0.80, 1.27) for household physical activity, and 1.02 (95% CI: 0.82, 1.28) for occupational sedentary behaviour. Conclusions
In addition to increasing occupational and recreational physical activity, promoting physical activity during transport and reducing sedentary behaviour in the workplace may also be useful colorectal cancer prevention strategies.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yOCUoz
via IFTTT
Does Donald Trump Have False Teeth? People Are Obsessed After Slurred Jerusalem SpeechNewsweek
President Donald Trump's teeth became an unexpected talking point following his speech on the recognition of Jerusalem as Israel's capital on Wednesday, after his slurred words made it appear he may be wearing dentures. The president's pronunciation of the United States-which sounded slurred-set tongues wagging, with a number of social media users questioning whether Trump was wearing false teeth.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jaJxwH
via IFTTT
Chicago Bulls Use Rise Science Sleep Program To Improve Rest, Recovery
To read more, visit Sport Techie.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kF3onY
via IFTTT
ALDI Voluntarily Recalls Choceur Dark Chocolate Bar Due to Undeclared Nut Allergen Products Could Contain Almond Pieces Not Listed on Packaging
In cooperation with Hofer KG ZNL Schokoladefab, ALDI has voluntarily recalled Choceur Dark Chocolate Bars as a precautionary measure due to the potential presence of almond pieces not listed on packaging. The recall was initiated after an ALDI employee identified almond pieces in the product. This product may cause an allergic reaction in customers who have a nut allergy.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nEewCC
via IFTTT
Domperidone prolongs oral to duodenal transit time in video capsule endoscopy
Abstract
Purpose
Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness.
Methods
Thirty-one patients received oral domperidone 20 mg pre-VCE. Thirty-three patients underwent VCE without domperidone pre-treatment. After 2 h, if the capsule remained intra-gastric, gastroscopy-assisted duodenal delivery was performed. Data was analysed using Mann-Whitney testing.
Results
Median oro-duodenal transit was 13 and 30 min in the untreated and domperidone groups, respectively (p = 0.01). Median oro-caecal transit was 242 and 267 min in the untreated and domperidone groups, respectively (p = 0.02). No difference in duodenal-caecal transit was seen (p = 0.60). Six percent of untreated and 13% of domperidone VCEs required gastroscopy-assisted duodenal capsule delivery (p = 0.65).
Conclusions
Unexpectedly domperidone delayed VCE gastric transit. Most studies on domperidone prokinetic effects have been in diabetic gastroparesis, demonstrating that domperidone can achieve good symptomatic relief, but with mixed results for gastric emptying. Our study suggests that any antiemetic effects of domperidone are not mediated through accelerated gastric transit.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BNwtkm
via IFTTT
Taxane, platinum and 5-FU prior to chemoradiotherapy benefits patients with stage IV neck node-positive head and neck cancer and a good performance status
Abstract
Purpose
The benefit of adding docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy to chemoradiotherapy (CRT) in head and neck squamous cell carcinoma (HNSCC) remains uncertain. We aimed to investigate whether ICT is well tolerated when given with prophylactic treatment against predicted adverse effects and which patients benefit most.
Methods
A single-centre audit identified 132 HNSCC patients with stage IVa/b neck node-positive disease, prescribed TPF followed by CRT. TPF involved three cycles of docetaxel (75 mg/m2 IV) and cisplatin (75 mg/m2 IV) on day 1 plus 5-FU (750 mg/m2 IV) on days 2–5. Planned CRT was 66 Gy in 30 fractions of intensity-modulated radiotherapy with concurrent cisplatin (100 mg/m2 IV) at the beginning of week 1 and 4 (days 1 and 22). All patients received prophylactic antibiotics and granulocyte colony-stimulating factor.
Results
Median follow-up was 39.5 months. 92.4% of patients completed three cycles of TPF; 95.5% of patients started chemoradiotherapy. Grade 3/4 adverse events were low (febrile neutropenia 3.0%), with no toxicity-related deaths. 3-year overall survival was 67.2%; disease-specific survival was 78.7%; locoregional control was 78.3%. Distant metastases rate was 9.8% (3.0% in those without locoregional recurrence). Good performance status (p = 0.002) and poor tumour differentiation (p = 0.018) were associated with improved overall survival on multivariate analysis.
