Αναζήτηση αυτού του ιστολογίου

Δευτέρα 14 Ιανουαρίου 2019

Serum irisin level in thyroid disorder


Assessment of serum irisin level in thyroid disorder p. 197
Mohamed R Halawa, Mona M Abdelsalam, Bassem M Mostafa, Amira G Ahmed
DOI:10.4103/ejim.ejim_37_18  
Background Irisin is a newly discovered myokin secreted by myocytes responsible for transmission of signals from muscles to other body tissues. Irisin improves systemic metabolism by increasing the energy expenditure. Owing to numerous similarities in action between irisin and thyroid hormones it seems imperative to explore these substances' potential mutual influence on the body. Objective To estimate serum irisin concentration in patients with hypothyroid and hyperthyroid diseases, and to detect the relation of serum irisin in patients with thyroid disorders with creatine kinase (CK), a serum marker of muscle damage. Patients and methods The study comprised 30 hyperthyroid patients (group 1), 30 hypothyroid patients (group 2), and 30 normal persons (group 3). Irisin was measured using enzyme-linked immunosorbent assay. Thyroid-stimulating hormone, triiodothyronine, and free thyroxine levels were measured using chemiluminescent microparticle immunoassay technology. Results Irisin hormone level significantly decreased in hypothyroid patients in comparison with hyperthyroid patients. Irisin hormone level increased in hyperthyroid patients in comparison with normal persons, whereas it decreased in hypothyroid patients in comparison with normal persons. CK level significantly decreased in hyperthyroid patients in comparison with hypothyroid patients. CK level significantly increased in hypothyroid patients in comparison with normal persons, whereas it significantly decreased in hyperthyroid patients in comparison with normal persons. Conclusion Obtained results suggest the influence of thermometabolic state on irisin level.

Fibronectin type III domain-containing protein 5, the precursor of irisin, is a protein that is encoded by the FNDC5 gene.[5] Irisin is a cleaved version of FNDC5, named after the Greekmessenger goddess Iris.[6]

Fibronectin domain-containing protein 5 is a membrane protein comprising a short cytoplasmic domain, a transmembrane segment, and an ectodomain consisting of a ~100 kDa fibronectin type III (FNIII) domain.

History[edit]

FNDC5 was discovered during a genome search for fibronectin type III domains[7] and independently in a search for peroxisomal proteins.[5][8]

The ectodomain was proposed to be cleaved to give a soluble peptide hormone named irisin. Separately it was proposed that irisin is secreted from muscle in response to exercise, and may mediate some beneficial effects of exercise in humans and the potential for generating weight loss and blocking diabetes has been suggested.[6][9][10][11][12][13][14][15] Others questioned these findings.[5][16][17][18]

Biosynthesis and secretion[edit]

The FNDC5 gene encodes a prohormone, a single-pass type I membrane protein (human, 212 amino acids; mouse and rat, 209 amino acids) that is upregulated by muscular exercise and undergoes post-translational processing to generate irisin. The sequence of the protein includes a signal peptide, a single fibronectin type III domain, and a C-terminal hydrophobic domain that is anchored in the cell membrane.

The production of irisin is similar to the shedding and release of other hormones and hormone-like polypeptides, such as epidermal growth factor and TGF alpha, from transmembrane precursors. After the N-terminal signal peptide is removed, the peptide is proteolytically cleaved from the C-terminal moiety, glycosylated and released as a hormone of 112 amino acids (in human, amino acids 32-143 of the full-length protein; in mouse and rat, amino acids 29-140) that comprises most of the FNIII repeat region.

The sequence of irisin, the cleaved and secreted portion of FNDC5, is highly conserved in mammals; the human and murine sequences are identical.[6] However, the start codon of human FNDC5 is mutated to ATA, which causes it to be expressed at only 1% the level of other animals with the normal ATG start. A mass spectrometry study reported irisin levels ~3 ng/ml in human plasma, a level on par with other key human hormones, such as insulin.[19]. There is no comparable study of irisin levels in other animals, where the ATG vs ATA start codon would predict a 100x higher concentration.

