In the original published version of this article, the middle name for author Mirko H. H. Schmidt is missing.
https://ift.tt/2RcB5s8
Τρίτη 23 Οκτωβρίου 2018
Damage-regulated autophagy modulator 1 in oral inflammation and infection
Abstract
Objectives
Damage-regulated autophagy modulator (DRAM) 1 is a p53 target gene with possible involvement in oral inflammation and infection. This study sought to examine the presence and regulation of DRAM1 in periodontal diseases.
Material and methods
In vitro, human periodontal ligament fibroblasts were exposed to interleukin (IL)-1β and Fusobacterium nucleatum for up to 2 days. The DRAM1 synthesis and its regulation were analyzed by real-time PCR, immunocytochemistry, and ELISA. Expressions of other autophagy-associated genes were also studied by real-time PCR. In vivo, synthesis of DRAM1 in gingival biopsies from rats and patients with and without periodontal disease was examined by real-time PCR and immunohistochemistry. For statistics, ANOVA and post-hoc tests were applied (p < 0.05).
Results
In vitro, DRAM1 was significantly upregulated by IL-1β and F. nucleatum over 2 days and a wide range of concentrations. Additionally, increased DRAM1 protein levels in response to both stimulants were observed. Autophagy-associated genes ATG3, BAK1, HDAC6, and IRGM were also upregulated under inflammatory or infectious conditions. In vivo, the DRAM1 gene expression was significantly enhanced in rat gingival biopsies with induced periodontitis as compared to control. Significantly increased DRAM1 levels were also detected in human gingival biopsies from sites of periodontitis as compared to healthy sites.
Conclusion
Our data provide novel evidence that DRAM1 is increased under inflammatory and infectious conditions in periodontal cells and tissues, suggesting a pivotal role of DRAM1 in oral inflammation and infection.
Clinical relevance
DRAM1 might be a promising target in future diagnostic and treatment strategies for periodontitis.
https://ift.tt/2F1nlvh
Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial
Abstract
Objective
The aim of this study was to compare the clinical and radiographic efficacy of guided tissue regeneration with a modified perforated collagen membrane (MPM) or standard collagen membrane (CM) in the treatment of intrabony defects in patients with aggressive periodontitis (AgP).
Materials and methods
Fifteen AgP patients were included in the study. Two single intrabony defects of at least 3 mm depth with ≥ 6 mm probing pocket depth (PPD) from each patient were randomly assigned to either xenogenic graft plus MPM (test group) or xenogenic graft plus CM (control group). PPD, clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and at 12 months. The radiographic assessments included the measurements of defect depth (DD), change in alveolar crest position (ACP), linear defect fill (LDF), and percentage defect fill (%DF).
Results
After treatment, PPD, CAL, DD, and ACP values improved significantly in both groups, without statistical differences between them. However, with respect to LDF and %DF, the 12-month radiographic analysis at MPM-treated sites showed a significant improvement compared to the 6-month outcomes, that was not observed at control sites (additional LDF of 0.4 ± 0.5 mm, p = 0.010 and %DF of 6.4 ± 7.6%, p = 0.025).
Conclusions
Both strategies proved effective in the treatment of intrabony defects in patients with AgP. Nonetheless, enhanced LDF and %DF 12 months postoperatively at MPM-treated sites may stem from cellular and molecular migration from the periosteum and overlying gingival connective tissue through barrier's pores.
Clinical relevance
Modification of CM may have positive ramifications on periodontal regeneration.
https://ift.tt/2E4VZYb
Oral health-related quality of life is associated with disease specific parameters in patients with ankylosing spondylitis
Abstract
Background
The aim of this cross-sectional study was to investigate oral health-related quality of life (OHRQoL) in patients with ankylosing spondylitis (AS) and its association to oral health as well as AS specific parameters.
Methods
Patients with AS and a healthy control group (HC) were included and examined. The oral examination included decayed-, missing-, and filled-teeth index (DMF-T) as well as assessment of periodontal probing depth and clinical attachment loss to classify patients into healthy/mild, moderate, or severe periodontitis. Furthermore, the German short form of the oral health impact profile (OHIP G14) was used.
Results
A total of 50 patients each group (age: AS, 47.18 ± 15.67; HC, 55.82 ± 10.56; p < 0.01, gender male: AS, 52%; HC, 46%; p = 0.69) was included. AS patients showed worse D-T (p < 0.01) and periodontal condition (p = 0.01). The OHIP G14 score was clinically relevant and statistically significant higher in AS compared to HC (AS, 6.2 [2; 0–10.75]; HC, 1.7 [0; 0–2.0]; < 0.01). Only in HC, an association of OHIP G14 to DMF-T (p = 0.01) and M-T (p = 0.01) was found, while the OHIP G14 in AS group was not associated to oral health parameters. Within the AS group, the majority of investigated AS specific parameters were statistically significant and clinically relevant associated to OHIP G14 scores (pi < 0.05).
Conclusion
Patients with AS show worse OHRQoL compared to HC, irrespective of oral status. The high general disease burden might affect OHRQoL, making an increased attention of these patients in dental care, especially considering psychological aspects, necessary.
Clinical relevance
Increased consideration of psychosocial and disease related aspects in dental care of AS patients appear recommendable.
https://ift.tt/2q6aLEi
A 30-s exposure to ethanol 20% is cytotoxic to human keratinocytes: possible mechanistic link between alcohol-containing mouthwashes and oral cancer
Abstract
Objectives
To provide mechanistic evidence for the epidemiological link between long-term use of alcohol-containing mouthwashes and oral cancer.
Material and methods
Human epithelial keratinocytes were exposed for 30 s to concentrations of ethanol commonly present in mouthwashes. After a recovery period, cell viability was assessed with the MTT assay.
Results
A marked cytotoxic effect was observed for ethanol concentrations of 20% and above.
