Πέμπτη, 6 Ιουλίου 2017

Sternoclavicular joint osteophytosis: a difficult diagnosis to swallow

Unexplained dysphagia requires prompt investigation to rule out a possible underlying malignancy. We describe the case of a 60-year-old man who presented to his family practitioner with a 1-year history of increasing dysphagia with associated pain over the front of his chest. He was referred on to an ear, nose and throat specialist where no obvious laryngeal pathology was found at direct laryngoscopy, but an ‘indentation’ of the right anterior larynx, which increased with external pressure on the sternoclavicular joint (SCJ), was noted. A subsequent CT scan of his neck demonstrated osteoarthritis of the right SCJ with an abnormally large posterior osteophyte. The patient was subsequently referred on to an orthopaedic surgeon specialising in SCJ surgery and underwent an arthroscopic excision of his right SCJ. Soon after surgery, the patient’s dysphagia had settled and his symptoms remain resolved 1 year post surgery.



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Cupping at the ends of ribs is not always rickets

Description

A 7-week-old baby boy presented with a history of cough, loose stools and respiratory distress since last 7 days. At admission he had a respiratory rate of 64/min, a heart rate of 144/min and an oxygen saturation of 56%. Chest examination revealed crepitations in both lung fields. Rest of the examination was unremarkable. Investigations revealed haemoglobin 82 g/L; white cell count 11.2x109/L (differential counts: polymorphs 68%, lymphocytes 1%, monocytes 26% and eosinophils 5%); absolute lymphocyte count 0.11x109/L; platelet count 102x109/L and C reactive protein 239 g/L. Chest X-ray showed non-homogenous opacities in bilateral lung fields (more on right side) with an absent thymic shadow, cupping at the anterior end of ribs (black arrow, figure 1), flattening of lower end of the right scapula (white arrow, figure 1) and a spur at the inferior-lateral angle of the left scapula (white arrow head, figure 1). These characteristic radiological changes (ie, cupping at...



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Isolated insulin-derived amyloidoma of the breast

Isolated amyloidomas derived from insulin are extremely rare, and there is only one reported case to date of insulin-derived amyloidoma in the breast.

We present the case of a 36-year-old woman reporting a lump in the right breast. It was clinically assessed as a probable fibroadenoma but was removed surgically given the size of the lesion. On histological analysis, the lesion had features consistent with amyloid. Further investigations showed the amyloid to be derived from insulin. The lump was removed in its entirety, and the patient made a full recovery.



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Evolution of the Oral Microbiome and Dental Caries

Abstract

Purpose of Review

Our paper reviews how dietary changes during human evolution have contributed to the increased incidence and prevalence of dental caries in modern populations by shifting the oral microbiome from a “healthy” to “carious” state. We addressed two questions: (1) what is the microbial difference between the states of health and caries, and (2) how has the development of an agricultural diet impacted the oral microbiome?

Recent Findings

The application of next-generation sequencing has revealed the complexity of the oral microbiome and lack of a simple compositional difference between health and caries. Genetic analysis of the oral microbiome from contemporary and ancient humans has shown that the introduction of agriculture was associated with increased frequency of caries-related bacteria and the evolution of the key carious pathogen, Streptococcus mutans.

Summary

The adoption of an agricultural diet has contributed to a modern rise in caries by changing the oral microbiome ecology. Identification of evolutionary factors that have influenced the oral microbiome in health and caries, and how the two states differ functionally, as opposed to compositionally, may help to reduce the current burden of caries.



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Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

A previously healthy 48-year-old man presented with a 1-week history of migrating polyarthropathy preceded by a viral illness, dysuria and bilateral red eyes. Ocular examination revealed anterior and interstitial stromal keratitis. He was systemically well but had raised erythrocyte sedimentation rate and C reactive protein and was positive for human leucocyte antigen B27 on extensive infective, rheumatological and autoimmune investigations. Although the exact triggering pathogen was not identified, clinical findings were consistent with reactive arthritis. Bilateral interstitial keratitis is a rare manifestation of reactive arthritis which, along with the anterior stromal keratitis, responded well to topical prednisolone sodium phosphate 0.5%. Systemic joint symptoms improved on oral sulfasalazine, non-steroid anti-inflammatory agent and low-dose prednisolone.



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Cancer therapies and the problem of me too many

Publication date: Available online 6 July 2017
Source:Seminars in Oncology
Author(s): Tito Fojo




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Evolution of the Oral Microbiome and Dental Caries

Abstract

Purpose of Review

Our paper reviews how dietary changes during human evolution have contributed to the increased incidence and prevalence of dental caries in modern populations by shifting the oral microbiome from a “healthy” to “carious” state. We addressed two questions: (1) what is the microbial difference between the states of health and caries, and (2) how has the development of an agricultural diet impacted the oral microbiome?

Recent Findings

The application of next-generation sequencing has revealed the complexity of the oral microbiome and lack of a simple compositional difference between health and caries. Genetic analysis of the oral microbiome from contemporary and ancient humans has shown that the introduction of agriculture was associated with increased frequency of caries-related bacteria and the evolution of the key carious pathogen, Streptococcus mutans.

Summary

The adoption of an agricultural diet has contributed to a modern rise in caries by changing the oral microbiome ecology. Identification of evolutionary factors that have influenced the oral microbiome in health and caries, and how the two states differ functionally, as opposed to compositionally, may help to reduce the current burden of caries.



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TOC



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Calendar



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Calendar Listings



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Editorial Board



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Instructions for Contributors



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Do gender and racial/ethnic disparities in sleep duration emerge in early adulthood? Evidence from a longitudinal study of U.S. adults

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Publication date: August 2017
Source:Sleep Medicine, Volume 36
Author(s): Katrina M. Walsemann, Jennifer A. Ailshire, Calley E. Fisk, Lauren L. Brown
ObjectiveGender and racial/ethnic disparities in sleep duration are well documented among the U.S. adult population, but we know little about how these disparities are shaped during the early course of adult life, a period marked by substantial changes in social roles that can influence time for sleep.MethodsProspective data was used from the National Longitudinal Survey of Youth 1997 (NLSY97), a U.S.-based representative sample of persons born between 1980 and 1984, who were first interviewed in 1997. Sleep duration was assessed in 2002, 2007/2008, 2009, 2010, and 2011. Random-coefficient models were estimated to examine gender and racial/ethnic disparities in trajectories of sleep duration across early adulthood as a function of educational experiences, employment, and family relationships.ResultsSleep duration declined during early adulthood. Women reported shorter sleep than men from age 18 to 22, but slept longer than men by age 28. Black Young adults reported sleep durations similar to those of White young adults until age 24, after which blacks slept less than whites. Educational experiences and employment characteristics reduced gender and racial/ethnic disparities, but family relationships exacerbated them.ConclusionThis study is the first to establish the emergence of gender and racial/ethnic disparities in sleep duration during early adulthood.



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Persistent sacral chloroma in refractory acute myelogenous leukaemia

Acute myelogenous leukaemia (AML) is a clonal process involving the myeloid subgroup of white blood cells. Chloromas, or myeloid sarcomas, are masses of myeloid leukaemic cells and are a unique aspect of AML. This case involves a 14-year-old boy with AML who presented with multiple chloromas at diagnosis. The patient’s extra-calvarial masses and bone marrow involvement responded to chemotherapy; however, his sacral epidural chloromas persisted despite four courses of chemotherapy. The central nervous system, bone marrow and testes have been known to be sanctuary sites for AML. This case illustrates that the sacral spinal canal may potentially be a sanctuary site for the disease process also.



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Cognitive Resilience and Psychological Responses across a Collegiate Rowing Season.

Introduction: Student-athletes face numerous challenges across their competitive season. Although mood states have been previously studied, little is known about adaptations in other psychological responses, specifically cognition. The purpose of this study was to characterize cognitive function, mood, sleep and stress responses at select time-points of a season in collegiate rowers. It was hypothesized that during baseline, typical training and recovery, athletes would show positive mental health profiles, in contrast to decreases in cognition with increases in negative mood and measurements of stress during peak training. Methods: Male and female Division I rowers (N = 43) and healthy controls (N = 23) were enrolled and assessed at baseline, typical training, peak training and recovery. At each time-point, measures of cognitive performance (Stroop color-naming task), academic and exercise load, perceived cognitive deficits, mood states, sleep and stress (via self-report & salivary cortisol) were recorded. Results: Repeated measures analysis of variance (ANOVA) revealed significant group by time interactions for perceived exercise load, cognitive deficits, mood states and perceived stress (p

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Use of fused deposit modeling for additive manufacturing in hospital facilities: European certification directives

The goal of this study was to identify current European Union regulations governing hospital-based use of fused deposit modeling (FDM), as implemented via desktop three-dimensional (3D) printers.

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Free-flap surgical correction of facial deformity after anteromedial maxillectomy

Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients. Herein, we report a series of eight free perforator flap procedures (anterolateral thigh [ALT] flap, 6; thoracodorsal artery perforator [TAP] flap, 2) used to correct such deformities.

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The self-defining axis of symmetry: A new method to determine optimal symmetry and its application and limitation in craniofacial surgery

Analysis of symmetry represents an essential aspect of plastic-reconstructive surgery. For cases in which reference points are either not fixed or are changed due to corrective intervention the determination of a symmetry axis is sometimes almost impossible and a pre-defined symmetry axis would not always be helpful. To assess cranial shape of surgical patients with craniosynostosis, a new algebraic approach was chosen in which deviation from the optimal symmetry axis could be quantified.

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Implant rehabilitation in fibular free flap reconstruction: A retrospective study of cases at 1-18 years following surgery

To determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized free fibula flap (FFF) for maxillary or mandibular reconstruction.