Conclusion
With prophylactic antibiotics and granulocyte colony-stimulating factor TPF was well tolerated with good survival outcomes. TPF should remain a treatment option for stage IV neck node-positive patients with a good performance status. The use of tumour grade to aid patient selection for TPF warrants investigation.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kbwwiI
via IFTTT
Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: A case report
Publication date: Available online 7 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Thomas Aerden, Koenraad Grisar, Margaux Nys, Constantinus Politis
We present the case of a 32-year-old male patient complaining of recurrent mandibular pain for 3.5 years. Panoramic radiography showed increased cortical density of the mandibular lower border. Scintigraphy and SPECT-CT revealed metabolic hyperactivity in that region without pathological lymph nodes. A bone biopsy of the mandibular lower border did not show inflammation or cytological atypia. Endocrinologic investigation confirmed secondary hyperparathyroidism due to hypovitaminosis D. Several weeks after starting therapy with oral vitamin D supplements, the symptoms completely disappeared. Increased cortical density is a rare manifestation of secondary hyperparathyroidism, which normally causes the lamina dura to vanish and a ground-glass appearance due to blurring of the trabecular bone pattern. As focal hyperostosis can have multiple benign or malignant causes, radiological examination of the jaw bones is indispensable for evaluating orofacial pain. Increased cortical density may be caused by metabolic diseases, requiring further investigations, including biopsy and blood analysis.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nJeZDJ
via IFTTT
Mother grieves in candid post about daughter's deadly seizure in dentist's Edina office
Laying bare her anguish for a child forever lost, an Eden Prairie mother whose daughter had a fatal seizure while getting her wisdom teeth removed has publicly and in unvarnished detail accused the doctor of cutting corners and "jumping ship" while his patient turned blue and lapsed into cardiac arrest. Diane Galleger's wide-ranging post this week on a CaringBridge page dedicated to her 17-year-old daughter includes a newly disclosed moment-by-moment account of that June 2015 day.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jvYC8M
via IFTTT
Comparative analysis of lactic acidosis induced by linezolid and vancomycin therapy using cohort and case–control studies of incidence and associated risk factors
Abstract
Purpose
Lactic acidosis is a rare complication of linezolid (LZD) therapy, and its incidence and risk factors remain unknown. This study aimed to compare the incidence of LZD-associated lactic acidosis (LALA) and vancomycin (VAN)-associated lactic acidosis (VALA) and investigate the risk factors for LALA.
Methods
We performed a retrospective cohort study using propensity score-matched analyses comparing the incidence of lactic acidosis between LZD and VAN therapy. We included adult patients administered LZD or VAN between April 2014 and March 2016 and extracted patient baseline data. In a case–control study, we identified the risk factors of lactic acidosis in patients treated with LZD.
Results
We identified 94 and 313 patients who were administered LZD and VAN, respectively. The incidence of lactic acidosis after LZD and VAN therapy was 10.6 and 0.3%, respectively. After propensity score-matched analyses, the incidence of lactic acidosis with LZD therapy was significantly higher than that with VAN therapy [10.0% (8/80) vs. 0% (0/80), respectively; risk difference, 0.1; 95% confidence interval (CI), 0.03–0.17; p = 0.004]. In a case–control study, 10 patients with LALA were matched to 20 non-lactic acidosis patients by age and sex. Patients with LALA were more likely to have renal insufficiency than non-lactic acidosis patients that were in the univariate analysis (odds ratio, 7.4; 95% CI, 1.0–84.4; p = 0.02).
Conclusions
This study indicates that LALA occurs more frequently than VALA does and is associated with renal insufficiency. Therefore, close monitoring of kidney function and serum lactate is recommended during LZD therapy.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BXL6CL
via IFTTT
Couple-based communication interventions for cancer: moving beyond a ‘one size fits all’ approach
.
from ! Medicine by Alexandros G. Sfakianakis via Αλέξανδρος Σφακιανάκης on Inoreader http://ift.tt/2nK8pwM
via IFTTT
Dental anomalies in different growth and skeletal malocclusion patterns.
Dental anomalies in different growth and skeletal malocclusion patterns.
Angle Orthod. 2017 Dec 07;:
Authors: Fernandez CCA, Pereira CVCA, Luiz RR, Vieira AR, De Castro Costa M
Abstract
OBJECTIVES: To evaluate prevalence, distribution, and sexual dimorphism of dental anomalies (DA) among different skeletal malocclusions (SM) and growth patterns (GP) under the hypothesis that specific clinical patterns exist and may indicate common etiological roots.