Conclusions
The cytotoxicity of ethanol may explain the epidemiological association between mouthwash use and oral cancer. Evidence suggests that the risk of developing cancer in a tissue is strongly determined by the number of stem cell divisions accumulated by the tissue during a person's lifetime; cell division is a major source of mutations and other cancer-promoting errors. Since cell death activates the division of stem cells, the possible cytotoxicity of ethanol on the cells lining the oral mucosa will promote the division of the stem cells located in deeper layers to produce new cells to regenerate the damaged epithelium. If we regularly use mouthwashes containing cytotoxic concentrations of ethanol, the stem cells of the oral cavity may need to divide more often than usual and our risk of developing oral cancer may increase.
Clinical relevance
Many mouthwashes contain percentages of ethanol above 20%. Because ethanol is not crucial to prevent and reduce gingivitis and plaque, members of the dental team should consider the potential risk of oral cancer associated with frequent use of alcohol-containing mouthwashes when advising their patients.
https://ift.tt/2RdvWA5
Novel evaluation method of dentin repair by direct pulp capping using high-resolution micro-computed tomography
Abstract
Objectives
We evaluated a novel micro-computed tomography (micro-CT) assessment for quality and quantity of dentin repair, which is difficult to visualize by histological analysis, after direct pulp capping under standardized cavity preparation.
Materials and methods
Standardized cavities were prepared on Wistar rats and direct pulp capping was performed using two commercial bioceramics, ProRoot MTA, and iRoot BP Plus. After 2 or 4 weeks, quality and quantity of tertiary dentin formation were evaluated using high-resolution micro-CT analyses including dentin mineral density, dentin mineral contents, compactness and integrity of tertiary dentin, and dentin volume with/without void space. Reproducibility of micro-CT analyses was confirmed by histological evaluation of the same specimen.
Results
The exposed pulp area sizes were similar between iRoot BP Plus and ProRoot MTA. Micro-CT analysis of 2-week samples showing compactness of tertiary dentin was significantly higher in iRoot BP Plus than ProRoot MTA (p < 0.05). Tertiary dentin volume without void space, dentin mineral contents, and density were not significantly different between the groups. In 4-week samples, a significant increase was observed in dentin mineral density, compactness, and dentin volume with/without void space induced by iRoot BP Plus (p < 0.05). Micro-CT analysis of tertiary dentin integrity demonstrated that some ProRoot MTA specimens had small defects and lacked continuity (6/512 images). No defects were observed with iRoot BP Plus.
Conclusions
Micro-CT analysis was confirmed as an accurate, objective, and inclusive approach for evaluating quality and quantity of dentin repair.
Clinical relevance
These multifaceted approaches to evaluate pulp capping materials may accelerate review processes, ultimately improving vital pulp therapy.
https://ift.tt/2o24h87
Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP
Abstract
Objectives
The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP).
Material and methods
The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°–55°; 1.2 × 106 cycles 0–50 N) and subsequent linear loading until failure.
Results
Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024).
Conclusions
Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure.
Clinical relevance
CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.
https://ift.tt/2nMwZK1
N -acetyl- l -cysteine protects dental tissue stem cells against oxidative stress in vitro
Abstract
Objectives
The aim of our study was to investigate whether N-acetyl-l-cysteine (NAC) could protect stem cells from exfoliated deciduous teeth (SHED) against oxidative damage, during in vitro cultivation, to preserve regenerative potential of these cells. Accordingly, we examined the potential of cell culture supplementation with NAC in prevention of lipid peroxidation, unfavorable changes of total lipids fatty acid composition, and the effects on the activity of antioxidant enzymes.
Material and methods
We analyzed the extent of oxidative damage in SHED after 48 h treatment with different NAC concentrations. Cellular lipid peroxidation was determined upon reaction with thiobarbituric acid. All enzyme activities were measured spectrophotometrically, based on published methods. Fatty acid methyl esters were analyzed by gas-liquid chromatography.
Results
Concentration of 0.1 mM NAC showed the most profound effects on SHED, significantly decreasing levels of lipid peroxidation in comparison to control. This dose also diminished the activities of antioxidant enzymes. Furthermore, NAC treatment significantly changed fatty acid composition of cells, reducing levels of oleic acid and monounsaturated fatty acids and increasing linoleic acid, n-6, and total polyunsaturated fatty acid (PUFA) proportions.
Conclusion
Low dose of NAC significantly decreased lipid peroxidation and altered fatty acid composition towards increasing PUFA. The reduced oxidative damage of cellular lipids could be strongly related to improved SHED survival in vitro.
Clinical relevance
Low doses of antioxidants, applied during stem cells culturing and maintenance, could improve cellular characteristics in vitro. This is prerequisite for successful use of stem cells in various clinical applications.
https://ift.tt/2o9G0gy
CAD/CAM produces dentures with improved fit
Abstract
Objectives
Resin polymerisation shrinkage reduces the congruence of the denture base with denture-bearing tissues and thereby decreases the retention of conventionally fabricated dentures. CAD/CAM denture manufacturing is a subtractive process, and polymerisation shrinkage is not an issue anymore. Therefore, CAD/CAM dentures are assumed to show a higher denture base congruence than conventionally fabricated dentures. It has been the aim of this study to test this hypothesis.
Materials and methods
CAD/CAM dentures provided by four different manufacturers (AvaDent, Merz Dental, Whole You, Wieland/Ivoclar) were generated from ten different master casts. Ten conventional dentures (pack and press, long-term heat polymerisation) made from the same master casts served as control group. The master casts and all denture bases were scanned and matched digitally. The absolute incongruences were measured using a 2-mm mesh.
Results
Conventionally fabricated dentures showed a mean deviation of 0.105 mm, SD = 0.019 from the master cast. All CAD/CAM dentures showed lower mean incongruences. From all CAD/CAM dentures, AvaDent Digital Dentures showed the highest congruence with the master cast surface with a mean deviation of 0.058 mm, SD = 0.005. Wieland Digital Dentures showed a mean deviation of 0.068 mm, SD = 0.005, Whole You Nexteeth prostheses showed a mean deviation of 0.074 mm, SD = 0.011 and Baltic Denture System prostheses showed a mean deviation of 0.086 mm, SD = 0.012.
Conclusions
CAD/CAM produces dentures with better fit than conventional dentures.