A difference in the nucleotide sequence of human FNDC5 from that of mouse Fndc5 creates a different initiation codon, potentially generating a protein that begins at methionine-76 (Met-76). A protein initiated at Met-76 would be missing the signal peptide and would be trapped in the cytoplasm. Via mass spectrometry, irisin has been found to circulate in humans in levels similar to other key hormones, such as insulin.[19].

Function[edit]

Exercise causes increased expression in muscle of peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1alpha), which is involved in adaptation to exercise. In mice, this causes production of the FNDC5 protein which is cleaved to give a new product irisin.[6][11] Due to its production through a mechanism initiated by muscular contraction, irisin has been classified as a myokine.[20]

Based on the findings that FNDC5 induces thermogenin expression in fat cells, overexpression of FNDC5 in the liver of mice prevents diet-induced weight gain, and FNDC5 mRNA levels are elevated in human muscle samples after exercise, it has been proposed that irisin promotes the conversion of white fat to brown fat in humans which would make it a health promoting hormone.[9][10] However this proposal has been challenged[21] because FNDC5 is upregulated only in highly active elderly humans.[16]

A 2016 in vitro study of white and brown fat cell tissue found dose-related upregulation of a protein called UCP1 that contributes to the browning of white fat and found other markers that would indicate that the white cells were browning and that fat cells were more metabolically active. Many of the stem cells became a type of cell that matures into bone. The tissue treated with irisin produced about 40 percent fewer mature fat cells.[22]

In mice, irisin released from skeletal muscle during exercise acts directly on bone by increasing cortical bone mineral density, bone perimeter and polar moment of inertia.[23][24][unreliable medical source]

See also[edit]

References[edit]