MATERIALS AND METHODS: A total of 1047 orthodontic records of patients older than 8 years were evaluated. The SN-GoGn angle was used to classify GP (hypodivergent, normal, and hyperdivergent), and the ANB angle was used to verify SM (Angle Classes I, II, and III). These assessments were done from lateral cephalometric radiographs. DA were diagnosed using panoramic radiographs by one calibrated investigator. Odds ratios, chi-square, and Student's t-tests were used.
RESULTS: Of the subjects, 56.7% were female, with mean age of 16.41 (±10.61) years. The prevalence of DA was 15.7%. Impaction and tooth agenesis were the most prevalent DA, with relative frequencies of 14.4% and 9.7%, respectively. DA were most prevalent in Class III SM (80.8%) and in hypodivergent GP (82.5%), although this was not statistically significant. Tooth agenesis (P < .01) and microdontia (P = .025) were significantly more common among hypodivergent GP and Class III SM, respectively.
CONCLUSIONS: The results of this study support the idea that DA are preferentially associated with certain patterns of malocclusion.
PMID: 29215300 [PubMed - as supplied by publisher]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AoKloY
via IFTTT
The glycoprotein of vesicular stomatitis virus promotes release of virus-like particles from tetherin-positive cells.
The glycoprotein of vesicular stomatitis virus promotes release of virus-like particles from tetherin-positive cells.
PLoS One. 2017;12(12):e0189073
Authors: Brinkmann C, Hoffmann M, Lübke A, Nehlmeier I, Krämer-Kühl A, Winkler M, Pöhlmann S
Abstract
Vesicular stomatitis virus (VSV) release from infected cells is inhibited by the interferon (IFN)-inducible antiviral host cell factor tetherin (BST-2, CD317). However, several viruses encode tetherin antagonists and it is at present unknown whether residual VSV spread in tetherin-positive cells is also promoted by a virus-encoded tetherin antagonist. Here, we show that the viral glycoprotein (VSV-G) antagonizes tetherin in transfected cells, although with reduced efficiency as compared to the HIV-1 Vpu protein. Tetherin antagonism did not involve alteration of tetherin expression and was partially dependent on a GXXXG motif in the transmembrane domain of VSV-G. However, mutation of the GXXXG motif did not modulate tetherin sensitivity of infectious VSV. These results identify VSV-G as a tetherin antagonist in transfected cells but fail to provide evidence for a contribution of tetherin antagonism to viral spread.
PMID: 29216247 [PubMed - in process]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kHjY6U
via IFTTT
A randomized phase II trial of induction chemotherapy followed by cisplatin chronotherapy versus constant rate delivery combined with radiotherapy.
A randomized phase II trial of induction chemotherapy followed by cisplatin chronotherapy versus constant rate delivery combined with radiotherapy.
Chronobiol Int. 2017 Dec 07;:1-9
Authors: Zhang PX, Jin F, Li ZL, Wu WL, Li YY, Long JH, Chen GY, Chen XX, Gan JY, Gong XY, He QY, Bi T
Abstract
Chronotherapy is no longer a novel concept in cancer treatment after approximately 20 years of development. Many clinical trials have provided strong supporting evidence that chronomodulated treatment yields better results than a traditional dosage regimen. This study aimed to evaluate the adverse reactions, effect on immune functions, and therapeutic efficacy of chronomodulated infusion versus flat intermittent infusion of cisplatin (DDP) combined with intensity-modulated radiation therapy (IMRT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). A total of 148 patients with biopsy-diagnosed untreated stage III-IVb NPC were randomly assigned to undergo two cycles of chronomodulated infusion (study group) or flat intermittent infusion (control group) of DDP (100 mg/m2 on day 1, 21 days/cycle) synchronized with radical radiotherapy. Patients in the study group received chronomodulated infusion, with peak delivery of DDP at 16:00 pm. Patients in the control group received a routine constant rate of infusion. Both groups were treated with the same radiotherapy techniques. Over a median follow-up of 20 months, the study group had better outcomes for adverse effects and immune functions compared with the control group. During the phase of concurrent chemoradiotherapy, the incidence of nausea, vomiting, and oral mucositis in the study and control groups was 66.7% and 79.5% (p < 0.05), 47.9% and 71.2% (p < 0.05), and 73.9% and 87.7% (p < 0.05), respectively. There was no significant difference in 2-year overall survival, progression-free survival, and distant metastasis-free survival between the two groups (p > 0.05). Chronochemotherapy significantly reduced the incidence of adverse reactions and enhanced the tolerance for treatment without affecting survival. It is worth mentioning that reduced destruction of immune function is a novel area of exploration in chronotherapy research.