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Reorganization of gene network for degradation of polycyclic aromatic hydrocarbons (PAHs) in Pseudomonas aeruginosa PAO1 under several conditions

Abstract

Although polycyclic aromatic hydrocarbons (PAHs) are harmful to human health, their elimination from the environment is not easy. Biodegradation of PAHs is promising since many bacteria have the ability to use hydrocarbons as their sole carbon and energy sources for growth. Of various microorganisms that can degrade PAHs, Pseudomonas aeruginosa is particularly important, not only because it causes a series of diseases including infection in cystic fibrosis patients, but also because it is a model bacterium in various studies. The genes that are responsible for degrading PAHs have been identified in P. aeruginosa, however, no gene acts alone as various stresses often initiate different metabolic pathways, quorum sensing, biofilm formation, antibiotic tolerance, etc. Therefore, it is important to study how PAH degradation genes behave under different conditions. In this study, we apply network analysis to investigating how 46 PAH degradation genes reorganized among 5549 genes in P. aeruginosa PAO1 under nine different conditions using publicly available gene coexpression data from GEO. The results provide six aspects of novelties: (i) comparing the number of gene clusters before and after stresses, (ii) comparing the membership in each gene cluster before and after stresses, (iii) defining which gene changed its membership together with PAH degradation genes before and after stresses, (iv) classifying membership-changed-genes in terms of category in Pseudomonas Genome Database, (v) postulating unknown gene's function, and (vi) proposing new mechanisms for genes of interests. This study can shed light on understanding of cooperative mechanisms of PAH degradation from the level of entire genes in an organism, and paves the way to conduct the similar studies on other genes.



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Hydroxyapatite collagen scaffold with autologous bone marrow aspirate for mandibular condylar reconstruction

This study was designed with the aim to assess the efficiency of hydroxyapatite/collagen (HA/Col) bio-scaffold with bone marrow aspirate (BMA) to reconstruct mandibular condyle in patients with temporomandibular joint (TMJ) ankylosis.

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The validity and reliability of computed tomography orbital volume measurements

Orbital volume calculations allow surgeons to design patient-specific implants to correct volume deficits. It is estimated that changes as small as 1 ml in orbital volume can lead to enophthalmos. Awareness of the limitations of orbital volume computed tomography (CT) measurements is critical to differentiate between true volume differences and measurement error. The aim of this study is to analyze the validity and reliability of CT orbital volume measurements.

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The pterygoalar bar: A meta-analysis of its prevalence, morphology and morphometry

The pterygoalar (PA) bar is a bony bridge resulting from the partial or complete ossification of a PA ligament. The aim of this meta-analysis was to systematically analyze and provide the most comprehensive data on the prevalence, morphology and topographical anatomy of the PA bar.

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Filamin B: The next hotspot in skeletal research?

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Publication date: Available online 6 July 2017
Source:Journal of Genetics and Genomics
Author(s): Qiming Xu, Nan Wu, Lijia Cui, Zhihong Wu, Guixing Qiu
Filamin B (FLNB) is a large dimeric actin-binding protein which crosslinks actin cytoskeleton filaments into a dynamic structure. Up to present, pathogenic mutations in FLNB are solely found to cause skeletal deformities, indicating the important role of FLNB in skeletal development. FLNB-related disorders are classified as spondylocarpotarsal synostosis (SCT), Larsen syndrome (LS), atelosteogenesis (AO), boomerang dysplasia (BD), and isolated congenital talipes equinovarus, presenting with scoliosis, short-limbed dwarfism, clubfoot, joint dislocation and other unique skeletal abnormalities. The formation of ossification center is opposite between SCT and LS, as SCT presents with premature fusion of carpal and tarsal bones, while LS shows supernumerary ossification centers of carpal or tarsal bones. Several mechanisms of FLNB mutations causing skeletal malformations have been proposed, including delay of ossification in long bone growth plate, reduction of bone mineral density (BMD), dysregulation of muscle differentiation, ossification of intervertebral disc (IVD), disturbance of proliferation, differentiation and apoptosis in chondrocytes, impair of angiogenesis, and hypomotility of osteoblast, chondrocyte and fibroblast. Interventions on FLNB-related diseases require prenatal surveillance by sonography, gene testing in high-risk carriers, and proper orthosis or orthopedic surgeries to correct malformations including scoliosis, cervical spine instability, large joint dislocation, and clubfoot. Gene and cell therapies in treating FLNB-related diseases are also promising but require further studies.



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Cognitive Resilience and Psychological Responses across a Collegiate Rowing Season.

Introduction: Student-athletes face numerous challenges across their competitive season. Although mood states have been previously studied, little is known about adaptations in other psychological responses, specifically cognition. The purpose of this study was to characterize cognitive function, mood, sleep and stress responses at select time-points of a season in collegiate rowers. It was hypothesized that during baseline, typical training and recovery, athletes would show positive mental health profiles, in contrast to decreases in cognition with increases in negative mood and measurements of stress during peak training. Methods: Male and female Division I rowers (N = 43) and healthy controls (N = 23) were enrolled and assessed at baseline, typical training, peak training and recovery. At each time-point, measures of cognitive performance (Stroop color-naming task), academic and exercise load, perceived cognitive deficits, mood states, sleep and stress (via self-report & salivary cortisol) were recorded. Results: Repeated measures analysis of variance (ANOVA) revealed significant group by time interactions for perceived exercise load, cognitive deficits, mood states and perceived stress (p

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Biphasic synovial sarcoma of the epiglottis: Case report and literature review

Synovial sarcomas are rare malignant tumors supposed to arise from pluripotent mesenchymal stem cells predominantly affecting the deep soft tissue of the lower and upper extremities in young adults. The occurrence of this tumor entity in the head and neck is very uncommon and hence, timely diagnosis and treatment of synovial sarcoma in this region remain a challenge.We describe the clinical and molecular pathological features of a biphasic synovial sarcoma of the epiglottis, a site where the primary manifestation of this tumor entity has not been documented to date.

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Hyperthyroidism, Hypothyroidism, and Cause-Specific Mortality in a Large Cohort of Women

Thyroid , Vol. 0, No. 0.


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Variations in Serum Free Thyroxine Concentration Within the Reference Range Predicts the Incidence of Metabolic Syndrome in Non-Obese Adults: A Cohort Study

Thyroid Jul 2017, Vol. 27, No. 7: 886-893.


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Contrasting Phenotypes in Resistance to Thyroid Hormone Alpha Correlate with Divergent Properties of Thyroid Hormone Receptor α1 Mutant Proteins

Thyroid Jul 2017, Vol. 27, No. 7: 973-982.


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Future Meetings

Thyroid Jul 2017, Vol. 27, No. 7: 985-985.


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Corrigendum to Aetiology, pathogenesis, and specific management of Stahl's ear: role of the transverse muscle insertion

The authors regret that Figures 1, 3, and 4 are from Dr Viard's collection at Hôpital Saint Luc Saint Joseph Lyon, which had previously not been acknowledged in the text.

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Thoracostomy Tube Removal: Implementation of a Multidisciplinary Procedural Pain Management Guideline

Thoracostomy tubes are placed following cardiothoracic surgery for the repair or palliation of congenital heart defects. The aim of this project was to develop and implement a clinical practice guideline for the provision of optimal analgesia during removal of thoracostomy tubes in pediatric postoperative cardiothoracic surgery patients.

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Mapping Geospatial Gaps in Early Identification of Children With Autism Spectrum Disorder

Despite the known developmental benefits of early intervention for autism spectrum disorder (ASD), diagnosis before age 5 years is often not achieved. Research suggests that lack of health insurance and living in rural areas and areas of severe provider shortages contribute significantly to these delays. The purpose of this project was to conduct a geospatial evaluation of potential gaps in early ASD diagnosis of uninsured children in Virginia. A secondary purpose was to show the use of geospatial analysis by pediatric nurse practitioners for policy advocacy.

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Contrasting Phenotypes in Resistance to Thyroid Hormone Alpha Correlate with Divergent Properties of Thyroid Hormone Receptor α1 Mutant Proteins

Thyroid Jul 2017, Vol. 27, No. 7: 973-982.


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Future Meetings

Thyroid Jul 2017, Vol. 27, No. 7: 985-985.


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Corrigendum to Aetiology, pathogenesis, and specific management of Stahl's ear: role of the transverse muscle insertion

The authors regret that Figures 1, 3, and 4 are from Dr Viard's collection at Hôpital Saint Luc Saint Joseph Lyon, which had previously not been acknowledged in the text.

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Spectral-Temporal Modulated Ripple Discrimination by Children With Cochlear Implants.