  1. Jump up to:a b c GRCh38: Ensembl release 89: ENSG00000160097 - Ensembl, May 2017
  2. Jump up to:a b c GRCm38: Ensembl release 89: ENSMUSG00000001334 - Ensembl, May 2017
  3. ^ "Human PubMed Reference:".
  4. ^ "Mouse PubMed Reference:".
  5. Jump up to:a b c Erickson HP (October 2013). "Irisin and FNDC5 in retrospect: An exercise hormone or a transmembrane receptor?". Adipocyte. 2 (4): 289–93. doi:10.4161/adip.26082PMC 3774709PMID 24052909.
  6. Jump up to:a b c d Boström P, Wu J, Jedrychowski MP, Korde A, Ye L, Lo JC, Rasbach KA, Boström EA, Choi JH, Long JZ, Kajimura S, Zingaretti MC, Vind BF, Tu H, Cinti S, Højlund K, Gygi SP, Spiegelman BM (January 2012). "A PGC1-α-dependent myokine that drives brown-fat-like development of white fat and thermogenesis". Nature. 481 (7382): 463–8. doi:10.1038/nature10777PMC 3522098PMID 22237023.
  7. ^ Teufel A, Malik N, Mukhopadhyay M, Westphal H (September 2002). "Frcp1 and Frcp2, two novel fibronectin type III repeat containing genes". Gene. 297(1–2): 79–83. doi:10.1016/S0378-1119(02)00828-4PMID 12384288.
  8. ^ Ferrer-Martínez A, Ruiz-Lozano P, Chien KR (June 2002). "Mouse PeP: a novel peroxisomal protein linked to myoblast differentiation and development". Developmental Dynamics. 224 (2): 154–67. doi:10.1002/dvdy.10099PMID 12112469.
  9. Jump up to:a b Courage KH. "Newly Discovered Hormone Boosts Effects of Exercise, Could Help Fend Off Diabetes". Observations. Scientific American. Retrieved January 12, 2012.
  10. Jump up to:a b Park A (April 8, 2009). "Brown Fat: A Fat That Helps You Lose Weight?". Health & Family. Time Magazine. Retrieved January 12, 2012.
  11. Jump up to:a b Reynolds G (January 11, 2012). "Exercise Hormone May Fight Obesity and Diabetes". Well. New York Times. Retrieved January 12, 2012.
  12. ^ Zhang Y, Li R, Meng Y, Li S, Donelan W, Zhao Y, Qi L, Zhang M, Wang X, Cui T, Yang LJ, Tang D (February 2014). "Irisin stimulates browning of white adipocytes through mitogen-activated protein kinase p38 MAP kinase and ERK MAP kinase signaling". Diabetes. 63 (2): 514–25. doi:10.2337/db13-1106PMID 24150604.
  13. ^ Wrann CD, White JP, Salogiannnis J, Laznik-Bogoslavski D, Wu J, Ma D, Lin JD, Greenberg ME, Spiegelman BM (November 2013). "Exercise induces hippocampal BDNF through a PGC-1α/FNDC5 pathway". Cell Metabolism. 18 (5): 649–59. doi:10.1016/j.cmet.2013.09.008PMC 3980968PMID 24120943.
  14. ^ Wu J, Boström P, Sparks LM, Ye L, Choi JH, Giang AH, Khandekar M, Virtanen KA, Nuutila P, Schaart G, Huang K, Tu H, van Marken Lichtenbelt WD, Hoeks J, Enerbäck S, Schrauwen P, Spiegelman BM (July 2012). "Beige adipocytes are a distinct type of thermogenic fat cell in mouse and human". Cell. 150 (2): 366–76. doi:10.1016/j.cell.2012.05.016PMC 3402601PMID 22796012.
  15. ^ Zhang Y, Xie C, Wang H, Foss RM, Clare M, George EV, Li S, Katz A, Cheng H, Ding Y, Tang D, Reeves WH, Yang LJ (August 2016). "Irisin exerts dual effects on browning and adipogenesis of human white adipocytes". American Journal of Physiology. Endocrinology and Metabolism. 311 (2): E530–41. doi:10.1152/ajpendo.00094.2016PMID 27436609.
  16. Jump up to:a b Timmons JA, Baar K, Davidsen PK, Atherton PJ (August 2012). "Is irisin a human exercise gene?". Nature. 488 (7413): E9–10, discussion E10-1. doi:10.1038/nature11364PMID 22932392.
  17. ^ Albrecht E, Norheim F, Thiede B, Holen T, Ohashi T, Schering L, Lee S, Brenmoehl J, Thomas S, Drevon CA, Erickson HP, Maak S (2015). "Irisin - a myth rather than an exercise-inducible myokine". Scientific Reports. 5: 8889. doi:10.1038/srep08889PMC 4352853PMID 25749243.
  18. ^ Raschke S, Elsen M, Gassenhuber H, Sommerfeld M, Schwahn U, Brockmann B, Jung R, Wisløff U, Tjønna AE, Raastad T, Hallén J, Norheim F, Drevon CA, Romacho T, Eckardt K, Eckel J (2013). López-Lluch G, ed. "Evidence against a beneficial effect of irisin in humans". PLoS One. 8 (9): e73680. doi:10.1371/journal.pone.0073680PMC 3770677PMID 24040023.
  19. Jump up to:a b Jedrychowski MP, Wrann CD, Paulo JA, Gerber KK, Szpyt J, Robinson MM, Nair KS, Gygi SP, Spiegelman BM (October 2015). "Detection and Quantitation of Circulating Human Irisin by Tandem Mass Spectrometry". Cell Metabolism. 22 (4): 734–40. doi:10.1016/j.cmet.2015.08.001PMC 4802359PMID 26278051.
  20. ^ Pedersen BK, Febbraio MA (October 2008). "Muscle as an endocrine organ: focus on muscle-derived interleukin-6". Physiological Reviews. 88 (4): 1379–406. doi:10.1152/physrev.90100.2007PMID 18923185.
  21. ^ Servick K (March 2015). "Biomedicine. Woes for 'exercise hormone'". Science. 347 (6228): 1299. doi:10.1126/science.347.6228.1299PMID 25792309.
  22. ^ Reynolds G (2016-10-12). "How Exercise May Turn White Fat Into Brown". The New York Times. ISSN 0362-4331. Retrieved 2016-10-13.
  23. ^ "A molecule that helps the 'exercise hormone' do its work". Nature. 2018-12-13. Retrieved 2018-12-21.
  24. ^ Colaianni G, Cuscito C, Mongelli T, Pignataro P, Buccoliero C, Liu P, Lu P, Sartini L, Di Comite M, Mori G, Di Benedetto A, Brunetti G, Yuen T, Sun L, Reseland JE, Colucci S, New MI, Zaidi M, Cinti S, Grano M (September 2015). "The myokine irisin increases cortical bone mass". Proceedings of the National Academy of Sciences of the United States of America. 112 (39): 12157–62. doi:10.1073/pnas.1516622112PMC 4593131PMID 26374841.