Clinical Relevance
The present study explains the clinically observed enhanced retention and lower traumatic ulcer-frequency in CAD/CAM dentures.
https://ift.tt/2Rgm9JF
Zinc and silica are active components to efficiently treat in vitro simulated eroded dentin
Abstract
Objectives
Biomaterials for treating dentin hypersensitivity and dentin wear were evaluated to efficiently occlude the dentinal tubules and to increase dentin resistance to abrasion.
Materials and methods
Twenty-four dentin surfaces were treated with EDTA to expose dentinal tubules and were (1) non-brushed, (2) brushed with distilled water, or with pastes containing (3) monetite, (4) brushite, (5) Zn-monetite, (6) Zn-brushite, (7) Silica-brushite, and (8) NovaMin®. Topographical, nanomechanical, and chemical analysis were assessed on dentin surfaces (n = 3) after artificial saliva immersion for 24 h, and after citric acid challenge. Twenty-one further dentin specimens were created to evaluate dentin permeability after brushing, saliva storage, and acid application (n = 3). ANOVA, Student-Newman-Keuls (p < 0.05), and Student t test (p < 0.001) were used.
Results
Particles containing major proportion of silica attained intratubular occlusion by carbonate crystals (Raman carbonate peak heights 15.17 and 19.24 au; complex modulus 110 and 140 GPa, at intratubular dentin). When brushing with pastes containing higher proportion of silica or zinc, phosphate calcium compounds were encountered into tubules and over dentin surfaces (Raman intratubular phosphate peak heights 49 to 70 au, and at the intertubular dentin 78 to 92). The formed carbonated apatite and calcium phosphate layer were resistant to citric acid application. Zinc compounds drastically increased tubule occlusion, decreased dentin permeability (up to 30%), and augmented mechanical properties at the intertubular dentin (90–130 GPa); it was maintained after acid challenging.
Conclusions
Zinc-containing pastes occluded dentinal tubules and improved dentin mechanical properties.
Clinical relevance
Using zinc as an active component to treat eroded dentin is encouraged.
https://ift.tt/2BYZBVv
Influence of operator skill level on the clinical outcome of non-surgical periodontal treatment: a retrospective study
Abstract
Objectives
The aim of this study is to evaluate the effect of operators experience and skill on treatment results of initial non-surgical periodontal therapy.
Materials and methods
Initial periodontal treatment was carried out by either second-year periodontal residents (PR) or last year dental students (DS). From the treatment records of patients in each group, plaque and bleeding indices, and pocket depth (PD) at baseline and at re-evaluation were collected retrospectively on each tooth at six locations. Data were separated according to tooth type, area, and probing depth categories, sub-grouped to 1–3, 4–5, and ≥ 6 mm.
Results
Fifty and 49 records of DS and PR patients, accordingly, were analyzed. Initial periodontal treatment improved patient compliance in both groups and reduced signs of inflammation with significantly superior results in the PR group. Significant change in percentage of pockets was recorded in each category. The increase in percentage of sites with PD 1–3 mm and decrease in percentage of PD ≥ 6 mm pockets was significantly (p ≤ 0.001) superior in patients treated by PR. Percentage of 4–5 mm pockets was significantly reduced in both groups (p ≤ 0.01), with a significantly greater reduction in the mandibular molar and anterior teeth in the PR group.
Conclusions
Experience and skill significantly affect the outcome of non-surgical periodontal therapy, with more positive improvement in patient compliance and clinical parameters when performed by a more qualified operator.
Clinical relevance
Improvement of operator skills may decrease the number of residual pockets and increase patient compliance following non-surgical periodontal treatment.
https://ift.tt/2C1fMGa
Study of salivary and serum vaspin and total antioxidants in anorexia nervosa
Abstract
Objectives
Patients with anorexia nervosa (AN) are primarily at high risk of multiple somatic complications, including oral diseases. In recent years, a number of new molecules that may play a potentially important role in AN progress and prognosis have been identified in saliva, but their exact roles are still poorly understood. Two such group of substances are antioxidants and vaspin. The purpose of this observational, cross-sectional study was to measure both the salivary and serum total antioxidant status (TAS), and vaspin (VASP) concentrations of patients with AN in comparison to an average population.
Material and methods
Ninety subjects participated (30 patients with AN, 60 matched healthy control subjects). A clinical examination was made, and blood and salivary samples were taken during the acute stage of AN (BMI < 15 kg/m2) in the first week of hospitalization. Enzyme immunoassay (ELISA) suitable for measuring VASP and colorimetric assay for TAS were used.
Results
Anorexic patients had significant reductions in salivary flow, TAS, and an elevation in VASP levels in their saliva and serum. Significant correlations between TAS, VASP, salivary flow, and nutritional status were detected.
Conclusion
Determination of TAS and VASP in combined biological material confirmed that saliva might be a reliable non-invasive source of information for potent nutritional biomarkers.
Clinical relevance
Our findings suggest that VASP cannot be excluded, as its increased concentration in saliva is an adaptive mechanism in reduced TAS, one resulting from diminished salivary secretion. It is therefore worth conducting further research aimed at recognizing the role of TAS and VASP in the saliva of underweight patients.
https://ift.tt/2BYlXuF
The Plasma NAD+ Metabolome Is Dysregulated in “Normal” Aging
Rejuvenation Research, Ahead of Print.
https://ift.tt/2JdZIlh
A paediatric case of cutaneous larva migrans acquired in the UK
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2q8QRIM
Multi-disciplinary evaluation of a 5-month-old with hypertrophic cardiomyopathy related to a functional adrenocortical tumor
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2yDfTVt
Long-term follow-up of gonadal dysfunction in morbidly obese adolescent boys after bariatric surgery
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2JerfmK
Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2yyWbKh
Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2JdcCA2
A novel hydroxyapatite-binding antimicrobial peptide against oral biofilms
Abstract
Objectives
Novel synthetic antimicrobial peptides which consist of a new immunomodulatory peptide 1018 and two different modifications with hydroxyapatite-binding affinity were developed. We compared the effect(s) of these peptides against oral plaque biofilms and measured their effectiveness in killing biofilm microbes and in reducing biofilm volume.
