Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: a cross‐sectional study of outpatients with dysphagia

gnorimies2015 shared this article with you from Inoreader Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: a cross‐sectional study of outpatients with dysphagia Via Journal of Oral Rehabilitation Abstract Background Tongue muscle strength is important for swallowing but decreases with age, in association with reduced skeletal muscle mass. However, the relationships between pharyngeal dynamics and both skeletal muscle mass and tongue muscle strength are unknown. Objective To investigate the effect of reductions in tongue muscle strength on pharyngeal movement during swallowing in patients with dysphagia. Methods Subjects were selected from male outpatients ≥65 years old who were examined for the main complaint of dysphagia. Patients with history of neurodegenerative disease affecting tongue movement, cerebrovascular disease, or oral cancer, were excluded. As a result, 82 men (mean age, 80.6±6.8 years) participated. Skeletal muscle mass index (SMI) as physical parameters and maximum tongue pressure (MTP) as tongue muscles strength were measured. Status and dynamics of the pharyngeal organs, including change in posterior pharyngeal wall advancement (PPWA) when swallowing 3.0 ml of moderately thick liquid, were measured by analyzing videofluoroscopic images. Simple bivariate correlation and multiple regression analysis were used to statistically analyze correlations between parameters. Results MTP showed a significant positive correlation with SMI (r = 0.43, p < 0.01). PPWA showed a significant negative correlation with MTP (r = ‐0.30, p < 0.01), but no association with SMI. Conclusions While tongue muscle strength is affected by skeletal muscle mass, posterior pharyngeal wall advancement is not readily affected by decreases in skeletal muscle mass. Posterior pharyngeal wall advancement may increase to compensate for swallowing function among individuals with reduced tongue muscle strength. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of percutaneous dilatational tracheotomy versus open surgical technique in severe COVID-19: complication rates, relative risks and benefits

gnorimies2015 shared this article with you from Inoreader Comparison of percutaneous dilatational tracheotomy <em>versus</em> open surgical technique in severe COVID-19: complication rates, relative risks and benefits Via Auris Nasus Larynx Publication date: Available online 28 October 2020 Source: Auris Nasus Larynx Author(s): Cecilia Botti, Francesca Lusetti, Tommaso Neri, Stefano Peroni, Andrea Castellucci, Pierpaolo Salsi, Angelo Ghidini View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Drug concentration estimation using contrast-enhanced MRI in intra-arterial chemotherapy for head and neck cancers

gnorimies2015 shared this article with you from Inoreader Drug concentration estimation using contrast-enhanced MRI in intra-arterial chemotherapy for head and neck cancers Via Auris Nasus Larynx In cases of head and neck cancer treated with intra-arterial chemotherapy, no objective indices are available for determining the distribution of anticancer drugs administered to multiple arteries. To establish such indices, noninvasive measurements of drug concentrations are required in the arterial perfusion area of each artery. In MRI, changes in 1/T1 (Δ1/T1) are correlated with the contrast agent concentration. We focused on these properties and investigated whether it is possible to estimate anticancer drug concentrations within tissue based on Δ1/T1. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi‐institutional study

gnorimies2015 shared this article with you from Inoreader Prognostic value of the 8th edition American Joint Commission Cancer nodal staging system for patients with head and neck cutaneous squamous cell carcinoma: A multi‐institutional study Via Head & Neck Abstract Background The 8th edition American Joint Committee on Cancer staging manual (AJCC8) introduced a separate staging system for head and neck cutaneous squamous cell carcinoma (HNcSCC) which parallels mucosal SCC and incorporates extranodal extension (ENE). This study aims to evaluate its prognostic utility. Methods Univariate analysis of 1146 patients with metastatic HNcSCC from four Australian cancer centers was performed according to both AJCC 7th (AJCC7) and the 8th editions. Results AJCC8 increased classification of 924 (80.6%) patients to either pN2a or pN3b and 341 patients (29.8%) from stage III to IV compared to AJCC7. The disease‐specific survival (DSS) was not significantly different between pN1, pN2 or pN3a categories per AJCC8. Estimates of model performance for the AJCC8 pN staging revealed modest predictive capacity (Harrell's C of 0.62 for DSS). Conclusions The risk stratification according to pN classification of AJCC8 staging system performed poorly as a prognostic indicator. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Family History of Cancer Predicts Allergic Rhinitis and Asthma Development