Environmental Radioactivity

Research Articles

  1. 210Po sequential extraction applied to wetland soils at uranium mining sites

    Pages 1-6
    Purchase PDF
    Abstract

    Former uranium mining activities have led to the presence of naturally occurring nuclides embedded in soil. Such activities have also modified the secular equilibrium between radionuclides in 238U decay series. The objective of this paper is to quantify the long-term effect of former uranium mining activities on the behavior of the final radionuclide in the 238U-series, i.e. polonium-210 (210Po), present in soils. Soil samples are extracted from two uranium sites in France, specifically a quarried site and a natural site. The polonium distribution is studied within the various soil fractions, namely: water soluble, exchangeable, bound to carbonates, bound to iron/manganese oxides, bound to organic matter, and residual. 210Po is mainly found in the residual fraction of both study sites (87–90%), followed by the carbonates fraction (5–9%). The 210Po activity in the other fractions is very small in comparison with total activity.

  2. Monte Carlo simulation of dose coefficients for a fish eye lens model exposed to monoenergetic electrons

    Pages 7-15
    Purchase PDF
    Abstract

    Vision is an important sense for the majority of the wildlife species, affecting their ability to find food and escape predation. Currently, no study on radiation induced cataract frequency on the fish eyes lens has been done. However, any thorough future study of this subject will require more accurate dose estimates for the fish eye lens than those currently available. For this purpose, the eye lens absorbed dose per unit fluence conversion coefficients for electron irradiation were calculated using the MCNPX Monte Carlo radiation transport code package. All results were validated against three different fish voxel models. The discrepancies between model results mainly originate from the different fish eye dimensions used in the different studies and in two of the cases the lack of a defined eye lens region.

    The dose conversion coefficients calculated in this work can be used to estimate the dose to the fish eye lens based on the activity concentration of the surrounding water. The model developed in this work has also demonstrated that the mathematical models still have several advantages over the voxel models.

  3. High 222Rn concentrations and dynamics in Shawan Cave, southwest China

    Pages 16-24
    Purchase PDF
    Abstract

    Cave 222Rn has been a major health issue and subject of scientific debate for decades. While the basics of natural ventilation physics are well understood, it is difficult to make blind predictions of 222Rn concentrations in a given cave due to the complexity of cave systems. In-situ continuous observation is necessary to improve our ability to quantify radiation dose exposure and reduce radiation hazard to cave users, and trace the air exchange patterns occurring in caves. In this study, continuous monitoring using a RAD7 radon detector revealed high 222Rn concentrations and large fluctuations in 222Rn concentration in a small karst cave in southwest China, Shawan Cave. From August 2016 to July 2017, the average annual concentration was 47,419 Bqm−3 and ranged between 3720 and 123,000 Bqm−3, with lower values during summer than other seasons. Taking Shawan Cave as a case study, we suggest a framework to evaluate the potential dose exposure, allowing cave users to minimize risk of exposure to hazardous levels of 222Rn. Furthermore, we comparing results from this study with other studies in 35 caves worldwide, and conclude that there are three patterns of seasonal 222Rn variation. They were classified into five types of ventilation mode based on diversity of cave locations, geometry and connectivity of bed rock fracture networks, together with temperature differences between outside atmosphere and cave air.