Materials and methods
The high affinity hydroxyapatite (HA)-binding peptide 1018 (SHABP), the mild affinity HA-binding peptide 1018 (MHABP), and peptide 1018 without additional amino acid sequence (peptide 1018) were synthesized. Oral multispecies biofilms were grown anaerobically for 3 days. The biofilms were exposed to three peptides at two different concentrations (0.65 and 3.25 μmol/L) for 24, 48, and 72 h. The biofilms were also treated for 3 or 9 min with the peptides (3.25 μmol/L). The percentage of killed biofilm bacteria and biofilm volume were determined by using LIVE/DEAD viability staining and confocal laser scanning microscopy.
Results
SHABP was superior to MHABP and peptide 1018 in its killing efficacy of the pre-formed biofilms, especially at concentration of 3.25 μmol/L (p < 0.05). SHABP performed also better than MHABP and peptide 1018 in reducing the overall biofilm volume at both concentrations (p < 0.05). During the 3 days of long-term exposure, MHABP and peptide 1080 killed more bacteria in the top half of the biofilms, compared to bottom half. SHABP killed more bacteria in the bottom half (39%) of the biofilms than in the top half (29%) at day 1 (p < 0.05), whereas more bacteria were killed in the upper layers on days 2 and 3. SHABP killed a much higher percentage of plaque biofilm bacteria when used on 3-day-old biofilms for one or three times for 3 min than MHABP or peptide 1018 at high concentration (p < 0.05).
Conclusions
The modified peptide 1018 with high HA-binding affinity had higher antimicrobial activity against biofilm microbes and reduced biofilm volume more than the other peptides tested.
Clinical relevance
Modified peptide 1018 with high hydroxyapatite-binding affinity is a promising agent for use in oral antibiofilm strategies in the future.
https://ift.tt/2PkKDnm
A Phase Ib, Open‐Label Study of Dalantercept, an Activin Receptor‐Like Kinase 1 Ligand Trap, plus Sorafenib in Advanced Hepatocellular Carcinoma
Lessons Learned. Patients with hepatocellular carcinoma (HCC) often have limited therapeutic responses to the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor sorafenib, which is standard of care in advanced HCC. Targeting the activin receptor‐like kinase 1 (ALK1) and VEGF pathways simultaneously by combining the ALK1 ligand trap dalantercept with sorafenib may result in more effective angiogenic blockade and delay tumor progression in patients with advanced HCC.Although the combination was generally well tolerated, there was no additive antitumor activity with the combination of dalantercept plus sorafenib in patients with advanced HCC. No complete or partial responses were observed, and overall survival ranged from 1.9 to 23.3 months.These results suggest that, in this patient population, further development of the possible limited benefits of combination therapy with dalantercept plus sorafenib is not warranted.Background.Targeting the activin receptor‐like kinase 1 (ALK1) and vascular endothelial growth factor (VEGF) pathways may result in more effective angiogenic blockade in patients with hepatocellular carcinoma (HCC).Methods.In this phase Ib study, patients with advanced HCC were enrolled to dose‐escalation cohorts, starting at 0.6 mg/kg dalantercept subcutaneously every 3 weeks plus 400 mg sorafenib orally once daily, or to a dose expansion cohort. The primary objective was to determine the safety and tolerability and the dalantercept maximum tolerated dose (MTD) level. Secondary objectives were to assess the preliminary activity and the association of pharmacodynamic biomarkers with tumor response.Results.A total of 21 patients were enrolled in the study. Five patients received 0.6 mg/kg dalantercept in the first dose escalation cohort. Based on the initial safety results, the dose level was de‐escalated to 0.4 mg/kg in the second cohort (n = 6). The MTD was identified as 0.4 mg/kg and used for the dose expansion cohort (n = 10). At this dose level, the combination was generally well tolerated. Overall survival ranged from 1.9 to 23.3 months, and the best overall response was stable disease.Conclusion.The addition of dalantercept to sorafenib did not improve antitumor activity in patients with HCC. The dalantercept program in this population was discontinued.
https://ift.tt/2NZp47q
A Case of Metastatic Biliary Tract Cancer Diagnosed Through Identification of an IDH1 Mutation
AbstractThe role of next‐generation sequencing from either circulating tumor DNA (ctDNA) or formalin‐fixed paraffin‐embedded (FFPE) tissue to identify therapeutically targetable genomic alterations has been well established. Genomic profiling may also have untapped potential as a diagnostic tool in cases in which traditional immunohistochemistry assays cannot establish a clear histologic diagnosis. Expanding the number of histologies with unique genomic signatures or alterations is critical in this setting. Here we describe a case of a 73‐year‐old man who presented with a duodenal mass extending to the liver and peritoneal carcinomatosis, initially thought to be metastatic duodenal adenocarcinoma. Subsequent genomic profiling of ctDNA and FFPE tissue revealed an IDH1 mutation, which is rare in duodenal adenocarcinoma but common in biliary tract cancers (BTCs). This finding prompted a second biopsy, which revealed pancreaticobiliary adenocarcinoma. The clinical significance of IDH mutations in terms of their molecular specificity to certain histologies is reviewed. Recent and ongoing investigations into IDH inhibitors for advanced and metastatic BTCs are also discussed.Key Points. This case demonstrates a novel use of next‐generation sequencing as a diagnostic tool to modify a primary cancer diagnosis, leading to important changes in therapy.Isocitrate dehydrogenase mutations are rare in solid organ malignancies and are highly specific for biliary tract cancers (BTCs) within the gastrointestinal malignancies.IDH inhibition is an active area of investigation in metastatic BTCs; early results have been promising.