gnorimies2015 shared this article with you from Inoreader Family History of Cancer Predicts Allergic Rhinitis and Asthma Development Via Annals of Allergy, Asthma & Immunology The respiratory tract is a common entry point into the human body for both allergens and natural/manmade carcinogens, the latter of which could result in lung, gastrointestinal, and other malignancies.(1) We previously determined, in analyzing data from the National Health Interview Survey (NHIS) that there was a significant negative relationship between diagnoses of cancer with allergic rhinitis or asthma. The obstruction associated with both allergic rhinitis and asthma may act to block the entry of both allergens and carcinogens.(2) Although other studies have examined the relationship between personal cancer diagnoses in asthmatic or allergic individuals, or via biomarkers such as IgE, (3, 4), the heritability of such an effect, which may provide a survival benefit, has not been evaluated through family studies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stimulierende und inhibierende Signalwege der APZ- und T-Zell-Interaktion sowie Einfluss von TLR-Agonisten auf APZ

gnorimies2015 shared this article with you from Inoreader Stimulierende und inhibierende Signalwege der APZ- und T-Zell-Interaktion sowie Einfluss von TLR-Agonisten auf APZ Via HNO Zusammenfassung Hintergrund CD8+-T-Effektor-Zellen spielen eine Schlüsselrolle in der Identifikation und Elimination von Tumorzellen. Tumoren entkommen einer effektiven T‑Zell-Antwort durch Induktion eines Erschöpfungszustands, der die zytotoxische Kapazität der Effektorzellen mindert. Neuartige Checkpointinhibitoren wirken u. a. durch Reaktivierung erschöpfter, dysfunktionaler T‑Zellen. CD8+-T-Zellen eliminieren Tumorzellen nach Darbietung tumorspezifischer Antigene durch antigenpräsentierende Zellen (APZ). Die APZ-vermittelte Tumorerkennung wird v. a. Toll-like-Rezeptoren (TLR) stimuliert. Ziel der Arbeit Untersucht wurde der Einfluss von TLR-Agonisten auf APZ sowie stimulierende und inhibierende Signalwege der T‑Zell- und APZ-Interaktion. Material und Methoden Die Genexpression von Interleukin (IL-)12 und PDL1 wurde nach Stimulation von CD14+-Zellen mit CpG über 0, 8, 24 und 48 h analysiert. Die Expression des inhibitorischen kappa-B-Proteins (IκBα) nach Stimulation mit CpG wurde mittels Westernblot ausgewertet. CD8+-T-Zellen wurden über 72 h mit und ohne PD1-Checkpointblockade stimuliert und mittels Durchflusszytometrie auf die Expression von PD1, Tim‑3, CTLA4 und Lag3 untersucht. Ergebnisse Durch TLR-Stimulation (unmethylierte CpG-DNA) von APZ wurden immunstimulierende Signale wie die IL-12-Expression gesteigert, aber auch immuninhibierende Signalwege wie die PDL1-Expression aktiviert. Diese Signalwege werden NF-κB-vermittelt. Nach alleiniger Blockade der PD1-PDL1-Signalwege zeigte sich eine Überexpression anderer Immuncheckpointrezeptoren als potenzielle Ursache für fehlendes Ansprechen auf TLR-Stimulation mit PD1-Checkpointblockade. Schlussfolgerung Durch eine TLR-Stimulation exprimieren APZ im Tumormikromilieu NF-κB-vermittelt PDL1 und tragen so zur Erschöpfung von CD8+-T-Zellen bei. Der Effekt einer PD1-Blockade wird dabei potenziell durch Überexpression anderer Checkpointinhibitoren beeinträchtigt. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