PMID: 29215933 [PubMed - as supplied by publisher]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kELAtj
via IFTTT
IFN-λ1 in CHO cells: its expression and biological activity.
IFN-λ1 in CHO cells: its expression and biological activity.
Cell Mol Biol Lett. 2017;22:26
Authors: Yuan WM, Zhang WJ, Ma FL, Li JS, Zhang Q, Zheng LS
Abstract
Background: Many studies have investigated the characteristics and biological activities of type III interferon (IFN), finding that it has similar features to type I IFN but also unique actions because it is recognized by a different receptor.
Results: A full-length recombinant human IFN-λ1 (rhIFN-λ1) cDNA was cloned into the pDF expression vector and stably expressed in Flp-In-CHO cells. After four purification steps (ammonium sulfate precipitation, SP Sepharose chromatography, Blue Sepharose 6 fast flow affinity chromatography and molecular sieve chromatography), the rhIFN-λ1 had a purity of about 90% and was found to have the predicted biological activities. The anti-viral activity of rhIFN-λ1 was determined as 106 IU/mg using the vesicular stomatitis virus (WISH-VSV) assay system. The anti-proliferation activity of rhIFN-λ1 was measured using the MTS method and the growth inhibition ratio was 57% higher than that for recombinant human IFN-α2b (rhIFN-α2b) when the rhIFN-λ1 concentration was 1000 IU/ml. rhIFN-λ1 had lower natural killer cell cytotoxicity than rhIFN-α2b.
Conclusion: The Flp-In-CHO system is suitable for stably expressing rhIFN-λ1 that possesses the predicted anti-viral, anti-proliferation and natural killer cell cytotoxicity-promoting activities.
PMID: 29213292 [PubMed - in process]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AH97zC
via IFTTT
Control of HTLV-1 Infection by Eliminating Envelope Protein-Positive Cells with Recombinant Vesicular Stomatitis Viruses Encoding HTLV-1 Primary Receptor.
Control of HTLV-1 Infection by Eliminating Envelope Protein-Positive Cells with Recombinant Vesicular Stomatitis Viruses Encoding HTLV-1 Primary Receptor.
J Virol. 2017 Dec 06;:
Authors: Tezuka K, Okuma K, Kuramitsu M, Matsuoka S, Tanaka R, Tanaka Y, Hamaguchi I
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) infection causes adult T-cell leukemia (ATL), which is frequently resistant to current available therapies and has a very poor prognosis. To prevent the development of ATL among carriers it is important to control HTLV-1-infected cells in infected individuals. Therefore, the establishment of novel therapies with drugs specifically targeting infected cells is urgently required. This study aimed to develop a potential therapy by generating recombinant vesicular stomatitis viruses (rVSVs) that lack an envelope glycoprotein G and instead encode HTLV-1 receptor(s) with human glucose transporter 1 (GLUT1), neuropilin 1 (NRP1), or heparan sulfate proteoglycans (HSPGs) including syndecan 1 (SDC1), designated as VSVΔG-GL, VSVΔG-NP, or VSVΔG-SD, respectively. In an attempt to enhance the infectivity of rVSV against HTLV-1-infected cells, we also constructed rVSVs with a combination of two or three receptor genes, designated as VSVΔG-GLN and VSVΔG-GLNS, respectively. The current study demonstrated VSVΔG-GL, VSVΔG-NP, VSVΔG-GLN, and VSVΔG-GLNS have tropism for HTLV-1 envelope (Env) expressing cells. Notably, the inoculation of VSVΔG-GL or VSVΔG-NP significantly eliminated HTLV-1-infected cells in the culture conditions. Furthermore, in an HTLV-1-infected humanized mouse model, VSVΔG-NP was capable of efficiently preventing HTLV-1-induced leukocytosis in the periphery and eliminating HTLV-1-infected Env-expressing cells in the lymphoid tissues. In summary, an rVSV engineered to express HTLV-1 primary receptor, especially human NRP1, may represent a drug candidate that has potential for the development of unique virotherapy against HTLV-1 de novo infection.IMPORTANCEAlthough several anti-ATL therapies are currently available, ATL is still frequently resistant to therapeutic approaches and its prognosis remains poor. Control of de novo HTLV-1 infection or expansion of HTLV-1-infected cells in the carrier holds considerable promise for the prevention of ATL development. In this study, we developed rVSVs that specifically target and kill HTLV-1 Env-expressing cells (not ATL cells, which generally do not express Env in vivo) through replacement of the G gene with HTLV-1 receptor gene(s) in the VSV genome. Notably, an rVSV engineered to express human NRP1 controlled the number of HTLV-1-infected Env-expressing cells in vitro and in vivo, suggesting the present approach may be a promising candidate for novel anti-HTLV-1 virotherapy in HTLV-1 carriers, including as a prophylactic treatment against the development of ATL.