  4. Structural-functional modifications of the liver to chronic radioactive exposure in pygmy wood mouse (Apodemus uralensis) within the East-Urals Radioactive Trace

    Pages 25-38
    Purchase PDF
    Graphical abstract

    Image 1

Wide excision and microvascular reconstruction for maxillomandibular ameloblastomas


: local control, functional, and esthetic outcomes p. 82
Deepak Balasubramanian, Narayana Subramaniam, Sherry Peter, Latha Rao, Pramod Subhash, Arjun Krishnadas, V Manju, Janarthanan Ramu, Jimmy Mathew, Mohit Sharma, Krishnakumar Thankappan, Subramania Iyer
DOI:10.4103/jhnps.jhnps_39_18  
Introduction: Ameloblastomas are benign but aggressive odontogenic tumors with have a high propensity for bony destruction. They require to be excised completely to avoid local recurrence, and these resections involve significant functional and esthetic disturbances. With the advent of microvascular reconstruction, they can be excised, and defects are reconstructed with preservation of form and function. This paper presents our experience with wide excision and microvascular reconstruction for maxillomandibular ameloblastomas, and to describe the planning, resection, microvascular reconstruction, and rehabilitation of these patients. Materials and Methods: A retrospective review of records for patients treated with wide excision and microvascular reconstruction for maxillomandibular ameloblastomas at Amrita Institute of Medical Sciences Kochi between 2003 and 2015 was performed. Clinical and pathological features were described, and a literature review was performed. Results: A total of 48 patients were identified with equal sex distribution and mean age at presentation of 35 (range 16–71) years. Half of these patients had primary lesions, and the remaining half had the recurrent disease (range 1–4 previous surgeries). Forty patients (83%) had mandibular lesions and the remaining had the maxillary disease. All patients had wide excision with a gross bony margin of 1 cm and reconstruction with microvascular flaps (fibula free flap = 41, distal circumflex iliac artery flap = 3 and scapular free flap = 2, anterolateral thigh flap = 1 and radial forearm free flap = 1). Mean tumor size was 4.73 (2–14) cm. At a median follow-up of 21 months, all patients were free of recurrence. Successful dental rehabilitation was achieved in 40 patients (83%). Conclusion: This approach leads to results in excellent local control, functional, and esthetic outcomes. Although managing these patients is challenging, multidisciplinary expertise and planning are crucial for successful management.

Recurrence pattern of glottic cancer patients treated by laser cordectomy

: Intent to treat analysis p. 78
Sajith Babu Thavarool, Amit Tyagi, KN Harsha, Bhushan Kathuria, Nagendra Kadappa, Sithara Aravind, KM Aswathi, Sangeetha Nayanar, Satheesan Balasubramaniam
DOI:10.4103/jhnps.jhnps_38_18  
Introduction: Organ preservation treatment for glottic cancers is done with radiotherapy and conservation surgery like laser surgery. Voice outcome and oncological outcome have been found to be equal in both in early cancers. Methodology: A retrospective study with the intent to treat analysis was done to find the feasibility of laser treatment in early glottic cancers during August 2013–2016 at a single center. Results: There were 39 patients with laser cordectomy, of which 29 had malignancy and 10 had dysplasia. Type I to V cordectomies were as per the extension of lesion with frozen control. Four patients had close margin and four had involved margin and seven of these had radiotherapy. Eight had recurrence, of which six were treated with laser, two with radiotherapy. The second recurrence was seen in three of which one had laser surgery, one had open partial laryngectomy, and one had total laryngectomy with radiotherapy. Five-year overall survival was 90% and higher stages were found to have more recurrence (P = 0.05). Conclusion: Laser cordectomy is a feasible option for treatment with favorable oncological outcome in early glottic cancers. Higher stages (T2 and T3) have higher recurrence with laser surgery alone.