2015 American Thyroid Association guidelines and thyroid‐stimulating hormone suppression after thyroid lobectomy

gnorimies2015 shared this article with you from Inoreader 2015 American Thyroid Association guidelines and thyroid‐stimulating hormone suppression after thyroid lobectomy Via Head & Neck Abstract Background 2015 American Thyroid Association (ATA) guidelines recommended more conservative treatment in low‐risk well‐differentiated thyroid cancer (WDTC), stating that lobectomy alone may be sufficient. The guidelines further recommend mild thyroid‐stimulating hormone (TSH) level suppression (0.5‐2 mU/L) for this population. Our goal is to evaluate the natural history of patients undergoing lobectomy to determine the percentage that would require postoperative levothyroxine supplementation under these guidelines. Methods Retrospective chart review of 168 patients that underwent lobectomy between 2010 and 2019 was performed. Preoperative and postoperative TSH values and the rate of patients prescribed levothyroxine were analyzed. Results Thirty‐five percent of patients were prescribed levothyroxine postoperatively. At 6 weeks postoperatively, 66% had TSH value of >2; this increased to 76% by 6 to 12 months. Conclusion To adhere to ATA guidelines for WDTC managed with lobectomy alone, the majority of patients (76%) would require postoperative levothyroxine supplementation. Low preoperative TSH was found to be the most significant predictor for postoperative TSH < 2. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Swallowing Assessment in Parkinson’s Disease: Patient and Investigator Reported Outcome Measures are not Aligned

gnorimies2015 shared this article with you from Inoreader Swallowing Assessment in Parkinson's Disease: Patient and Investigator Reported Outcome Measures are not Aligned Via Dysphagia Abstract This study determines the relationship between patient and investigator reported outcome measures (PROMs versus IROMs) on oropharyngeal dysphagia (OD) in Parkinson's disease (PD). The PROMs used are the MD Anderson Dysphagia Inventory (MDADI) and the Dysphagia Severity Scale (DSS). The IROMs used are fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy of swallowing (VFS). Ninety dysphagic PD patients were included. Multilayer perceptron (MLP) neural network analysis was used to investigate the relationship between PROMs and IROMs on OD in PD. MLP neural network analysis showed a moderate agreement between PROMs and IROMs, with an area under the curve between 0.6 and 0.7. Two-step cluster analysis revealed several clusters of patients with similar scores on FEES and/or VFS variables, but with significant different scores on MDADI and DSS variables. This study highlights that there are PD patients with similar FEES and/or VFS findings that cannot be lumped together under the same pathophysiological umbrella due to their differences in PROMs. Since the exact origin of these differences is not fully understood, it seems appropriate for the time being to take into account the different dimensions of OD during the swallowing assessment so that they can be included in a patient-tailored treatment plan. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunological imprint of COVID‐19 on human peripheral blood leukocyte populations

gnorimies2015 shared this article with you from Inoreader Immunological imprint of COVID‐19 on human peripheral blood leukocyte populations Via Allergy Abstract Background SARS‐CoV‐2 has triggered a pandemic that is now claiming many lives. Several studies have investigated cellular immune responses in COVID‐19 patients during disease but little is known regarding a possible protracted impact of COVID‐19 on the adaptive and innate immune system in COVID‐19‐convalescent patients. Methods We used multiparametric flow cytometry to analyze whole peripheral blood samples, and determined SARS‐CoV‐2 specific antibody levels against the S‐protein, its RBD‐subunit and viral nucleocapsid in a cohort of COVID‐19 convalescent patients who had mild disease approximately 10 weeks after infection (n=109) and healthy control subjects (n=98). Furthermore, we correlated immunological changes with clinical and demographic parameters. Results Even ten weeks after disease COVID‐19 convalescent patients had fewer neutrophils, while their cytotoxic CD8+ T cells were activated, reflected as higher HLA‐DR and CD38 expression. Multiparametric regression analyses showed that in COVID‐19 patients both CD3+CD4+ and CD3+CD8+ effector memory cells were higher, while CD25+Foxp3+ T regulatory cells were lower. In addition, both transitional B cell and plasmablast levels were significantly elevated in COVID‐19 patients. Fever (duration, level) correlated with numbers of central memory CD4+ T cells and anti‐S and anti‐RBD, but not anti‐NC antibody levels. Moreover, a "young immunological age" as determined by numbers of CD3+CD45RA+CD62L+CD31+ recent thymic emigrants was associated with a loss of sense of taste and/or smell. Conclusion Acute SARS‐CoV‐2 infection leaves protracted beneficial (i.e., activation of T cells) and potentially harmful (i.e., reduction of neutrophils) imprints in the cellular immune system in addition to induction of specific antibody responses. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spotlight on microRNAs in allergy and asthma