PMID: 29212930 [PubMed - as supplied by publisher]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BTF4mB
via IFTTT
The benefit of everolimus in recurrent/epithelioid angiosarcoma patients: Case reports and literature review.
The benefit of everolimus in recurrent/epithelioid angiosarcoma patients: Case reports and literature review.
Oncotarget. 2017 Nov 07;8(55):95023-95029
Authors: Zhang SL, Liang L, Ji Y, Wang ZM, Zhou YH
Abstract
Epithelioid angiosarcoma (EA) is a kind of rare malignant soft tissue sarcoma, with high recurrence/metastatic rate and poor prognosis. To date, no effective standardized treatment regimen has been available for patients with recurrence/metastatic EA. Everolimus is an oral rapamycin derivative that highly inhibits the mechanistic target of rapamycin(mTOR) signal pathway. Previous studies have suggested that everolimus is effective and safe in some soft tissue sarcoma. We reported two cases with recurrence/metastatic EA, who received everolimus after failure of surgery, radiotherapy, chemotherapy or interventional therapy. Two cases obtained clinical benefit within 1 week, and were evaluated as partial response (PR). The progression free survival (PFS) time was nearly 12.0 and 6.0 months, respectively. The overall survival (OS) time was 18.0 and 10.0 months, respectively. The main adverse event was stomatitis syndrome (grade 1-2), which was well controllable and tolerable. It indicated that everolimus may be more beneficial for recurrence/metastatic EA patients.
PMID: 29212287 [PubMed]
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jbtEG9
via IFTTT
Improved adductor function after canine recurrent laryngeal nerve injury and repair using muscle progenitor cells
Objective
Muscle progenitor cells (MPCs) can be isolated from muscle samples and grown to a critical mass in culture. They have been shown to survive and integrate when implanted into rat laryngeal muscles. In this study, the ability of MPC implants to enhance adductor function of reinnervated thyroarytenoid muscles was tested in a canine model.
Study Design
Animal study.
Methods
Sternocleidomastoid muscle samples were harvested from three canines. Muscle progenitor cells were isolated and cultured to 107 cells over 4 to 5 weeks, then implanted into right thyroarytenoid muscles after ipsilateral recurrent laryngeal nerve transection and repair. The left sides underwent the same nerve injury, but no cells were implanted. Laryngeal adductor force was measured pretreatment and again 6 months later, and the muscles were harvested for histology.
Results
Muscle progenitor cells were successfully cultured from all dogs. Laryngeal adductor force measurements averaged 60% of their baseline pretreatment values in nonimplanted controls, 98% after implantation with MPCs, and 128% after implantation with motor endplate-enhanced MPCs. Histology confirmed that the implanted MPCs survived, became integrated into thyroarytenoid muscle fibers, and were in close contact with nerve endings, suggesting functional innervation.
Conclusion
Muscle progenitor cells were shown to significantly enhance adductor function in this pilot canine study. Patient-specific MPC implantation could potentially be used to improve laryngeal function in patients with vocal fold paresis/paralysis, atrophy, and other conditions. Further experiments are planned.
Level of Evidence
NA. Laryngoscope, 2017
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A5itSP
via IFTTT
The development of the human hyoid–larynx complex revisited
Objectives/Hypothesis
The hyoid–larynx complex is highly prone to anatomical variation. The etiology of anatomical variants such as Eagle's syndrome and the aberrant hyoid apparatus can be explained from embryonic development. Modern textbooks state that the hyoid bone body develops from the second and third pharyngeal arch cartilages, and that thyroid cartilage derives from the fourth and sixth arch cartilages. This description, however, is incompatible with various anatomical variants, and it is unclear whether it was based on observations in human embryos or on comparative embryology.