Objectives: A postlingually implanted adult typically develops hearing with an intact auditory system, followed by periods of deafness (or near deafness) and adaptation to the implant. For an early implanted child whose brain is highly plastic, the auditory system matures with consistent input from a cochlear implant. It is likely that the auditory system of early implanted cochlear implant users is fundamentally different than postlingually implanted adults. The purpose of this study is to compare the basic psychophysical capabilities and limitations of these two populations on a spectral resolution task to determine potential effects of early deprivation and plasticity. Design: Performance on a spectral resolution task (Spectral-temporally Modulated Ripple Test [SMRT]) was measured for 20 bilaterally implanted, prelingually deafened children (between 5 and 13 years of age) and 20 hearing children within the same age range. Additionally, 15 bilaterally implanted, postlingually deafened adults, and 10 hearing adults were tested on the same task. Cochlear implant users (adults and children) were tested bilaterally, and with each ear alone. Hearing listeners (adults and children) were tested with the unprocessed SMRT and with a vocoded version that simulates an 8-channel cochlear implant. Results: For children with normal hearing, a positive correlation was found between age and SMRT score for both the unprocessed and vocoded versions. Older hearing children performed similarly to hearing adults in both the unprocessed and vocoded test conditions. However, for children with cochlear implants, no significant relationship was found between SMRT score and chronological age, age at implantation, or years of implant experience. Performance by children with cochlear implants was poorer than performance by cochlear implanted adults. It was also found that children implanted sequentially tended to have better scores with the first implant compared with the second implant. This difference was not observed for adults. An additional finding was that SMRT score was negatively correlated with age for adults with implants. Conclusions: Results from this study suggest that basic psychophysical capabilities of early implanted children and postlingually implanted adults differ when assessed in the sound field using their personal implant processors. Because spectral resolution does not improve with age for early implanted children, it seems likely that the sparse representation of the signal provided by a cochlear implant limits spectral resolution development. These results are supported by the finding that postlingually implanted adults, whose auditory systems matured before the onset of hearing loss, perform significantly better than early implanted children on the spectral resolution test. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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CORP: Improving the status quo for measuring whole body sweat losses (WBSL)

The measurement of whole body sweat losses (WBSL) is important to the study of body heat balance, body water balance, establishing guidelines for water and electrolyte consumption, and the study of metabolism and health. In principal, WBSL is measured by an acute change in body mass (BM) in response to a thermoregulatory sweating stimulus. In this CORP review, we re-visit several basic, but rarely discussed assumptions important to WBSL research, including the common equivalences: mass = weight = water = sweat. Sources of large potential measurement errors are also discussed, as are best practices for avoiding them. The goal of this CORP review is to ultimately improve the accuracy, reproducibility, and application of WBSL research.



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Corrigendum to Aetiology, pathogenesis, and specific management of Stahl's ear: role of the transverse muscle insertion

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Publication date: Available online 6 July 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): A. Gleizal, R. Viard, J.T. Bachelet




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Spectrophotometric analysis of the effectiveness of a novel in-office laser-assisted tooth bleaching method using Er,Cr:YSGG laser

Abstract

The purpose of this in vitro study was to compare the effectiveness of a novel Er,Cr:YSGG laser-assisted in-office tooth bleaching method with a conventional method by spectrophotometric analysis of the tooth color change. Furthermore, the influence of the application time of the bleaching gel on the effectiveness of the methods and the maintenance of the results 7 days and 1 month after the treatments were also evaluated. Twenty-four bovine incisors were stained and randomly distributed into four groups. Group 1 specimens received an in-office bleaching treatment with 35% H2O2 for 2 × 15 min. Group 2 specimens received the same treatment but with extended application time (2 × 20 min). In Group 3, the same in-office bleaching procedure (2 × 15 min) was carried out as that in Group 1, using Er,Cr:YSGG laser irradiation for 2 × 15 s on each specimen to catalyze the reaction of H2O2 breakdown. Group 4 specimens received the same bleaching treatment as Group 3 but with extended application time (2 × 20 min). Er,Cr:YSGG laser-assisted tooth bleaching treatment is more effective than the conventional treatment regarding color change of the teeth. Application time of the bleaching agent may influence the effectiveness of the methods. The color change of the tested treatments decreases after 7 days and 1 month. The clinical relevance of this study is that this novel laser-assisted bleaching treatment may be more advantageous in color change and application time compared to the conventional bleaching treatment.



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A Systematic Review of Comorbidity Measurement Methods for Patients With Nontraumatic Brain Injury in Inpatient Rehabilitation Settings.

This review summarizes comorbidity measurements used on patients with nontraumatic brain injury in inpatient rehabilitation and describes findings on measurement validation and comorbidity profiles. MEDLINE and MEDLINE In-Process, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews, Health, and Psychosocial Measurement Instruments were searched. Two reviewers screened results according to predefined inclusion and exclusion criteria. Population, statistical methods, comorbidity measurement, justification of its use, and results involving comorbidity were extracted using a standard table. Of 9476 articles retrieved, 16 were included. Comorbidity has been measured using various methods including the following: number and type within various classification systems, such as the International Disease Classification system, the Charlson comorbidity index, Centers for Medicare and Medicaid Services comorbidity tiers and patient comorbidity and complexity level values and subsets of diagnoses within nonadministrative data studies. No studies have assessed the predictive ability of the comorbidity measurements for inpatient rehabilitation outcomes in this population. Because comorbidities are common among the nontraumatic brain injury population, the predictive validity of comorbidity measurements should be assessed to determine the most appropriate measure to predict or risk adjust rehabilitation outcomes, which has implications for the development of clinical guidelines, and to inform health service research, planning, and delivery. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Functional Balance Deterioration on Daily Activities in Patients With Migraine: A Controlled Study.

Objective: This study aimed to assess functional activities in different subgroups of patients with migraine. Design: One-hundred forty subjects were uniformly divided into the following four groups: headache-free controls, migraine with aura, without aura, and chronic migraine. Subjects performed the tests walk across, tandem walk, sit to stand, and step up and over at the Balance Master system (Neurocom). Results: All migraine groups had slower velocity and shorter step length at the walk across test (P

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Wnt/ss-catenin activation by epigenetically aberrant stroma drives myelodysplastic syndrome

The bone marrow microenvironment influences malignant hematopoiesis but how it promotes leukemogenesis has not been elucidated. Additionally, the role of the bone marrow stroma in regulating clinical responses to DNA methyltransferase inhibitors (DNMTi) is also poorly understood. In this study, we conducted a DNA methylome analysis of bone marrow-derived stromal cells from myelodysplastic syndrome (MDS) patients and observed widespread aberrant cytosine hypermethylation occurring preferentially outside CpG islands. Stroma derived from 5-azacytidine-treated patients lacked aberrant methylation and DNMTi treatment of primary MDS stroma enhanced its ability to support erythroid differentiation. An integrative expression analysis revealed that the WNT pathway antagonist FRZB was aberrantly hypermethylated and underexpressed in MDS stroma. This result was confirmed in an independent set of sorted, primary MDS-derived mesenchymal cells. We documented a WNT/ß-catenin activation signature in CD34+ cells from advanced cases of MDS where it associated with adverse prognosis. Constitutive activation of ß-catenin in hematopoietic cells yielded lethal myeloid disease in a NUP98-HOXD13 mouse model of MDS, confirming its role in disease progression. Our results define novel epigenetic changes in the bone marrow microenvironment which lead to ß-catenin activation and disease progression of MDS.

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Targeting histone demethylases in MYC-driven neuroblastomas with ciclopirox

Histone lysine demethylases facilitate the activity of oncogenic transcription factors including possibly MYC. Here we show that multiple histone demethylases influence the viability and poor prognosis of neuroblastoma cells where MYC is often overexpressed. We also identified the approved small molecule antifungal agent ciclopirox as a novel pan-histone demethylase inhibitor. Ciclopirox targeted several histone demethylases including KDM4B implicated in MYC function. Accordingly, ciclopirox inhibited Myc signaling in parallel with mitochondrial oxidative phosphorylation, resulting in suppression of neuroblastoma cell viability and inhibition of tumor growth associated with an induction of differentiation. Our findings provide new insights into epigenetic regulation of MYC function and suggest a novel pharmacologic basis to target histone demethylases as an indirect MYC targeting approach for cancer therapy.

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The molecular pathophysiology of chronic non-bacterial osteomyelitis (CNO)—a systematic review

Abstract

Chronic non-bacterial osteomyelitis (CNO) belongs to the growing spectrum of autoinflammatory diseases and primarily affects the skeletal system. Peak onset ranges between 7 and 12 years of age. The clinical spectrum of CNO covers sometimes asymptomatic inflammation of single bones at the one end and chronically active or recurrent multifocal osteitis at the other.

Despite the intense scientific efforts, the exact molecular mechanisms of CNO remain unknown. Recent data suggest CNO as a genetically complex disorder with dysregulated TLR4/MAPK/inflammasome signaling cascades resulting in an imbalance between pro- and anti-inflammatory cytokine expression, leading to osteoclast activation and osteolytic lesions.

In this manuscript, the current understanding of molecular patho-mechanisms in CNO will be discussed.



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TOC

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Publication date: July 2017
Source:Journal of Voice, Volume 31, Issue 4





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Functional Balance Deterioration on Daily Activities in Patients With Migraine: A Controlled Study.

Objective: This study aimed to assess functional activities in different subgroups of patients with migraine. Design: One-hundred forty subjects were uniformly divided into the following four groups: headache-free controls, migraine with aura, without aura, and chronic migraine. Subjects performed the tests walk across, tandem walk, sit to stand, and step up and over at the Balance Master system (Neurocom). Results: All migraine groups had slower velocity and shorter step length at the walk across test (P

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Calendar Listings

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Publication date: July 2017
Source:Journal of Voice, Volume 31, Issue 4





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An Investigation of Protective Effects of Litium Borate on Blood and Histopathological Parameters in Acute Cadmium-Induced Rats

Abstract

This study was carried out to determine the protective effects of lithium borate (LTB) on blood parameters and histopathological findings in experimentally induced acute cadmium (Cd) toxicity in rats. Twenty-eight male Wistar albino rats were used, weighing 200–220 g, and they were randomly divided into four groups, including one control and the following three experimental groups: a Cd group (0.025 mmol/kg), a LTB group (15 mg/kg/day orally for 5 days), and a LTB + Cd group (15 mg/kg/day orally for 5 days and Cd 0.025 mmol/kg by intraperitoneal injection on the fifth day). All the rats in the study were anesthetized with ketamine at the end of the sixth day, blood was taken from their hearts, and then the rats were decapitated. The values in the control and LTB group were usually close to each other. White blood cell (WBC), neutrophil %, and C-reactive protein (CRP) levels increased in the Cd and LTB + Cd groups while lymphocyte and monocyte levels decreased in a statistically significant manner, in comparison to the other groups. It was determined that the levels of red blood cells (RBCs), hematocrit (Htc), and hemoglobin (Hb) did not change in the groups. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the Cd and LTB + Cd groups significantly increased, in comparison to the other groups, while the glucose, alkaline phosphatase (ALP), albumin (ALB), and total protein (TP) levels decreased. According to histopathological findings in the control and LTB groups, the liver and kidney tissues were found to have normal histological structures. In the Cd group, severe necrotic hemorrhagic hepatitis, mild steatosis, and mononuclear cell infiltration were detected in the liver. In the LTB + Cd group, degeneration and mild mononuclear cell infiltration were found in the liver. Regarding the kidney tissue in the Cd group, severe intertubular hyperemia in both kidney cortex and medulla, as well as degeneration and necrosis in the tubulus epithelium, was observed. In the LTB + Cd group, mild interstitial hyperemia and mononuclear cell infiltration was detected. Resultantly, it can be said that LTB at this dose has non-toxic effects and some beneficial effects for liver and kidney damage caused by acute Cd toxicity.