gnorimies2015 shared this article with you from Inoreader Spotlight on microRNAs in allergy and asthma Via Allergy Abstract In past ten years, microRNAs (miRNAs) have gained scientific attention due to their importance in the pathophysiology of allergic diseases and theirpotential as biomarkersin liquid biopsies. They act as master post‐transcriptional regulators that control most cellular processes. As one miRNA can target several mRNAs, often within the same pathway, dysregulated expression of miRNAs may alter particular cellular responses and contribute, or lead, to the development of various diseases.In this review, we give an overview of the current research on miRNAs in allergic diseases, including atopic dermatitis, allergic rhinitis and asthma. Specifically, we discuss howindividualmiRNAs function in the regulation of immune responses in epithelial cells and specialized immune cells in response to different environmental factors and respiratory viruses. In addition, we review insightsobtained fromexperiments with murine models of allergic airway and skin inflammation andoffer an overview of s tudiesfocusing on miRNA discovery using profiling techniques and bioinformatic modelling of the network effect of multiple miRNAs. In conclusion, we highlight the importance of research intomiRNA function in allergy and asthma to improve our knowledge of the molecular mechanisms involved in the pathogenesis of this heterogeneousgroup of diseases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Non‐invasive and minimally‐invasive techniques for the diagnosis and management of allergic diseases

gnorimies2015 shared this article with you from Inoreader Non‐invasive and minimally‐invasive techniques for the diagnosis and management of allergic diseases Via Allergy Abstract Allergic diseases of the (upper and lower) airways, the skin as well as the gastrointestinal tract, are on the rise, resulting in impaired quality of life, decreased productivity and increased healthcare costs. As allergic diseases are mostly tissue specific, local sampling methods for respective biomarkers offer the potential for increased sensitivity and specificity. Additionally, local sampling using non‐invasive or minimally‐invasive methods can be cost‐effective and well tolerated, which may even be suitable for primary or home care sampling. Non‐ or minimally‐invasive local sampling and diagnostics may enable a more thorough endotyping, may help to avoid under‐ or overdiagnosis, and may provide the possibility to approach precision prevention, due to early diagnosis of these local diseases even before they get systemically manifested and detectable. At the same time, dried blood samples may help to facilitate minimal‐invasive primary or home care sampling for classical systemic diagnostic approaches. This EAACI position paper contains a thorough review of the various technologies in allergy diagnosis available on the market, which analytes or biomarkers are employed, and which samples or matrices can be used. Based on this assessment, EAACIs position is to drive these developments to efficiently identify allergy and possibly later also viral epidemics and take advantage of comprehensive knowledge to initiate preventions and treatments. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improvement of oral hypofunction by a comprehensive oral and physical exercise program including textured lunch gatherings

gnorimies2015 shared this article with you from Inoreader Improvement of oral hypofunction by a comprehensive oral and physical exercise program including textured lunch gatherings Via Journal of Oral Rehabilitation Abstract Background The deterioration of oral function to a state of oral hypofunction (OHF) is reportedly associated with malnutrition and frailty. Objective Investigate the association of OHF with physical characteristics and function and test the effects of a program including comprehensive oral and physical exercises and textured lunch gatherings (COPE‐TeL program) on oral and physical function in older adults with OHF. Materials and Methods Eighty‐six community‐dwelling older adults were randomly assigned into control (n = 43) or intervention (n = 43) groups. The participants were further divided into OHF and normal oral function (NOF) sub‐groups based on initial oral examinations. The intervention group participated in the 12‐week COPE‐TeL program, while the control group performed the physical exercise regimen only. The differences in measured variables for physical and oral function between the OHF and NOF groups were statistically tested, and changes in the proportion of participants with OHF were examined. Results Physical function, such as hand grip strength and walking speed, was significantly lower in the OHF group at the initial assessment. The proportion of participants with OHF was 56% in the intervention group and 67% in the control group before the trial, which became significantly reduced after completing the COPE‐TeL program in the intervention group (26%, P = 0.002), but not in the controls (61%, P = 0.549). Conclusion Older adults with OHF may have diminished physical function. The COPE‐TeL program of oral and physical exercises along with textured lunch gatherings may be effective for older adults with OHF. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.