https://ift.tt/2OFIvHz
Phase Angle and the Diagnosis of Impending Death in Patients with Advanced Cancer: Preliminary Findings
AbstractBackground.Phase angle is a prognostic factor in patients with months of survival, but its accuracy has not been examined in patients with weeks/days of survival. We determined the association between phase angle and survival in patients with advanced cancer admitted to an acute palliative care unit (APCU).Subjects, Materials, and Methods.We prospectively assessed phase angle in consecutive patients with advanced cancer admitted to our APCU. We conducted univariate and multivariate survival analyses adjusting for established prognostic factors. Post hoc subgroup analyses examined patients with and without edema.Results.Among 204 patients, the median overall survival was 10 days (95% confidence interval [CI] 8–11 days). Seventy‐four (36%) did not have edema. The median phase angle was 3.7° for the entire cohort, 3.9° for the nonedematous subgroup and 3.6° for the edematous subgroup. In univariate analysis, a low phase angle was associated with decreased survival for the entire cohort (≤3° vs. >3°, median survival 7 vs. 10 days, p = .045) and the nonedematous subgroup (5 vs. 18 days, p < .001) but not the edematous subgroup (9 vs. 9 days, p = .84). In multivariate analysis, phase angle did not reach significance for the entire cohort but remained significant in the nonedematous subgroup (hazard ratio 2.46, 95% CI 1.14–5.31, p < .001). Specifically, phase angle ≤3° had an accuracy of 86% (95% CI 77%–93%) for 3‐day survival in patients without edema.Conclusion.Phase angle had limited prognostic utility in unselected APCU patients but was significant in the nonedematous subgroup. Further studies are required to confirm these preliminary findings.Implications for Practice.In this prospective study involving 204 patients with advanced cancer, phase angle as measured by bioelectric impedance analysis was a significant predictor of mortality independent of known prognostic factors in patients without edema but not patients with edema. Among patients without edema, a phase angle ≤3° had an accuracy of 86% for 3‐day survival, which may inform the diagnosis of impending death and potentially end‐of‐life decision making.
https://ift.tt/2O4YKsE
A stereotaxic MRI template set of mouse brain with fine sub-anatomical delineations: Application to MEMRI studies of 5XFAD mice
Publication date: Available online 22 October 2018
Source: Magnetic Resonance Imaging
Author(s): Binbin Nie, Di Wu, Shengxiang Liang, Hua Liu, Xi Sun, Panlong Li, Qi Huang, Tianhao Zhang, Ting Feng, Songtao Ye, Zhijun Zhang, Baoci Shan
Abstract
Purpose
Manganese-enhanced magnetic resonance imaging (MEMRI) can help us trace the active neurons and neuronal pathway in transgenic mouse AD model. 5XFAD has been widespread accepted as a valuable model system for studying brain dysfunction progresses in the courses of AD. To further understand the development of AD at early stages, an effective and objective data analysis platform for MEMRI studies should be constructed.
Materials and methods
A set of stereotaxic templates of mouse brain in Paxinos and Franklin space, "the Institute of High Energy Physics Mouse Template", or IMT for short, was constructed by iteratively registration and averaging. An atlas image was reconstructed from the Paxinos and Franklin atlas figures and each sub-anatomical segmentation was assigning a unique integer. An analysis SPM plug-in toolbox was further created, that automates and standardizes the time-consuming processes of brain extraction, tissue segmentation, and statistical analysis for MEMRI scans.
Results
The IMT comprised a T2WI template image, a MEMRI template image, intracranial tissue segmentations, and accompany with a digital mouse brain atlas image, in which 707 sub-anatomical brain regions are delineated. Data analyses were performed on groups of developing 5XFAD mice to demonstrate the usage of IMT, and the results shows that abnormal neuronal activity occurs at early stage in 5XFAD mice.
Conclusion
We have constructed a stereotaxic template set of mouse brain named IMT with fine delineations of sub-anatomical structures, which is compatible with SPM. It will give a widely range of researchers a standardized coordinate system for localization of any mouse brain related data.
https://ift.tt/2Jgj5KI
Adjuvant De-Escalated Radiation + Adjuvant Nivolumab for Intermediate-High Risk P16+ Oropharynx Cancer
Conditions: Carcinoma, Squamous Cell of Head and Neck; Oropharynx Squamous Cell Carcinoma
Interventions: Drug: Nivolumab Injection; Radiation: Radiotherapy (RT)
Sponsors: Robert Ferris; Bristol-Myers Squibb
Not yet recruiting
https://ift.tt/2z0kzUn
Interventions: Drug: Nivolumab Injection; Radiation: Radiotherapy (RT)
Sponsors: Robert Ferris; Bristol-Myers Squibb
Not yet recruiting
https://ift.tt/2z0kzUn
IgG Fc N-glycosylation: Alterations in neurologic diseases and potential therapeutic target?
Publication date: Available online 22 October 2018
Source: Journal of Autoimmunity
Author(s): Yannick Kronimus, Richard Dodel, Sebastian P. Galuska, Sascha Neumann
Abstract
Immunoglobulin G (IgG) is the most abundant antibody subclass of the human circulatory system and has important functions in the adaptive immune response. On the one hand, recognition and neutralization of antigens is mediated by the fab fragment, and on the other hand, processes such as phagocytosis, complement activation and inflammatory reactions are triggered by the Fc fragment. Here, the composition of conserved N-glycans attached to asparagine 297 of the IgG CH2 domain is a major critical factor that particularly modulates the effector functions of IgG. Additional attachments of fucoses, galactoses, N-acetylglucosamines, and sialic acids have been identified as factors that influence the affinity to a wide range of complement proteins and receptors and, thus, secondarily induce the secretion of pro- and anti-inflammatory cytokines. Consequently, alterations in the IgG Fc N-glycosylation pattern can provoke disruptions in the immunological state and are accompanied by various diseases, although the involvement of changed IgG glycosylation in disease outbreaks remains unknown. In addition to many autoimmune diseases, which have already been extensively reviewed, there are a number of further disorders related to altered IgG glycosylation patterns. In the present review, we focus on neurologic diseases, as in the last few years, an increasing number of studies have been published in this field. Due to the absence of reliable early biomarkers as well as therapeutic options in many cases, such analyses are of great interest and reveal possible future approaches.