Predictors of postoperative pneumonia

Predictors of postoperative pneumonia in patients undergoing oral cancer resections and its management p. 69
Ridhi Sood, Jerry Paul, Sunil Rajan, Sobha Subramanian, Deepak Balasubramanian, Sivakumar Vidhyadharan, Krishnakumar Thankappan, Subramania Iyer
DOI:10.4103/jhnps.jhnps_41_18  
Background: Head-and-neck resections carry a major risk of postoperative pulmonary complications. It adds to morbidity and mortality, adversely affects recovery, and contributes to financial burden. The objective of this study is to find out the incidence of pneumonia and the utility of our institution protocol in the prevention of postoperative pneumonia (POP). Materials and Methods: Retrospective study including patients undergoing oral cavity resection at the tertiary hospital from August 2017 to July 2018. The patients were analyzed in terms of demographic profile, operative findings, and postoperative course. Diagnosis of pneumonia was established by intensivist based on symptoms and signs. Results: Incidence of pneumonia was 5.79% (15 out of 239). Average age of patients with pneumonia was 64.8 years and 60% were male. All had multiple comorbidities. Average preoperative serum albumin was 3.49. POP was seen commonly in patients who had composite resections involving alveolar arch and tongue (26.67%). Majority had reconstruction in the form of free flap (46.6%) with fibula flap being most common. Average intraoperative time was 10.5 h. The most common isolate was Pseudomonas aeruginosa (40%), followed by Klebsiella pneumonia (33.3%). About 26% were multidrug-resistant strains. Average hospital stay was found to be 30.6 days in patients of pneumonia. Conclusions: Data from our cohort indicated a much lower incidence compared to published literature. We attribute this to our routine practice of intensive care unit care in the immediate postoperative setting with a nursing care ratio of 1:1, postoperative early mobilization, frequent tracheal toileting, chest physiotherapy, early diagnosis of pneumonia, and prompt initiation of treatment.

Cisplatin therapies,To protect the kidneys, this treatment is often combined with mannitol infusion to promote osmotic diuresis.

The Nephroprotective Effect of Mannitol in Head and Neck Cancer Patients Receiving Cisplatin Therapy
Show all authors
Erik Hägerström, Lotte Lindberg, Jens Bentzen, ...
First Published January 7, 2019 Research Article  
Article information 
 Article has an altmetric score of 1   Open Access  Creative Commons Attribution, Non Commercial 4.0 License
Abstract
Introduction:
Cisplatin is used as treatment for several different malignancies and a well-known complication is irreversible kidney damage. To protect the kidneys, this treatment is often combined with mannitol infusion to promote osmotic diuresis. Earlier studies investigating the nephroprotective effect of mannitol have shown conflicting results.

Objective:
To investigate changes in kidney function in head and neck cancer patients treated with cisplatin with and without additional mannitol infusion.

Methods:
A single center, retrospective cohort study of patients with squamous cell carcinoma of the head and neck receiving radiotherapy with cisplatin. Patient data were collected from November 2013 to December 2014.

Results:
After exclusion, a total of 78 patients were considered evaluable. They were equally distributed between a mannitol and a non-mannitol group and anthropomorphometrically similar. 51Cr-EDTA clearance declined in the mannitol group from 99.7 (19.9) to 96.4 (20.8) mL/min and in the non-mannitol group from 102.2 (17.8) to 92.3 (23.1) mL/min.

Conclusions:
There was a significantly smaller decrease in 51Cr-EDTA clearance in the mannitol group indicating a nephroprotective effect of mannitol.