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Immunodeficiency in Pancreatic Adenocarcinoma with Diabetes Revealed by Comparative Genomics

Purpose: Pancreatic adenocarcinomas (PAAD) often are not diagnosed until their late stages leaving no effective treatments. Currently immunotherapy provides a promising treatment option against this malignancy. However, a set of immunotherapy agents benefit patients with many types of cancer, but not PAAD. Sharing the origin in the same organ, diabetes and PAAD tend to occur concurrently. We aimed to identify the impact of diabetes on immunotherapy of PAAD by conducting a comparative genomics analysis.    <p>Experimental Design: We analyzed levels 3 PAAD genomics data (RNAseq, miRNAseq, DNA methylation, somatic copy number and somatic mutation) from TCGA and Firehose. The differential molecular profiles in PAAD with/out diabetes were performed by the differential gene expression, pathway analysis, epigenetic regulation, somatic copy number alteration and somatic gene mutation.</p> <p>Results: Differential gene expression analysis revealed a strong enrichment of immunogenic signature genes in diabetic individuals including PD-1 and CTLA4 that were currently targetable for immunotherapy. Pathway analysis further implied that diabetic individuals were defective in immune modulation genes. Somatic copy number aberration (SCNA) analysis showed a higher frequency of amplification and deletion occurred in the cohort without diabetes. Integrative analysis revealed strong association between differential gene expression and epigenetic regulations, however seemed not affected by SCNAs. Importantly, our somatic mutation analysis showed that the occurrence of diabetes in PAAD was associated with a large set of gene mutations encoding genes participating in immune modulation.</p> Conclusions: Our analysis reveals the impact of diabetes on immunodeficiency in PAAD patients and provides novel insights into new therapeutic opportunities.



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Biodegradation and biodetoxification of Fusarium mycotoxins by Sphaerodes mycoparasitica

A fungus Sphaerodes mycoparasitica SMCD 2220-01 is a host specific mycoparasite against plant pathogenic Fusarium species. Fusarium spp. are producing a plethora of mycotoxins including zearalenone (ZEN), deoxyni...

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Effect of Eudragit S100 nanoparticles and alginate chitosan encapsulation on the viability of Lactobacillus acidophilus and Lactobacillus rhamnosus

In this study, we examined a novel method of microencapsulation with calcium alginate-chitosan and Eudragit S100 nanoparticles for the improving viability of probiotic bacteria, Lactobacillus acidophilus and Lact...

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Editorial Board

Publication date: July 2017
Source:Journal of Voice, Volume 31, Issue 4





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Calendar

Publication date: July 2017
Source:Journal of Voice, Volume 31, Issue 4





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Optimization of DSC MRI Echo Times for CBV Measurements Using Error Analysis in a Pilot Study of High-Grade Gliomas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The optimal TE must be calculated to minimize the variance in CBV measurements made with DSC MR imaging. Simulations can be used to determine the influence of the TE on CBV, but they may not adequately recapitulate the in vivo heterogeneity of precontrast T2*, contrast agent kinetics, and the biophysical basis of contrast agent–induced T2* changes. The purpose of this study was to combine quantitative multiecho DSC MRI T2* time curves with error analysis in order to compute the optimal TE for a traditional single-echo acquisition.

MATERIALS AND METHODS:

Eleven subjects with high-grade gliomas were scanned at 3T with a dual-echo DSC MR imaging sequence to quantify contrast agent–induced T2* changes in this retrospective study. Optimized TEs were calculated with propagation of error analysis for high-grade glial tumors, normal-appearing white matter, and arterial input function estimation.

RESULTS:

The optimal TE is a weighted average of the T2* values that occur as a contrast agent bolus transverses a voxel. The mean optimal TEs were 30.0 ± 7.4 ms for high-grade glial tumors, 36.3 ± 4.6 ms for normal-appearing white matter, and 11.8 ± 1.4 ms for arterial input function estimation (repeated-measures ANOVA, P < .001).

CONCLUSIONS:

Greater heterogeneity was observed in the optimal TE values for high-grade gliomas, and mean values of all 3 ROIs were statistically significant. The optimal TE for the arterial input function estimation is much shorter; this finding implies that quantitative DSC MR imaging acquisitions would benefit from multiecho acquisitions. In the case of a single-echo acquisition, the optimal TE prescribed should be 30–35 ms (without a preload) and 20–30 ms (with a standard full-dose preload).



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Impact of air masses on the distribution of 210Pb in the southeast of Iberian Peninsula air

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Publication date: October 2017
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): E. Chham, F. Piñero-García, P. González-Rodelas, M.A. Ferro-García
The current research has been developed in the southern of the Iberian Peninsula in order to better understand the atmospheric processes and also the influence of the air masses origin and pathways in the transport of 210Pb-aerosols in the atmosphere. Simultaneous measurements of the radionuclides 7Be and 210Pb on airborne have been routinely carried out at Granada (Spain 37.177N, 3.598 W, 687 m a.s.l.) from 2010 to 2014. The long term monitoring evolution on 210Pb is discussed in this study and also the useful ratio 7Be/210Pb.The maximum monthly activity concentration for 210Pb at ground level in Granada was detected during summer and early autumn (September), whereas minimum activity was measured in the winter. The monthly mean activity concentration for 210Pb was 617.8 ± 33.0 μBq·m−3. The results show that the annual average 210Pb concentrations in samples collected during the same period were almost constant.The lowest activity concentration for 210Pb are associated with maritime air masses coming from Atlantic and Norwest of Spain, while the highest activity concentrations for this radiotracers were positively correlated with the arrival of mineral dust linked to continental air masses coming from Mediterranean, Africa and Local area. The concentrations values show a nice agreement with the relevant reported results.



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Atmospheric tritium concentrations under influence of AREVA NC La Hague reprocessing plant (France) and background levels

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Publication date: October 2017
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): O. Connan, D. Hébert, L. Solier, D. Maro, G. Pellerin, C. Voiseux, M. Lamotte, P. Laguionie
In-air tritium measurements were conducted around the AREVA NC La Hague reprocessing plant, as well as on other sites that are not impacted by the nuclear industry in northwest of France. The results indicate that the dominant tritium form around the AREVA site is HT (86%). HT and HTO levels are lower than 5 and 1 Bq. m−3 for hourly samples taken in the plume. No tritiated organic molecules (TOM) were detected. 26 measurement campaigns were performed and links were established between near-field 85Kr, HT and HTO activities. Environmental measurements are in line with those taken at the discharge stack, and tend to demonstrate that there are no rapid changes in the tritium forms released. Out of the influence of any nuclear activities, the levels measured were below 13 mBq.m−3 for HT and 5 mBq.m−3 for HTO (<0.5 Bq. L−1). HTO level in air seems to be influenced by HTO activities in surrounding seawater.



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Calendar Listings

Publication date: July 2017
Source:Journal of Voice, Volume 31, Issue 4





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Aktuelle Entwicklung der molekular zielgerichteten Therapie von Kopf-Hals-Karzinomen

Laryngo-Rhino-Otol
DOI: 10.1055/s-0037-1600927



© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text



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Hörgeräteversorgung für Erwachsene

Laryngo-Rhino-Otol
DOI: 10.1055/s-0037-1600928



© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text



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Anti-diabetic activity of aerial parts of Sarcopoterium spinosum

Sarcopoterium spinosum (S. spinosum) is used by Bedouin medicinal practitioners for the treatment of diabetes. While the anti-diabetic activity of S. spinosum root extract was validate...

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Chinese acute ischemic stroke treatment outcome registry (CASTOR): protocol for a prospective registry study on patterns of real-world treatment of acute ischemic stroke in China

Stroke presents a serious health problem in China. Despite progresses made in recent years, there is still a lack of effective treatments for acute ischemic stroke (AIS) in clinical practices.