Study Design
14 human embryos from the Carnegie collection between Carnegie stage 17 and 23 (42–60 days) were selected based on their histological quality.
Methods
Histological sections of the selected embryos were examined. Three-dimensional models were prepared in an interactive format. These anatomical models provide crucial spatial information and facilitate interpretation.
Results
We observed a less-complicated development of the hyoid–larynx complex than is currently described in textbooks. The body of the hyoid bone originates from a single growth center, without overt contributions from second and third pharyngeal arch cartilages. The fourth and sixth arch cartilages were not detected in human embryos; the thyroid and cricoid cartilages develop as mesenchymal condensations in the neck region.
Conclusions
Despite new research techniques, theories about hyoid–larynx complex development from the beginning of the 20th century have not been refuted properly and can still be found in modern literature. Based on observations in human embryos, we propose a new and relatively simple description of the development of the hyoid–larynx complex to facilitate better understanding of the etiology of anatomical variants.
Level of Evidence
NA Laryngoscope, 2017
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Bi5qkS
via IFTTT
The development and validation of the speech quality instrument
Objective
Although speech perception tests are available to evaluate hearing, there is no standardized validated tool to quantify speech quality. The objective of this study is to develop a validated tool to measure quality of speech heard.
Study Design
Prospective instrument validation study of 35 normal hearing adults recruited at a tertiary referral center.
Methods
Participants listened to 44 speech clips of male/female voices reciting the Rainbow Passage. Speech clips included original and manipulated excerpts capturing goal qualities such as mechanical and garbled. Listeners rated clips on a 10-point visual analog scale (VAS) of 18 characteristics (e.g. cartoonish, garbled).
Results
Skewed distribution analysis identified mean ratings in the upper and lower 2-point limits of the VAS (ratings of 8–10, 0–2, respectively); items with inconsistent responses were eliminated. The test was pruned to a final instrument of nine speech clips that clearly define qualities of interest: speech-like, male/female, cartoonish, echo-y, garbled, tinny, mechanical, rough, breathy, soothing, hoarse, like, pleasant, natural. Mean ratings were highest for original female clips (8.8) and lowest for not-speech manipulation (2.1). Factor analysis identified two subsets of characteristics: internal consistency demonstrated Cronbach's alpha of 0.95 and 0.82 per subset. Test–retest reliability of total scores was high, with an intraclass correlation coefficient of 0.76.
Conclusion
The Speech Quality Instrument (SQI) is a concise, valid tool for assessing speech quality as an indicator for hearing performance. SQI may be a valuable outcome measure for cochlear implant recipients who, despite achieving excellent speech perception, often experience poor speech quality.
Level of Evidence
2b. Laryngoscope, 2017
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A2v9Ka
via IFTTT
Phenomenology, genetics, and CNS network abnormalities in laryngeal dystonia: A 30-year experience
Objective
Laryngeal dystonia (LD) is a functionally specific disorder of the afferent–efferent motor coordination system producing action-induced muscle contraction with a varied phenomenology. This report of long-term studies aims to review and better define the phenomenology and central nervous system abnormalities of this disorder and improve diagnosis and treatment.
Methods
Our studies categorized over 1,400 patients diagnosed with LD over the past 33 years, including demographic and medical history records and their phenomenological presentations.
Patients were grouped on clinical phenotype (adductor or abductor) and genotype (sporadic and familial) and with DNA analysis and functional magnetic resonance imaging (fMRI) to investigate brain organization differences and characterize neural markers for genotype/phenotype categorization. A number of patients with alcohol-sensitive dystonia were also studied.
Results
A spectrum of LD phenomena evolved: adductor, abductor, mixed, singer's, dystonic tremor, and adductor respiratory dystonia. Patients were genetically screened for DYT (dystonia) 1, DYT4, DYT6, and DYT25 (GNAL)–and several were positive. The functional MRI studies showed distinct alterations within the sensorimotor network, and the LD patients with a family history had distinct cortical and cerebellar abnormalities. A linear discriminant analysis of fMRI findings showed a 71% accuracy in characterizing LD from normal and in characterizing adductor from abductor forms.