https://ift.tt/2PfLlSX
Scholar : ΠΑΡΕΣΗ BELL - νέα αποτελέσματα
[PDF] Νοσηλευτικές παρεμβάσεις σε ασθενείς με κακώσεις νωτιαίου μυελού
Α ΑΛΕΞΑΝΔΡΟΠΟΥΛΟΥ - 2018
… αφορά τη γνώση του νωτιαίου μυελού. Ο Χούμπερ (1707-1778 μ.Χ.) περιέγραψε με ακρίβεια
τις νωτιαίες ρίζες. Ο Charles Bell (1774-1842) έκανε τη διάκριση μεταξύ κινητικών και
αισθητικών νεύρων. Ο CE Brown Sequard ξεκίνησε μοντέρνες μελέτες τόσο της ανατομίας …
τις νωτιαίες ρίζες. Ο Charles Bell (1774-1842) έκανε τη διάκριση μεταξύ κινητικών και
αισθητικών νεύρων. Ο CE Brown Sequard ξεκίνησε μοντέρνες μελέτες τόσο της ανατομίας …
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Scholar : Myringotomy and tubes - νέα αποτελέσματα
[PDF] COMPARATIVE EVALUATION OF ADENOIDECTOMY AND MYRINGOTOMY WITH OR WITHOUT VENTILATION TUBE PLACEMENT IN THE TREATMENT OF OTITIS …
WQ Dar, SM Qazi, J Nisar - GLOBAL JOURNAL FOR RESEARCH ANALYSIS, 2018
INTRODUCTION Otitis media with effusion (OME) is an accumulation of non-purulent
fluid in the middle ear cleft usually resulting from alteration of mucociliary clearance within
the cleft associated with a negative middle ear pressure. OME is a common otological …
fluid in the middle ear cleft usually resulting from alteration of mucociliary clearance within
the cleft associated with a negative middle ear pressure. OME is a common otological …
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Diagnosis and management of otitis media with effusion in a tertiary hospital in Kano: a best practice implementation project
A Ahmed, E Kolo, A Aluko, H Abdullahi, A Ajiya… - JBI Database of Systematic …, 2018
Objective: To implement the best available practice to improve
the diagnosis and management of OME.
the diagnosis and management of OME.
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The Influence of Age on the Relationship Between Allergic Rhinitis and Otitis Media
RE Roditi, JJ Shin - Current Allergy and Asthma Reports, 2018
… with otologic symptoms and evaluating for presence of allergy based on
examination, tympanometry, skin prick testing, eustachian tube function,
and … In patients with allergic rhinitis who required myringotomy, the level of …
examination, tympanometry, skin prick testing, eustachian tube function,
and … In patients with allergic rhinitis who required myringotomy, the level of …
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[HTML] The clinical and economic consequences of practice style variations in common surgical interventions: A protocol for systematic review
M Nouhi, M Hadian, A Olyaeemanesh - Medicine, 2018
Background: Surgical intervention is one of the common
therapeutic interventions applied to a vast.
therapeutic interventions applied to a vast.
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Amplitude Modulation Detection in Children with a History of Temporary Conductive Hearing Loss Remains Impaired for Years After Restoration of Normal Hearing
MMK Benoit, M Orlando, K Henry, P Allen - Journal of the Association for Research in …
… were identified by searching billing records for the procedure codes
associated with myringotomy and tympanostomy … examination, including
pneumatic otoscopy when possible; tympanometry to confirm normal …
associated with myringotomy and tympanostomy … examination, including
pneumatic otoscopy when possible; tympanometry to confirm normal …
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Αυτή η ειδοποίηση αποστέλλεται από τον Μελετητή Google. Ο Μελετητής Google είναι μια υπηρεσία που παρέχεται από την Google.
Scholar : ΠΑΡΑΛΥΣΗ BELL ΠΡΟΣΩΠΙΚΟΥ - νέα
[PDF] Νοσηλευτικές παρεμβάσεις σε ασθενείς με κακώσεις νωτιαίου μυελού
Α ΑΛΕΞΑΝΔΡΟΠΟΥΛΟΥ - 2018
… Το 1667 οι Stenonis και Swammerdam, δημοσίευσαν τις εργασίες τους,
παρατηρώντας την παράλυση των πίσω άκρων κουνελιού, μετά τον
αποκλεισμό κοιλιακής αορτής … τις νωτιαίες ρίζες. Ο Charles Bell (1774-1842) …
παρατηρώντας την παράλυση των πίσω άκρων κουνελιού, μετά τον
αποκλεισμό κοιλιακής αορτής … τις νωτιαίες ρίζες. Ο Charles Bell (1774-1842) …
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Αυτή η ειδοποίηση αποστέλλεται από τον Μελετητή Google. Ο Μελετητής Google είναι μια υπηρεσία που παρέχεται από την Google.