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Extrakranielle Schwannome im Kopf-Hals-Bereich: Klinische Implikationen anhand von 20 Fällen

10-1055-s-0043-110860-1.jpg

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-110860

Hintergrund Schwannome sind seltene, benigne Tumore, die von den Gliazellen des peripheren Nervensystems (Schwannsche Zellen) ausgehen. Während es für intrakranielle Schwannome, insbesondere die des N. vestibularis, etablierte Therapiestrategien gibt, liegen zu den extrakraniellen Schwannomen weniger belastbare Daten vor. Methode Es wurde eine retrospektive Analyse von 20 Patienten mit histopathologisch gesicherten extrakraniellen Schwannomen im Kopf-Hals-Bereich mit einem Schwerpunkt auf Tumorlokalisation und postoperativem funktionellem Therapieergebnis durchgeführt. Ergebnisse Die Schwannome im vorliegenden Kollektiv entstammten vornehmlich dem N. facialis (n = 4), dem N. vagus (n = 4) oder dem sympathischen Grenzstrang (n = 3). Die häufigsten Primärsymptome waren Schwellungen (n = 12) und Schmerzen (n = 3). MRT (n = 13), Ultraschall (n = 12) und CT (n = 3) wurden zur Diagnostik eingesetzt. In 18 Fällen wurde ein chirurgischer Behandlungsansatz gewählt (n = 14 komplette Exstirpation, n = 3 Teilexstirpation, n = 1 unbekannter Resektionsumfang). Komplette Schwannomexstirpationen von motorisch-efferentenNerven (n = 10) machten ein Absetzen des Nervens häufiger erforderlich, wenn bereits präoperativ ein motorisches Defizit bestand (3 von 4 = 75 % bei präoperativem Defizit vs. 2 von 6 = 33 % ohne präoperatives Defizit). Schlussfolgerung Extrakranielle Schwannome stellen seltene, meist vom N. facialis, dem sympathischen Grenzstrang oder den kaudalen Hirnnerven ausgehende, benigne Tumore des HNO-Trakts dar, die in der Regel chirurgisch therapiert werden. Mit postoperativen motorischen Defiziten bei kompletten Exstirpationen muss insbesondere bei bereits präoperativ bestehenden Funktionsstörungen gerechnet werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



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Psychoonkologische Betreuung von Patienten mit Kopf-Hals-Tumoren

Laryngo-Rhino-Otol
DOI: 10.1055/s-0037-1600929



© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text



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Yellow Nail Syndrome With Dramatic Improvement of Nail Manifestations After Endoscopic Sinus Surgery

Objectives: Yellow nail syndrome (YNS) is a rare disease of unknown cause characterized by the triad of yellow nails, respiratory manifestations, and lymphedema. Although several therapies for YNS have been reported, there is no common consensus in the treatment. In this case report, we present a case of 56-year-old woman with YNS, whose nail manifestation was dramatically improved after endoscopic sinus surgery for the treatment of chronic rhinosinusitis. Methods: Endoscopic sinus surgery involving middle meatal antrostomy was performed for the case of YNS with chronic rhinosinusitis and bronchiectasis resistant to antibacterial drugs. Results: A month after the surgery, the patient’s nails eventually showed dramatic improvement. Conclusions: Otorhinolaryngologists should recognize that chronic rhinosinusitis can be a symptom of YNS, and that the aggressive treatment including surgical approach for chronic rhinosinusitis may be a useful in the control of nail manifestation in YNS.

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Body image mediates the effect of cancer-related stigmatization on depression: a new target for intervention

Abstract

Objective

Since cancer-related stigmatization is prevalent but difficult to change, research on its impact on psychological burden and intervening variables is needed. Therefore, we investigated the effect of stigmatization on depressive symptomatology and whether body image mediates this relationship.

Methods

This bi-centric study assessed patients of four major tumor entities. We measured stigmatization (SIS-D), depressive symptomatology (PHQ-9) and body image (FKB-20). Applying multiple mediator analyses, we calculated the total effect of stigmatization on depressive symptomatology and the indirect effects exerted via the two body image scales rejecting body evaluation and vital body dynamics.

Results

Among the 858 cancer patients recruited (breast: n=297; prostate: n=268; colorectal: n=168; lung: n=125), stigmatization showed total effects on depressive symptomatology across all stigma dimensions (all ptotal sample<.001). Except for lung cancer patients, this result was replicated for each cancer group. Body image was shown to mediate the effect across all samples (γtotal sample = .04, 95 %- CI: 0.03 – 0.06). Among the total sample and prostate cancer patients, the mediating effect of rejecting body evaluation was significantly larger than the effect of vital body dynamics (dtotal sample = .02, 95 %-CI: 0.01 – 0.04).

Conclusions

Perceived stigmatization is an important and generalizable risk factor for depressive symptomatology among cancer patients. Apart from interventions addressing stigmatization, improving body image could additionally help to reduce the psychological burden in stigmatized patients.



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Influence of relative humidity on heterogeneous reactions of O3 and O3/SO2 with soot particles: Potential for environmental and health effects

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Xiang He, Shufeng Pang, Jiabi Ma, Yunhong Zhang
The heterogeneous reactions of soot particles with O3 and the mixture of O3 and SO2 were studied as a function of relative humidities (RHs). The reactions were followed in real time using microscopic Fourier transform infrared (micro-FTIR) spectrometer to obtain kinetic data. The results show that the ketone (CO) group is the main product of the O3/soot reaction, and the sulfate is identified on the surface of soot particles in the presence of O3/SO2. Both reactions are sensitive to RHs and surrounding water significantly promotes the proceeding of the heterogeneous reactions. For the O3/soot reaction, the pseudo-first-order rate constant increases from 3.2 × 10−4 s−1 to 7.1 × 10−4 s−1 with increasing RH in the range of 1%–82%. When O3 and SO2 exist simultaneously during the reaction, the reaction rate and uptake coefficient are all enhanced by about an order of magnitude as the RH increases from 1% to 83%. The high productions of the ketone and sulfate on soot surface are of highly hydrophilic, which play a key role in environmental effect under humid environment. The possible reaction mechanism speculates that products of aromatic carbonyls and dihydrofuran species on soot particles will be more harmful to human health.

Graphical abstract

image


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Quantifying the uncertainties of China's emission inventory for industrial sources: From national to provincial and city scales

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Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Yu Zhao, Yaduan Zhou, Liping Qiu, Jie Zhang
A comprehensive uncertainty analysis was conducted on emission inventories for industrial sources at national (China), provincial (Jiangsu), and city (Nanjing) scales for 2012. Based on various methods and data sources, Monte-Carlo simulation was applied at sector level for national inventory, and at plant level (whenever possible) for provincial and city inventories. The uncertainties of national inventory were estimated at −17–37% (expressed as 95% confidence intervals, CIs), −21–35%, −19–34%, −29–40%, −22–47%, −21–54%, −33–84%, and −32–92% for SO2, NOX, CO, TSP (total suspended particles), PM10, PM2.5, black carbon (BC), and organic carbon (OC) emissions respectively for the whole country. At provincial and city levels, the uncertainties of corresponding pollutant emissions were estimated at −15–18%, −18–33%, −16–37%, −20–30%, −23–45%, −26–50%, −33–79%, and −33–71% for Jiangsu, and −17–22%, −10–33%, −23–75%, −19–36%, −23–41%, −28–48%, −45–82%, and −34–96% for Nanjing, respectively. Emission factors (or associated parameters) were identified as the biggest contributors to the uncertainties of emissions for most source categories except iron & steel production in the national inventory. Compared to national one, uncertainties of total emissions in the provincial and city-scale inventories were not significantly reduced for most species with an exception of SO2. For power and other industrial boilers, the uncertainties were reduced, and the plant-specific parameters played more important roles to the uncertainties. Much larger PM10 and PM2.5 emissions for Jiangsu were estimated in this provincial inventory than other studies, implying the big discrepancies on data sources of emission factors and activity data between local and national inventories. Although the uncertainty analysis of bottom-up emission inventories at national and local scales partly supported the “top-down” estimates using observation and/or chemistry transport models, detailed investigations and field measurements were recommended for further improving the emission estimates and reducing the uncertainty of inventories at local and regional scales, for both industrial and other sectors.



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Multi-year application of WRF-CAM5 over East Asia-Part II: Interannual variability, trend analysis, and aerosol indirect effects

S13522310.gif

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Yang Zhang, Kai Wang, Jian He
Following a comprehensive evaluation of WRF-CAM5 in Part I, Part II describes analyses of interannual variability, multi-year variation trends, and the direct, indirect, and total effects of anthropogenic aerosols. The interannual variations of chemical column and surface concentrations, and ozone (O3)/particulate matter (PM) indicators are strongly correlated to anthropogenic emission changes. Despite model biases, the model captures well the observed interannual variations of temperature at 2-m, cloud fraction, shortwave cloud forcing, downwelling shortwave radiation, cloud droplet number concentration, column O3, and column formaldehyde (HCHO) for the whole domain. While the model reproduces the volatile organic compound (VOC)-limited regimes of O3 chemistry at sites in Hong Kong, Taiwan, Japan, South Korea, and from the Acid Deposition Monitoring Network in East Asia (EANET) and the degree of sulfate neutralization at the EANET sites, it has limited capability in capturing the interannual variations of the ratio of O3 and nitrogen dioxide (O3/NO2) and PM chemical regime indicators, due to uncertainties in the emissions of precursors for O3 and secondary PM, the model assumption for ammonium bisulfate (NH4HSO4) as well as lack of gas/particle partitioning of total ammonia and total nitrate. While the variation trends in multi-year periods in aerosol optical depth and column concentrations of carbon monoxide, sulfur dioxide, and NO2 are mainly caused by anthropogenic emissions, those of major meteorological and cloud variables partly reflect feedbacks of chemistry to meteorological variables. The impacts of anthropogenic aerosol indirect effects either dominate or play an important role in the aerosol total effects for most cloud and chemical predictions, whereas anthropogenic aerosol direct effects influence most meteorological and radiation variables. The direct, indirect, and total effects of anthropogenic aerosols exhibit a strong interannual variability in 2001, 2006, and 2011.



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Hospitalization and rehospitalization in Parkinson disease patients: Data from the National Parkinson Foundation Centers of Excellence

by Leili Shahgholi, Sol De Jesus, Samuel S. Wu, Qinglin Pei, Anhar Hassan, Melissa J. Armstrong, Daniel Martinez-Ramirez, Peter Schmidt, Michael S. Okun

Background

Patients with Parkinson disease (PD) are at high risk of hospital encounters with increasing morbidity and mortality. This study aimed to determine the rate of hospital encounters in a cohort followed over 5 years and to identify associated factors.

Methods

We queried the data from the International Multicenter National Parkinson Foundation Quality Improvement study. Multivariate logistic regression with backward selection was performed to identify factors associated with hospital encounter prior to baseline visit. Kaplan-Meier estimates were obtained and Cox regression performed on time to hospital encounter after the baseline visit.