Conclusion
Continuous studies of LD patients over 30 years has led to an improved understanding of the phenomenological characteristics of this neurological disorder. Genetic and fMRI studies have better characterized the disorder and raise the possibility of making objective rather than subjective diagnoses, potentially leading to new therapeutic approaches. Laryngoscope, 128:S1–S9, 2018
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Bk2ggw
via IFTTT
Toxicity trial of canine posterior cricoarytenoid intramuscular vincristine injections
Objectives/Hypothesis
In animal studies, intramuscular vincristine injections have been shown to block reinnervation of the denervated target muscle. This application could be used selectively to influence recovery patterns following injury of recurrent laryngeal nerves (RLNs). However, vincristine is currently Food and Drug Administration approved only for intravenous use. A formal toxicity trial of intramuscular injections was performed.
Study Design
Animal study.
Methods
Sixteen female canines underwent direct laryngoscopy with injection of moderate- (0.4 mg, n = 8) or high-dose (0.6 mg, n = 8) vincristine into the posterior cricoarytenoid (PCA) muscles. Plasma samples were collected at various time points postinjection and vincristine levels determined. At 24 hours (n = 7) or 14 days (n = 9) postinjection, animals were anesthetized and videolaryngoscopy documented vocal fold mobility and mucosal appearance. Adductor function was measured during stimulation of the RLN. Larynges were processed for histology.
Results
Fifteen minutes after injection, plasma vincristine levels averaged 10.2% ± 6.7% of the intravenous maximum, suggesting about 90% of the vincristine remained within the PCA muscle. Plasma levels were usually below detectable limits within 24 hours. At the end points, all animals had grossly normal-appearing mucosa and full range of motion. Laryngeal adductor strength was normal in all cases. Histology showed moderate to severe acute inflammation in the submucosa only in the high-dose group at 24 hours. There was no necrosis of muscle or mucosa.
Conclusions
Intramuscular vincristine injections into the canine PCA muscles resulted in no significant local toxicity, even at the maximum dose. It would be reasonable to evaluate this treatment strategy in a phase I human trial.
Level of Evidence
NA Laryngoscope, 2017
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A3M1A4
via IFTTT
Minimal clinically important difference of voice handicap index-10 in vocal fold paralysis
Objectives/Hypothesis
The Voice Handicap Index-10 (VHI-10) is commonly used to measure patients' perception of vocal handicap. Clinical consensus has previously defined clinically meaningful improvement as a decrease ≥5. This study determines the minimal clinically important difference (MCID) for VHI-10 in patients with unilateral vocal fold paralysis (UVFP) using anchor-based methodology.
Study Design
Prospective cohort questionnaire analysis.
Methods
Two hundred eighty-one UVFP patients completed the VHI-10 on two consecutive visits (within 3 months). At the follow-up visit, patients answered an 11-point Global Rating of Change Questionnaire (GRCQ) scored from −5 to +5. Relationship between the GRCQ and change in VHI-10 was quantified using analysis of variance, and MCID for the VHI-10 was determined using receiver operating characteristic (ROC) curve analysis.
Results
Overall mean VHI-10 change was −3.71 (standard deviation [SD] = 8.89) and mean GRCQ was 1.37 (SD = 2.51). Average interval between measurements was 1.73 months (SD = 0.83). Mean changes in VHI-10 scores were −7.45, −0.53, and +4.40 for patients whose GRCQ scores indicated improvement, no change, and worsening, respectively. Differences between mean scores were statistically significant (P < .001). Area under the ROC curve was 0.80, demonstrating the classification accuracy of VHI-10 change scores. A VHI-10 change of −4 was determined to be the optimal threshold that discriminated between improvement and no improvement (sensitivity and specificity 0.62 and 0.88, respectively).
Conclusions
The MCID for improvement in VHI-10 in UVFP patients is a decrease of 4. This information improves understanding of patients' response to treatment and allows comparison between different treatments. Future research should determine MCID for VHI-10 across all voice disorders.
Level of Evidence
4 Laryngoscope, 2017
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2BghJOJ
via IFTTT
Categorization and association analysis of risk factors for adverse drug events
Abstract
Purpose
Adverse drug events (ADE) are among the leading causes of morbidity and hospitalization. This review analyzes risk factors for ADE, particularly their categorizations and association patterns, the prevalence, severity, and preventability of ADE, and method characteristics of reviewed studies.
Methods
Literature search was conducted via PubMed, Science Direct, CINAHL, and MEDLINE. A review was conducted of research articles that reported original data about specific risk factors for ADE since 2000. Data analyses were performed using Excel and R.