Scholar : Laryngotracheal reconstruction - νέα αποτελ
[HTML] Wound healing and plastic surgery-an introduction to a special issue
RE Horch - 2018
… rapier - in the fifteenth, sixteenth and seventeenth centuries it was the Italian
Branca family, who lived in 1400 in Catania, who were known to reconstruct
amputated noses … Laryngotracheal reconstruction using prefabricated and …
Branca family, who lived in 1400 in Catania, who were known to reconstruct
amputated noses … Laryngotracheal reconstruction using prefabricated and …
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[HTML] Relapsing polychondritis: state of the art on clinical practice guidelines
S Rednic, L Damian, R Talarico, CA Scirè, A Tobias… - RMD Open, 2018
Skip to main content. We use cookies to improve our service and to tailor our content and
advertising to you. More info You can manage your cookie settings via your browser at
any time. To learn more about how we use cookies, please see our cookies policy …
advertising to you. More info You can manage your cookie settings via your browser at
any time. To learn more about how we use cookies, please see our cookies policy …
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Scholar : ΛΟΓΟΘΕΡΑΠΕΙΑ - νέα αποτελέσμ
[PDF] Διερεύνηση της άνοιας και της κατάθλιψης σε άτομα τρίτης ηλικίας στα κέντρα ανοιχτής προστασίας ηλικιωμένων
Μ ΜΠΑΛΑΟΥΡΑ, Ι ΝΙΚΟΛΑΚΟΠΟΥΛΟΣ - 2018
Page 1. Σ.Δ.Ι ΓΤΣΙΚΗ ΔΛΛΑΓΟ ΥΟΛΗ: .Δ.Τ.Π ΣΜΗΜΑ: ΝΟΗΛΔΤΣΙΚΗ
ΠΣΤΥΙΑΚΗ ΔΡΓΑΙΑ Γηεξεύλεζε ηεο άλνηαο θαη ηεο θαηάζιηςεο ζε άηνκα
ηξίηεο ειηθίαο ζηα θέληξα αλνηρηήο πξνζηαζίαο ειηθησκέλσλ Δηζεγεηήο …
ΠΣΤΥΙΑΚΗ ΔΡΓΑΙΑ Γηεξεύλεζε ηεο άλνηαο θαη ηεο θαηάζιηςεο ζε άηνκα
ηξίηεο ειηθίαο ζηα θέληξα αλνηρηήο πξνζηαζίαο ειηθησκέλσλ Δηζεγεηήο …
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Scholar : ΜΑΣΤΟΕΙΔΙΤΙΣ - νέα αποτελέσμ
[PDF] Non-Hodgkin's Lymphoma of the Middle Ear Presenting as Mastoiditis
M Alqunaee, A Aldaihani, M AlHajery - Case Reports in Otolaryngology, 2018
Lymphoma originating from the middle ear is rare. The diagnosis of lymphoma as
with other cancers of the temporal bone is often made late, and this has a negative
implication on the treatment and prognosis of the condition. The delay of diagnosis is …
with other cancers of the temporal bone is often made late, and this has a negative
implication on the treatment and prognosis of the condition. The delay of diagnosis is …
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[PDF] AETIOLOGICAL FACTORS OF CEREBRAL VENOUS SINUS THROMBOSIS IN CHILDREN
CL Pauline, AV Saravanan, LA Ravi - PARIPEX-INDIAN JOURNAL OF RESEARCH, 2018
… The etiological risk factors identified in this cohort were infection in 7(43.7%), which
included meningitis in 3,systemic sepsis in 2, mastoiditis in 2 children … Vieira et al[4] found
that infection as the probable cause in 51%, mastoiditis in 43%, meningitis in 13 …
included meningitis in 3,systemic sepsis in 2, mastoiditis in 2 children … Vieira et al[4] found
that infection as the probable cause in 51%, mastoiditis in 43%, meningitis in 13 …
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An assessment of potential unintended consequences following a national antimicrobial stewardship programme in England: an interrupted time series analysis
V Balinskaite, S Bou-Antoun, AP Johnson, A Holmes… - Clinical Infectious Diseases, 2018
… mastoiditis, quinsy (peritonsillar abscess), meningitis, brain abscess, empyema, scarlet
fever and rheumatic fever) and urinary tract infection (pyelonephritis) … It is well known that
age is the risk factor for mastoiditis, meningitis and scarlet fever, and is more …
fever and rheumatic fever) and urinary tract infection (pyelonephritis) … It is well known that
age is the risk factor for mastoiditis, meningitis and scarlet fever, and is more …
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[PDF] COMPARATIVE EVALUATION OF ADENOIDECTOMY AND MYRINGOTOMY WITH OR WITHOUT VENTILATION TUBE PLACEMENT IN THE TREATMENT OF OTITIS …
WQ Dar, SM Qazi, J Nisar - GLOBAL JOURNAL FOR RESEARCH ANALYSIS, 2018
… conditions were present: previous myringotomy with or without insertion
of ventilation tubes, previous adenoidectomy or tonsillectomy, history of ear
surgery, cleft palate, Down syndrome, congenital malformations of the ear …
of ventilation tubes, previous adenoidectomy or tonsillectomy, history of ear
surgery, cleft palate, Down syndrome, congenital malformations of the ear …
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Probiotics in the treatment of otitis media. The past, the present and the future
A Coleman, A Cervin - International Journal of Pediatric Otorhinolaryngology, 2018
… it is estimated that approximately 21 000 people die from OM-related
complications around the world each year, the highest mortality rate is in
the first year of life [4]. Complications can include mastoiditis, cholesteatoma …
complications around the world each year, the highest mortality rate is in
the first year of life [4]. Complications can include mastoiditis, cholesteatoma …
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Predictors of Primary Intracranial Hypertension in children, using a newly suggested opening pressure cutoff of 280 mm H2O
AC Delaney, A Velarde, MB Harper, A Lebel… - Pediatric Neurology, 2018
… venography (MRV) is preferred, as evaluation of the venous sinuses may
reveal venous sinus stenosis or thrombosis especially in pre-pubertal and
very young children who may be at higher risk for cerebral venous sinus …
reveal venous sinus stenosis or thrombosis especially in pre-pubertal and
very young children who may be at higher risk for cerebral venous sinus …
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[PDF] Retraso en el diagnóstico de amenorrea primaria asociado a sindrome de turner en atencion primaria de salud
AS Robalino Pérez - 2018
… queratocono, glaucoma, lenticono, cataratas, daltonismo. Las alteraciones
auditivas se expresan en el (50-85%): otitis media y mastoiditis con
progresión a colesteatoma, particularmente entre uno y seis años de edad …
auditivas se expresan en el (50-85%): otitis media y mastoiditis con
progresión a colesteatoma, particularmente entre uno y seis años de edad …
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[HTML] Systematic microbiology
ME Török, FJ Cooke, E Moran - Oxford Handbook of Infectious Diseases and …
Abstracts and keywords to be supplied.
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Scholar : ΟΙΣΟΦΑΓΟΣ - νέα αποτελέσματα
[PDF] Η επίδραση της μουσικοθεραπείας στους ασθενείς που πρόκειται να υποβληθούν σε κολονοσκόπηση.