Results

Of the 7,507 PD patients (mean age 66.5±9.9 years and disease duration 8.9±6.4 years at baseline visit), 1919 (25.6%) had a history of a hospital encounter prior to their baseline visit. Significant factors associated with a history of a hospital encounter prior to baseline included race (white race: OR 0.49), utilization of physical therapy (OR 1.47), history of deep brain stimulation (OR 1.87), number of comorbidities (OR 1.30), caregiver strain (OR 1.17 per standard deviation), and the standardized Timed Up and Go Test (OR 1.21). Patients with a history of hospitalization prior to the baseline were more likely to have a re-hospitalization (HR1.67, P Conclusion

Hospitalization and re-hospitalization were common in this cohort of people with PD. Our results suggest addressing caregiver burden, simplifying medications, and emphasizing primary and multidisciplinary care for comorbidities are potential avenues to explore for reducing hospitalization rates.



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Multi-year application of WRF-CAM5 over East Asia-Part II: Interannual variability, trend analysis, and aerosol indirect effects

S13522310.gif

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Yang Zhang, Kai Wang, Jian He
Following a comprehensive evaluation of WRF-CAM5 in Part I, Part II describes analyses of interannual variability, multi-year variation trends, and the direct, indirect, and total effects of anthropogenic aerosols. The interannual variations of chemical column and surface concentrations, and ozone (O3)/particulate matter (PM) indicators are strongly correlated to anthropogenic emission changes. Despite model biases, the model captures well the observed interannual variations of temperature at 2-m, cloud fraction, shortwave cloud forcing, downwelling shortwave radiation, cloud droplet number concentration, column O3, and column formaldehyde (HCHO) for the whole domain. While the model reproduces the volatile organic compound (VOC)-limited regimes of O3 chemistry at sites in Hong Kong, Taiwan, Japan, South Korea, and from the Acid Deposition Monitoring Network in East Asia (EANET) and the degree of sulfate neutralization at the EANET sites, it has limited capability in capturing the interannual variations of the ratio of O3 and nitrogen dioxide (O3/NO2) and PM chemical regime indicators, due to uncertainties in the emissions of precursors for O3 and secondary PM, the model assumption for ammonium bisulfate (NH4HSO4) as well as lack of gas/particle partitioning of total ammonia and total nitrate. While the variation trends in multi-year periods in aerosol optical depth and column concentrations of carbon monoxide, sulfur dioxide, and NO2 are mainly caused by anthropogenic emissions, those of major meteorological and cloud variables partly reflect feedbacks of chemistry to meteorological variables. The impacts of anthropogenic aerosol indirect effects either dominate or play an important role in the aerosol total effects for most cloud and chemical predictions, whereas anthropogenic aerosol direct effects influence most meteorological and radiation variables. The direct, indirect, and total effects of anthropogenic aerosols exhibit a strong interannual variability in 2001, 2006, and 2011.



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Atar Extension Cables by Oscor: Recall - Cable Separating from Connector

[Posted 07/06/2017] AUDIENCE: Cardiology ISSUE: During the use of some Atar extension cables, the cable was separating from the connector at the proximal end. The analysis of the returned devices revealed a change in the manufacturing sequence...

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Migraine and the risk of post-traumatic stress disorder among a cohort of pregnant women

Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy.

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Guidelines for low intensity transcranial electrical stimulation – an overdue step in a fairly uncontrolled field.

Non-invasive brain stimulation is an important, rapidly growing field in modern clinical neurophysiology. While high voltage transcranial electrical stimulation and transcranial magnetic stimulation and its variants have been long around, low intensity electrical transcranial stimulation (LIETS) is relatively young and is one of the fastest expanding and most promising areas of clinical neurophysiology. LIETS in this context means stimulus intensities of < 4mA for up to 60 min as described by Bikson et al.

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Early childhood myoclonic epilepsy: An independent genetic generalized epilepsy with myoclonic seizures as the main seizure type

Genetic (idiopathic) generalized epilepsies (GGEs) constitute one-third of all epilepsies (ILAE, 1989; Engel and ILAE, 2001). They are genetically determined and affect otherwise normal individuals of both sexes. GGEs manifest with absences, myoclonic jerks or generalized tonic-clonic seizures (GTCS), alone or in varying combinations and severity (Panayiotopoulos, 2005). According to the age at onset, GGEs proposed by International League Against Epilepsy (ILAE) include: myoclonic epilepsy in infancy (MEI), epilepsy with myoclonic absences (MAE), epilepsy with myoclonic atonic seizures also named as Doose syndrome, childhood absence epilepsy (CAE), juvenile absence epilepsies (JAE), and juvenile myoclonic epilepsy (JME) and so on (Berg et al., 2010).

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Measuring alterations in oscillatory brain networks in Schizophrenia with resting-state MEG: State-of-the-art and methodological challenges

Schizophrenia (SZ) is a severe psychotic disorder with important cognitive impairments. It is one of the most debilitating psychiatric illnesses. Worldwide, an estimated 21 million individuals suffer from schizophrenia and other psychotic illnesses (World Health Organization 2016). SZ patients display psychotic symptoms (e.g., hallucination, delusion, etc.) and often mood symptoms such as depression (American Psychiatric Association, 2013). Despite a thriving body of research, progress in understanding the pathophysiological mechanisms that underlie the symptoms of the disorder, and its heterogeneous nature, is relatively slow.

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The impact of accelerated high frequency rTMS on brain neurochemicals in treatment-resistant depression: Insights from 1H MR spectroscopy

Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based non-invasive clinical tool to treat patients suffering from major depression (Lefaucheur et al. 2014). Compared to electroconvulsive therapy (ECT) the application of rTMS seems rather benign: subjects are fully awake, no anesthesia or additional medication is needed. Only minor side effects - if any - are to be expected (George et al. 2013). Nevertheless, to induce enough current to excite cortical neurons at a depth of 2–2.5 cm beneath the scalp, the changing current which passes through the coil develops an electromagnetic field of about 1.5–3 Tesla (Hallett 2000; George and Belmaker 2007).

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Suction drains in aesthetic breast implant exchange are associated with surgical site infections: A retrospective cohort study

Surgical site infection (SSI) following aesthetic breast implant exchange occurs in up to 2% of procedures. The effect of suction drains on SSI risk in these cases remains controversial. The goal of this study was to assess SSI risk in the presence of suction drains after aesthetic exchange of breast implants.

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A systematic review of the influence of burying or not burying Kirschner wires on infection rates following fixation of upper extremity fractures

Fractures of the upper extremity are common with bones in the hand most frequently fractured. Hand fractures are typically seen in men of working age, distal radius fractures in an older population following a fall and supracondylar fractures in children.1 Kirschner wire (K-wire) fixation is the most common method of surgical fixation. One of the key decisions is whether to bury or not to bury the wire ends. Current popular opinion suggests that buried wires reduce infection rates. However, burying wires still retains a risk of erosion through the skin with subsequent pin site infection.

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Perioperative Antibiotic Use in Diabetic Patients: A Retrospective Review of 670 Surgeries

Carpal tunnel syndrome (CTS) has a high incidence in diabetic patients, with a reported incidence up to 21%. In severe cases of CTS, patients may undergo carpal tunnel release (CTR) surgery, which involves risk of infection and other complications. Some physicians provide prophylactic antibiotics to decrease risk of infection. Our study examines the effects of prophylactic antibiotic use, especially in a high-risk, diabetic population.

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Perioperative Antibiotic Use in Diabetic Patients: A Retrospective Review of 670 Surgeries

Carpal tunnel syndrome (CTS) has a high incidence in diabetic patients, with a reported incidence up to 21%. In severe cases of CTS, patients may undergo carpal tunnel release (CTR) surgery, which involves risk of infection and other complications. Some physicians provide prophylactic antibiotics to decrease risk of infection. Our study examines the effects of prophylactic antibiotic use, especially in a high-risk, diabetic population.

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A Negative Pressure Wound Therapy for complex infected cranial defects overlying dura mater: An effective and safe procedure

Despite rare, large cranial infected defects involving dura mater are challenging for practicians. Many patients are poor candidates for immediate reconstruction because of original pathology, comorbidities or previous radiotherapy. Recently, few authors have reported the use of negative pressure wound therapy (NPWT) in association with a first-step debridement surgery with encouraging results (1-2). In our institution, when immediate reconstruction is not feasible, a standardized reproducible two-steps procedure has been established.

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A Negative Pressure Wound Therapy for complex infected cranial defects overlying dura mater: An effective and safe procedure

Despite rare, large cranial infected defects involving dura mater are challenging for practicians. Many patients are poor candidates for immediate reconstruction because of original pathology, comorbidities or previous radiotherapy. Recently, few authors have reported the use of negative pressure wound therapy (NPWT) in association with a first-step debridement surgery with encouraging results (1-2). In our institution, when immediate reconstruction is not feasible, a standardized reproducible two-steps procedure has been established.

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Predictors of CPAP failure in OSA/ COPD overlap: In which direction one may look

Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are independent risk factors for cardiovascular diseases; COPD acts as an additive risk factor in OSA patients for cardiovascular diseases[1]. Continuous positive airway pressure (CPAP) therapy is the recommend-ed therapy for COPD-OSA overlap, as it/because it improves survival, nocturnal hypoxemia, quality of life[2], and reduces hospitalisations [3].

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Venous thrombosis and stenosis after peripherally inserted central catheter placement in children

Abstract

Background

Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children.

Objective

To determine the incidence of venous thrombosis and/or stenosis after PICC placement and identify factors that increase the risk of venous thrombosis and/or stenosis after PICC placement in children.

Materials and methods

We conducted a retrospective review of children ages 1–18 years with a PICC placed between January 2010 and July 2013 at our center, and included those who had at least one vascular imaging study of the ipsilateral extremity (Doppler ultrasound, venogram or MR angiogram) after PICC placement. Logistic regression was applied to determine risk factors for development of venous thrombosis and/or stenosis.