Results
We summarized 211 risk factors for ADE, and grouped them into five main categories: patient-, disease-, medication-, health service-, and genetics-related. Among them, medication- and disease-related risk factors were most frequently studied. We further classified risk factors within each main category into subtypes. Among them, polypharmacy, age, gender, central nervous system agents, comorbidity, service utilization, inappropriate use/change use of drugs, cardiovascular agents, and anti-infectives were most studied subtypes. An association analysis of risk factors uncovered many interesting patterns. The median prevalence, preventability, and severity rate of reported ADE was 19.5% (0.29%~86.2%), 36.2% (2.63%~91%), and 16% (0.01%~47.4%), respectively.
Conclusions
This review introduced new categories and subtypes of risk factors for ADE. The broad and in-depth coverage of risk factors and their association patterns elucidate the complexity of risk factor analysis. Managing risk factors for ADE is crucial for improving patient safety, particularly for the elderly, comorbid, and polypharmacy patients. Some under-explored risk factors such as genetics, mental health and wellness, education, lifestyle, and physical environment invite future research.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2nIyH2f
via IFTTT
First evidence of bacterial translocation from the intestinal tract as a route of Helicobacter cinaedi bacteremia
Abstract
Background
The route of Helicobacter cinaedi bacteremia has not yet been clarified. Although bacterial translocation from the intestinal tract into the circulation has been suggested, it has not been demonstrated thus far. The objective of this study was to investigate the port of entry of this bacterium.
Material and Methods
We conducted a retrospective study on patients with H. cinaedi bacteremia between March 2009 and May 2013. Records of patients in whom H. cinaedi was detected in both blood and stool cultures were extracted. H. cinaedi was identified using gyrB-targeted PCR. Pulse-field gel electrophoresis was used to investigate the consistency of the genotypes.
Results
Seventy-one patients were diagnosed with H. cinaedi bacteremia during the study period. H. cinaedi was detected in both blood and stool samples of 21 patients. Pulse-field gel electrophoresis was used to investigate the consistency of the genotypes in 18 evaluable strains (from 9 patients). The pulse-field gel electrophoresis patterns of the stool- and blood-derived strains of H. cinaedi were consistent among all 9 patients. Most of the 9 patients analyzed were immunocompromised and being treated with anticancer drugs or steroids, which suggests reduced intestinal immunity.
Conclusions
This is the first study to demonstrate that bacterial translocation from the intestinal tract could represent one route of H. cinaedi bacteremia.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AGC26T
via IFTTT
Πέμπτη 7 Δεκεμβρίου 2017
Reconstruction of oral cavity defect using versatile buccinator myomucosal flaps in the treatment of cT2–3, N0 oral cavity squamous cell carcinoma: Feasibility, morbidity, and functional/oncological outcomes
In the surgical management of oral cavity squamous cell carcinoma (OCSCC), radical resection with adequate margins is paramount in achieving local control. To obtain microscopically clear margins >0.5 cm, additional resection of normal tissue >1.0–1.5 cm from the gross tumor border is recommended [1,2]. Therefore, defect size is always significantly larger than the tumor itself, and reconstruction is commonly required to establish form and function in the resected organ, with the exception of some T1 and T2 OCSCCs.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j3mX90
via IFTTT
Prognostic value of masticatory muscle involvement in nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy
In 2017, the UICC/AJCC published the 8th edition of their staging manual for NPC, which has gained universal acceptance. This is a revision based on the UICC/AJCC's 7th edition and the 2008 Chinese staging system. There are three important adjustments for primary tumor site (T) classifications: (1) T0 is added for Epstein-Barr virus (EBV)-positive cancers with cervical lymph node involvement and no identifiable primary tumor; (2) New evidence has confirmed the prognostic value of the prevertebral muscle in NPC patients with tumors designated as T2; (3) The previous T4 criteria of "masticator space" and "infratemporal fossa" are now replaced by a specific description of soft tissue involvement and tumors that invade the medial pterygoid muscle (MP) and/or the lateral pterygoid muscle (LP) are now down-staged as T2 [1].
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2kEjIFK
via IFTTT
Plasticity of oral mucosal cell sheets for accelerated and scarless skin wound healing
This study examined the potential utility of a newly developed oral mucosal cell sheet in skin excisional wounds. The oral mucosal cell sheet promoted wound healing with early wound closure and less scarring and demonstrated in vivo tissue plasticity through good adaptation in cutaneous wounds.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j7Zgwf
via IFTTT
Εγγραφή σε:
Αναρτήσεις (Atom)