IM Karataraki, ΙΜ Καραταράκη, ΕΧ Κλεισαρχάκη… - 2018
… Page 13. 10 • στοματική κοιλότητα (χείλη, δόντια, υπερώα, γλώσσα, παρειές) • φάρυγγας •
Οισοφάγος • Στόμαχος • λεπτό έντερο • παχύ έντερο • πρωκτός Προσαρτημένοι οι
επικουρικοί αδένες του πεπτικού: σιελογόνοι αδένες, ήπαρ, χοληδόχος κύστη ,πάγκρεας …
Οισοφάγος • Στόμαχος • λεπτό έντερο • παχύ έντερο • πρωκτός Προσαρτημένοι οι
επικουρικοί αδένες του πεπτικού: σιελογόνοι αδένες, ήπαρ, χοληδόχος κύστη ,πάγκρεας …
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Αυτή η ειδοποίηση αποστέλλεται από τον Μελετητή Google. Ο Μελετητής Google είναι μια υπηρεσία που παρέχεται από την Google.
Scholar : CPAP - νέα αποτελέσματα
Neuropathological investigation of cell layer thickness and myelination in the hippocampus of obstructive sleep apnea patients
JE Owen, B Benediktsdottir, T Gislason, SR Robinson - Sleep, 2018
… Patients known to have used continuous positive airway pressure (CPAP)
treatment showed no significant reductions in cortical thickness when
compared with controls, suggesting that CPAP had a protective effect …
treatment showed no significant reductions in cortical thickness when
compared with controls, suggesting that CPAP had a protective effect …
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Large posterior lingual thyroglossal duct cyst pneumatically splinted with auto-continuous positive airway pressure at low pressures
R Hoque, DL Bliwise - Sleep Medicine, 2018
… Figure 2. Download from patients Philips Respironics auto-continuous positive airway
pressure (auto-CPAP) device. Auto-CPAP was delivered through a nasal mask, with
pressure range from 5 to 20 cm H 2 0. Over the 50-day …
pressure (auto-CPAP) device. Auto-CPAP was delivered through a nasal mask, with
pressure range from 5 to 20 cm H 2 0. Over the 50-day …
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[HTML] Drug-induced sleep endoscopy (DISE) as a guide towards upper airway behavior and treatment outcome: the quest for a vigorous standardization of DISE
OM Vanderveken - Sleep and Breathing, 2018
… [18] were able to explore whether UPPP with tonsillectomy (UPPP-TE) would be able
to remove the CCCp DISE-phenotype in fifteen patients with CPAP intolerance in order
for these patients to fulfill the in- clusion criteria for UAS after UPPP-TE …
to remove the CCCp DISE-phenotype in fifteen patients with CPAP intolerance in order
for these patients to fulfill the in- clusion criteria for UAS after UPPP-TE …
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Stress causes bladder overactivity in mice: enhanced voiding and detrusor contractility.
EG West, DJ Sellers, C McDermott, R Chess-Williams - Australian & New Zealand …, 2018
… Inclusion criteria included: ≥40 years of age; nocturia; either urinary urgency or urge
incontinence (UUI) severe enough to require pharmacotherapy or sleep disordered
breathing (SDB) requiring continuous positive airway pressure (CPAP) …
incontinence (UUI) severe enough to require pharmacotherapy or sleep disordered
breathing (SDB) requiring continuous positive airway pressure (CPAP) …
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[HTML] Obesity, Sleep and Sleep-disordered Breathing
A Palm - 2018
… Paper III: A longitudinal observational cohort study aimed to investigate the impact of
adherence to continuous positive airway pressure (CPAP) treatment on IGF-1
concentration in 69 patients with OSA followed up after 4.8 ± 2.5 months …
adherence to continuous positive airway pressure (CPAP) treatment on IGF-1
concentration in 69 patients with OSA followed up after 4.8 ± 2.5 months …
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Drug-induced sleep endoscopy: the effect of different passive maneuvers on the distribution of collapse patterns of the upper airway in obstructive sleep apnea …
A Beelen, PE Vonk, N de Vries - Sleep and Breathing, 2018
… treatment options include oral appliance therapy (OAT), positional ther- apy
(PT), upper airway surgery (UASurg), or a combination of different treatment
modalities [5–8]. The gold standard thera- py to treat moderate to severe …
(PT), upper airway surgery (UASurg), or a combination of different treatment
modalities [5–8]. The gold standard thera- py to treat moderate to severe …
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Long-term quality of life outcomes of maxillomandibular advancement osteotomy in patients with obstructive sleep apnoea syndrome
L Pottel, N Neyt, K Hertegonne, D Pevernagie, B Veys… - International Journal of Oral …, 2018
… Mechanical measures include sleeping with a continuous positive airway pressure (CPAP)
device, which is currently considered the gold standard, or oral appliances that pull the
tongue forward by moving the mandible anteriorly, and in that way dilating the airway …
device, which is currently considered the gold standard, or oral appliances that pull the
tongue forward by moving the mandible anteriorly, and in that way dilating the airway …
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[HTML] Resolution of obstructive sleep apnea after mandibular distraction osteogenesis in setting of delayed tongue–lip adhesion takedown: A case report
RS Randall, A Kian, K Chin, B French - Medicine, 2018
Rationale: There is a high prevalence of obstructive sleep
apnea (OSA) in patients with Pierre Rob.
apnea (OSA) in patients with Pierre Rob.
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Sub-analysis of the prevalence of locomotive syndrome and its relationship with health-related quality of life in patients with obstructive sleep apnea syndrome as …
H Kataoka, N Miyatake, H Ichikawa, Y Arakawa, Y Mori - Sleep and Biological …, 2018
… age and sex. A total of 1173 patients with OSAS (1013 males and 160 females)
who were treated with con- tinuous positive airway pressure (CPAP) therapy were
enrolled in this cross-sectional study. Male participants were …
who were treated with con- tinuous positive airway pressure (CPAP) therapy were
enrolled in this cross-sectional study. Male participants were …
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Impact of elective caesarean section on neonatal retrieval in Western Australia during a 12-year period
KJ Macallister, LW Tho, M Epee-Bekima, S Resnick… - Journal of Perinatology, 2018
… 41.9% (95/227), p = 0.74) or CPAP (78.4% (120/153) vs. 82.8% (188/227), p = 0.28), during
the duration of inpatient stay, were similar in both groups. The duration of total respiratory
support (ventilation or CPAP) was also similar in both epochs …
the duration of inpatient stay, were similar in both groups. The duration of total respiratory
support (ventilation or CPAP) was also similar in both epochs …
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