Results

One thousand, one hundred and ten upper extremity PICCs were placed, with 703 PICCs in the right and 407 PICCs in the left. Eight hundred fifty-one imaging studies (609 Doppler ultrasounds, 193 contrast venograms and 49 MR angiograms) were performed in 376 patients. The incidence of venous thrombosis and/or stenosis in the imaged cohort was 26.3%. PICC laterality, insertion site, duration, patient height to PICC diameter ratio, and number of PICCs per patient were not associated with development of venous thrombosis and/or stenosis. Additionally, primary diagnosis and symptoms at the time of imaging did not predict findings of venous thrombosis and/or stenosis. However, patients exposed to non-PICC central venous catheters (CVC) were more likely to develop venous thrombosis and/or stenosis (odds ratio 1.95, 1.10–3.45).

Conclusion

More than a quarter of the vascular imaging studies performed in this study cohort showed previously unknown venous thrombosis and/or stenosis, irrespective of PICC laterality, insertion site, duration and size and the number of PICCs. A history of CVC was associated with a nearly two-fold increase in risk of venous thrombosis and/or stenosis after PICC placement. We suggest that PICCs and CVCs should be placed judiciously in all children, but especially in those with lifelong medical conditions who are more likely to incur direct consequences from limited vascular access.



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Targeting FGFR in Squamous Cell Carcinoma of the Lung

Abstract

Unlike for adenocarcinomas of the lung, no molecular targeted therapies have yet been developed for squamous cell lung cancers, because targetable oncogenic aberrations are scarce in this tumor type. Recent discoveries have established that the fibroblast growth factor (FGF) signaling pathway plays a fundamental role in cancer development by supporting tumor angiogenesis and cancer cell proliferation via different mechanisms. Through comprehensive genomic studies, aberrations in the FGF pathway have been identified in various tumor types, including squamous cell lung cancer, making FGF receptor (FGFR) a potentially druggable target in this malignancy. Several multi-targeted tyrosine kinase inhibitors include FGFR in their target spectrum and a number of these compounds have been approved for clinical use in different cancers. Novel agents selectively targeting FGFRs have been developed and are currently under investigation in clinical trials, showing promising results. This article reviews FGFR aberrations and the clinical data involving selective and multikinase FGFR inhibitors in squamous cell lung cancer.



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Short-term visual memory for location in depth: A U-shaped function of time

Abstract

Short-term visual memory was studied by displaying arrays of four or five numerals, each numeral in its own depth plane, followed after various delays by an arrow cue shown in one of the depth planes. Subjects reported the numeral at the depth cued by the arrow. Accuracy fell with increasing cue delay for the first 500 ms or so, and then recovered almost fully. This dipping pattern contrasts with the usual iconic decay observed for memory traces. The dip occurred with or without a verbal or color–shape retention load on working memory. In contrast, accuracy did not change with delay when a tonal cue replaced the arrow cue. We hypothesized that information concerning the depths of the numerals decays over time in sensory memory, but that cued recall is aided later on by transfer to a visual memory specialized for depth. This transfer is sufficiently rapid with a tonal cue to compensate for the sensory decay, but it is slowed by the need to tag the arrow cue’s depth relative to the depths of the numerals, exposing a dip when sensation has decayed and transfer is not yet complete. A model with a fixed rate of sensory decay and varied transfer rates across individuals captures the dip as well as the cue modality effect.



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The different roles of category- and feature-specific attentional control settings on attentional enhancement and inhibition

Abstract

Contingent attentional capture suggests that top-down attentional control settings (ACS) can enhance attentional processing of task-relevant properties and inhibit attentional processing of task-irrelevant properties. However, it remains unclear how ACS operates when a distractor has both task-relevant and task-irrelevant characteristics. In the present study, two lateralized ERP components, N2pc and distractor positivity (Pd), were employed as markers of attentional enhancement and inhibition, respectively. The degree of matching between a distractor and a conjunctively defined target was manipulated to illustrate attentional guidance by category-specific ACS (cACS) and feature-specific ACS (fACS), and the relative position between the distractor and the target was manipulated to isolate the processing of the distractor and the target. Experiment 1 showed that, with a long display duration for searching, a reliable N2pc component was elicited by a distractor that was feature-matched but category-mismatched (C-F+) relative to the target-defined properties, suggesting an enhancing effect of fACS. In contrast, Experiment 2 demonstrated that, with a short display duration, a Pd component was elicited by a distractor that was feature-mismatched but category-matched (C+F-) relative to the target-defined properties, suggesting an inhibitory effect of fACS. Moreover, both attentional enhancement and inhibition were only triggered by fACS but not by cACS. In summary, ACS can enhance target-relevant properties or inhibit target-irrelevant properties in response to the display duration, and fACS affects both enhancement and inhibition more than cACS.



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A single amino acid in MRGPRX2 necessary for binding and activation by pruritogens

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Publication date: Available online 6 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Vemuri B. Reddy, Thomas A. Graham, Ehsan Azimi, Ethan A. Lerner

Teaser

Substance P, a neuropeptide associated with itch, atopic dermatitis and inflammation, activates MRGPRX2, a member of the mas-related GPCR family. A specific amino acid in the receptor has been found to be critical for activity.


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Results from the 5-year SQ grass SLIT-tablet asthma prevention (GAP) trial in children with grass pollen allergy

Publication date: Available online 6 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Erkka Valovirta, Thomas Houmann Petersen, Teresa Piotrowska, Mette Kongensbjerg Laursen, Jens Strodl Andersen, Helle Frobøse Sørensen, Rabih Klink
BackgroundAllergy immunotherapy targets the immunological cause of allergic rhinoconjunctivitis and allergic asthma and has the potential to alter the natural course of allergic disease.ObjectiveThe primary objective was to investigate the effect of the SQ grass SLIT-tablet compared to placebo on the risk of developing asthma.Methods812 children (5-12 years), with a clinically relevant history of grass pollen allergic rhinoconjunctivitis and no medical history or signs of asthma, were included in the randomised, double-blind, placebo-controlled trial, comprising 3 years treatment and 2 years follow-up.ResultsThere was no difference in time to onset of asthma, defined by pre-specified asthma criteria relying on documented reversible impairment of lung function (primary endpoint). Treatment with the SQ grass SLIT-tablet significantly reduced the risk of experiencing asthma symptoms or using asthma medication at the end of trial (odds ratio=0.66, p<0.036), during the 2-year post treatment follow-up, and during the entire 5-year trial period. Also, grass allergic rhinoconjunctivitis symptoms were 22-30% reduced (p<0.005 for all 5 years). At the end of the trial, the use of allergic rhinoconjunctivitis pharmacotherapy was significantly less (27% relative difference to placebo, p<0.001). Total IgE, grass pollen specific IgE, and skin prick test reactivity to grass pollen were all reduced compared to placebo.ConclusionTreatment with the SQ grass SLIT-tablet reduced the risk of experiencing asthma symptoms and using asthma medication, and had a positive, long-term clinical effect on rhinoconjunctivitis symptoms and medication use but did not show an effect on the time to onset of asthma.

Graphical abstract

image

Teaser

SQ grass SLIT-tablet treatment prevented asthma symptoms and asthma medication use in children with grass pollen ARC and no pre-existing asthma. This disease-modifying effect persisted after end of treatment.


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Functional Role of Kynurenine and Aryl hydrocarbon Receptor Axis in Chronic Rhinosinusitis with Nasal Polyps

Publication date: Available online 6 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Heng Wang, Danh C. Do, Jinxin Liu, Baofeng Wang, Jingjing Qu, Xia Ke, Xiaoyan Luo, Ho Man Tang, Ho Lam Tang, Chengping Hu, Mark E. Anderson, Zheng Liu, Peisong Gao
BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is associated with mast cell-mediated inflammation and heightened oxidant stress. Kynurenine (KYN), an endogenous tryptophan metabolite, can promote allergen-induced mast cell activation through the aryl hydrocarbon receptor (AhR).ObjectivesDetermine the role of the KYN/AhR axis and oxidant stress in mast cell activation and the development of CRSwNP.MethodsWe measured expression of indoleamine 2, 3-dioxygenase 1 (IDO1), tryptophan 2, 3-dioxygenase (TDO2), KYN, and oxidized calmodulin-dependent protein kinase II (ox-CaMKII) in nasal polyps and controls. KYN-potentiated ovalbumin (OVA)-induced reactive oxygen species (ROS) generation, cell activation, and ox-CaMKII expression were investigated in wild type (WT) and AhR deficient (AhR-/-) mast cells. The role of ox-CaMKII in mast cell activation was further investigated.ResultsNasal polyps in CRSwNP showed an increased expression of IDO1, TDO2, and KYN compared with controls. AhR was predominantly expressed in mast cells in nasal polyps. Activated mast cells and local IgE levels were substantially increased in eosinophilic polyps compared with non-eosinophilic polyps and controls. Furthermore, KYN potentiated OVA-induced ROS generation, intracellular Ca2+ levels, cell activation, and expression of ox-CaMKII in WT, but not in AhR-/- mast cells. Compared with non-eosinophilic polyps and controls, eosinophilic polyps showed increased expression of ox-CaMKII in mast cells. Mast cells from ROS-resistant CaMKII MMVVδ mice or pre-treated with CaMKII inhibitor showed protection against KYN-promoted OVA-induced mast cell activation.ConclusionThese studies support a potentially critical but previously unidentified function of the KYN/AhR axis in regulating IgE-mediated mast cell activation through ROS and ox-CaMKII in CRSwNP.

Teaser

The pathogenesis of chronic rhinosinusitis with nasal polyps is associated with increased levels of kynurenine, a tryptophan metabolite, which potentiated allergen-induced mast cell activation through the aryl hydrocarbon receptor and Calmodulin-dependent protein kinase II.


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Peanut-specific Tr1 cells induced in vitro from allergic individuals are functionally impaired

Publication date: Available online 6 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Laurence Pellerin, Jennifer Anne Jenks, Sharon Chinthrajah, Tina Dominguez, Whitney Block, Xiaoying Zhou, Arram Noshirvan, Silvia Gregori, Maria Grazia Roncarolo, Kari Christine Nadeau, Rosa Bacchetta
BackgroundPeanut allergy is a life threatening condition which lacks regulatory-approved treatment. T regulatory type 1 (Tr1) cells are potent suppressors of immune responses and can be induced in vivo upon repeated antigen exposure or in vitro using tolerogenic dendritic cells (DC-10). Whether or not oral immunotherapy (OIT) leads to antigen-specific Tr1 cell induction has not been established.ObjectivesTo determine whether peanut-specific Tr1 cells can be generated in vitro from peripheral blood of peanut allergic (PA) individuals at baseline or during OIT, and whether they are functional as compared to peanut-specific Tr1 cells induced from healthy controls (HC).MethodsDC-10 were differentiated in the presence of IL-10 from peripheral blood mononuclear cells of PA individuals and HC pulsed with the main peanut allergens Arachis hypogaea (Ara h) 1 and 2, and used as antigen presenting cells for autologous CD4+T cells (pea-T10). Pea-T10 cells were characterized by the presence of CD49b+LAG3+ Tr1 cells, antigen-specific proliferative responses, and cytokine production.ResultsCD49b+LAG3+ Tr1 cells were induced in pea-T10 cells at comparable percentages from HC and PA individuals. Despite their antigen specificity, pea-T10 cells of PA individuals with or without OIT, as compared to those of HC, were not anergic and had high Th2 cytokine production upon peanut-specific restimulation.ConclusionsPeanut-specific Tr1 cells can be induced from HC and PA individuals, but those from PA individuals are functionally defective independently of the OIT. The unfavorable Tr1/Th2 ratio is discussed as possible cause of PA-Tr1 cell impairment.

Graphical abstract

image


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Targeting FGFR in Squamous Cell Carcinoma of the Lung

Abstract

Unlike for adenocarcinomas of the lung, no molecular targeted therapies have yet been developed for squamous cell lung cancers, because targetable oncogenic aberrations are scarce in this tumor type. Recent discoveries have established that the fibroblast growth factor (FGF) signaling pathway plays a fundamental role in cancer development by supporting tumor angiogenesis and cancer cell proliferation via different mechanisms. Through comprehensive genomic studies, aberrations in the FGF pathway have been identified in various tumor types, including squamous cell lung cancer, making FGF receptor (FGFR) a potentially druggable target in this malignancy. Several multi-targeted tyrosine kinase inhibitors include FGFR in their target spectrum and a number of these compounds have been approved for clinical use in different cancers. Novel agents selectively targeting FGFRs have been developed and are currently under investigation in clinical trials, showing promising results. This article reviews FGFR aberrations and the clinical data involving selective and multikinase FGFR inhibitors in squamous cell lung cancer.



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Quantification of dental plaque in oral cavity was enabled by a novel algorithm of image processing

Publication date: Available online 6 July 2017
Source:Journal of Oral Biosciences
Author(s): Naho Sueishi, Tomoko Ohshima, Takashi Oikawa, Hiroshi Takemura, Mai Kasai, Nobuko Maeda, Yoshiki Nakamura
ObjectivesQuantitative analysis of the biofilm has been critical for pathogenicity of oral diseases such as caries and periodontal disease. Currently, the plaque control record (PCR) is used most frequently to evaluate the presence of plaque on teeth, but no quantification methods exist so far. The aim of this study was to establish a method to quantify plaque adhesion on teeth.MethodsA novel algorithm and executing program was developed to calculate the staining volume of biofilm on plastic disks or extracted teeth inoculated by Streptococcus mutans from photographic image data. The biofilm's volume on plastic disks was determined using a confocal microscope, and correlations between image analysis data were analyzed. Subsequently, the amount of plaque in the oral cavity was clinically evaluated using this algorithm.ResultsA strong correlation was observed between the biofilm's volume and the image analysis data. Similar results were also obtained with the biofilm model using extracted teeth. Clinically, it was revealed that an assessment of the amount of plaque adhesion for every tooth was possible, which could not be determined by PCR in the oral cavity.ConclusionsWe successfully developed a novel method, designated “plaque volume ratio,” to quantify the plaque accurately from photographic image data. Our findings indicated that this method may be useful for the evaluation of the amount of plaque on the surfaces of not only teeth but also dental materials in the oral cavity.



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Clinicopathological Significance of Micropapillary Pattern in Lung Adenocarcinoma

Abstract

The aim of this study was to elucidate the clinicopathological characteristics of the micropapillary (MP) subtype and its correlation with survival in lung adenocarcinoma. We investigated the clinicopathological characteristics, including the incidence, sex, smoking history, tumor size, lymph node metastasis, lymphovascular invasion, distant metastasis, genetic alteration, and prognosis in lung adenocarcinoma with the MP pattern through a meta-analysis. From 48 eligible studies, 19,502 lung adenocarcinomas were included. The incidence rate of the MP pattern was 0.101 [95% confidence interval (CI) 0.075–0.136]. There was no significant difference between stage I and III tumors. Lung adenocarcinoma with the MP pattern showed higher rates of lymphatic invasion (0.526, 95% CI 0.403–0.645). MP pattern was found in 0.150 (95% CI 0.008–0.790) of lung adenocarcinoma with distant metastasis. In lung adenocarcinoma with the MP pattern, the estimated rates of ALK, EGFR, and KRAS mutations were 0.102 (95% CI 0.027–0.322), 0.620 (95% CI 0.444–0.769), and 0.118 (95% CI 0.027–0.393), respectively. The MP pattern of lung adenocarcinoma was significantly correlated with worse overall and disease-free survival rates (hazard ratio 1.704, 95% CI 1.216–2.387, and 2.082, 95% CI 1.541–2.813, respectively). Taken together, identification of the MP pattern in lung adenocarcinoma is useful for prediction of clinicopathological characteristics and prognosis of patients.



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Clinicopathological Significance of Micropapillary Pattern in Lung Adenocarcinoma

Abstract

The aim of this study was to elucidate the clinicopathological characteristics of the micropapillary (MP) subtype and its correlation with survival in lung adenocarcinoma. We investigated the clinicopathological characteristics, including the incidence, sex, smoking history, tumor size, lymph node metastasis, lymphovascular invasion, distant metastasis, genetic alteration, and prognosis in lung adenocarcinoma with the MP pattern through a meta-analysis. From 48 eligible studies, 19,502 lung adenocarcinomas were included. The incidence rate of the MP pattern was 0.101 [95% confidence interval (CI) 0.075–0.136]. There was no significant difference between stage I and III tumors. Lung adenocarcinoma with the MP pattern showed higher rates of lymphatic invasion (0.526, 95% CI 0.403–0.645). MP pattern was found in 0.150 (95% CI 0.008–0.790) of lung adenocarcinoma with distant metastasis. In lung adenocarcinoma with the MP pattern, the estimated rates of ALK, EGFR, and KRAS mutations were 0.102 (95% CI 0.027–0.322), 0.620 (95% CI 0.444–0.769), and 0.118 (95% CI 0.027–0.393), respectively. The MP pattern of lung adenocarcinoma was significantly correlated with worse overall and disease-free survival rates (hazard ratio 1.704, 95% CI 1.216–2.387, and 2.082, 95% CI 1.541–2.813, respectively). Taken together, identification of the MP pattern in lung adenocarcinoma is useful for prediction of clinicopathological characteristics and prognosis of patients.



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Prévention médicale et traitement des complications pulmonaires secondaires à la radiothérapie

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Publication date: Available online 5 July 2017
Source:Cancer/Radiothérapie
Author(s): A. Vallard, C. Rancoule, H. Le Floch, J.-B. Guy, S. Espenel, C. Le Péchoux, É. Deutsch, N. Magné, C. Chargari




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The Effects of Bit Wear on Respirable Silica Dust, Noise and Productivity: A Hammer Drill Bench Study

Abstract
Objectives:
Hammer drills are used extensively in commercial construction for drilling into concrete for tasks including rebar installation for structural upgrades and anchor bolt installation. This drilling task can expose workers to respirable silica dust and noise. The aim of this pilot study was to evaluate the effects of bit wear on respirable silica dust, noise, and drilling productivity.
Method:
Test bits were worn to three states by drilling consecutive holes to different cumulative drilling depths: 0, 780, and 1560 cm. Each state of bit wear was evaluated by three trials (nine trials total). For each trial, an automated laboratory test bench system drilled 41 holes 1.3 cm diameter, and 10 cm deep into concrete block at a rate of one hole per minute using a commercially available hammer drill and masonry bits. During each trial, dust was continuously captured by two respirable and one inhalable sampling trains and noise was sampled with a noise dosimeter. The room was thoroughly cleaned between trials.
Results:
When comparing results for the sharp (0 cm) versus dull bit (1560 cm), the mean respirable silica increased from 0.41 to 0.74 mg m−3 in sampler 1 (P = 0.012) and from 0.41 to 0.89 mg m−3 in sampler 2 (P = 0.024); levels above the NIOSH recommended exposure limit of 0.05 mg m−3. Likewise, mean noise levels increased from 112.8 to 114.4 dBA (P < 0.00001). Drilling productivity declined with increasing wear from 10.16 to 7.76 mm s−1 (P < 0.00001).
Discussion:
Increasing bit wear was associated with increasing respirable silica dust and noise and reduced drilling productivity. The levels of dust and noise produced by these experimental conditions would require dust capture, hearing protection, and possibly respiratory protection. The findings support the adoption of a bit replacement program by construction contractors.

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