Keywords Chemotherapy, head and neck cancer, toxicity management, hypopharyngeal cancer, laryngeal cancer, oropharyngeal cancer, radiotherapy, squamous cell carcinoma of the head and neck
References
1. De Conti, RC, Toftness, BR, Lange, RC, Creasey, WA. Clinical and pharmacological studies with cis-diamminedichloroplatinum (II). Cancer Res J. 1973;33:1310–1315. 
Google Scholar
2. Leu, L, Baribeault, D. A comparison in the rates of cisplatin-induced nephrotoxicity associated with sodium loading or sodium loading with forced diuresis as a preventative measure. J Oncol Pharm Pract. 2010;16:167–171. 
Google Scholar | SAGE Journals
3. Santoso, JT, Lucci, JA, Coleman, RL, Schafer, I, Hannigan, E. Saline, mannitol, and furosemide hydration in acute cisplatin nephrotoxicity: a randomized trial. Cancer Chemother Pharmacol. 2003;52:13–18. 
Google Scholar | ISI
4. Morgan, KP, Buie, LW, Savage, SW. The role of mannitol as a nephroprotectant in patients receiving cisplatin therapy. Ann Pharmacother. 2012;46:276–281. 
Google Scholar | SAGE Journals | ISI
5. Morgan, KP, Snavely, AC, Wind, LS. Rates of renal toxicity in cancer patients receiving cisplatin with and without mannitol. Ann Pharmacother. 2014;48:864. 
Google Scholar
6. McKibbin, T, Cheng, LL, Kim, S. Mannitol to prevent cisplatin-induced nephrotoxicity in patients with squamous cell cancer of the head and neck (SCCHN) receiving concurrent therapy. Support Care Cancer. 2016;24:1789–1793. 
Google Scholar | ISI
7. Bentzen, J, Toustrup, K, Eriksen, JG, Primdahl, H, Andersen, LJ, Overgaard, J. Locally advanced head and neck cancer treated with accelerated radiotherapy, the hypoxic modifier nimorazole and weekly cisplatin. Results from the DAHANCA 18 phase II study. Acta Oncol. 2015;54:1001–1007. 
Google Scholar
8. Hosmer, DW, Lemeshow, S, Sturdivant, RX. Applied Logistic Regression. 3rd ed. London, England: Wiley; 2013. 
Google Scholar
9. Fox, J, Weisberg, S. An {R} Companion to Applied Regression. 2nd ed. Thousand Oaks, CA: SAGE; 2011. 
Google Scholar
10. Yoshida, K, Bohn, J. tableone: create "Table1" to describe baseline characteristics (R package version 0.7.3).http://CRAN.R-project.org/package=tableone. Published 2015. 
Google Scholar
11. Fitzmaurice, GM, Laird, NM, Ware, JH. Applied Longitudinal Analysis. 2nd ed. London, England: Wiley; 2011. 
Google Scholar
12. Lindberg, L, Brødbæk, K, Hägerström, EG, Bentzen, J, Kristensen, B, Zerahn, B. Comparison of methods for estimating glomerular filtration rate in head and neck cancer patients treated with cisplatin. Scand J Clin Lab Invest. 2017;77:237–246. 
Google Scholar
Similar Articles:

Daily outpatient intravenous antibiotic therapy for the management of pediatric periorbital cellulitis, a retrospective case series of sixty‐six patients

Abstract

Objective

To evaluate whether outpatient treatment of periorbital cellulitis with daily administration of intravenous antibiotics and physician evaluation is an effective and safe alternative to admission.

Design

A retrospective chart review study of pediatric patients treated on an outpatient basis for periorbital cellulitis at a tertiary children's hospital between 2013‐2015 was performed. Children were assessed day by a pediatrician to monitor for resolution of symptoms or complications.

Setting

The Montreal Children's hospital, a tertiary care center.

Participants

Children diagnosed with an uncomplicated periorbital cellulitis secondary to an acute sinusitis or upper respiratory tract infection.

Main outcome measures

The number of days of intravenous antibiotics, complications or need for subsequent admission. Complications were defined as formation of an abscess or phlegmon confirmed on computerized tomography scan, worsening or recurrent persistent cellulitis, failure to improve on intravenous antibiotics, and intracranial complications.

Results

Sixty‐six children with a diagnosis of uncomplicated periorbital cellulitis secondary to sinusitis who received intravenous antibiotics via medical day hospital and who fit the inclusion criteria were identified. The mean duration of intravenous antibiotic therapy was 4.1 days. All children received ceftriaxone, with one patient also receiving cefuroxime. Two of 66 patients developed complications; one patient required admission for failure to improve/subperiosteal phlegmon and later underwent functional endoscopic sinus surgery, and one patient developed an eyelid abscess that did not require admission. No patients developed severe neurological or visual deficits.

Conclusions

Outpatient intravenous therapy with daily reassessment by a physician may be a safe alternative to admission in select cases of periorbital cellulitis without systemic signs of illness.

This article is protected by copyright. All rights reserved.



http://bit.ly/2SPsyww

Evaluation of nasal mucociliary clearance time in patients with Vitamin-D deficiency

Abstract

Objectives

The main purpose of the current study was to investigate nasal mucociliary clearance time (NMC) in patients with Vitamin-D deficiency.

Methods

A total of 55 patients with Vitamin-D deficiency and 32 controls were evaluated. NMC time was measured with subjective saccharine test and compared between study and control groups. In addition, NMC time was re-evaluated after Vitamin-D replacement protocol in patients with Vitamin-D deficiency.

Results

The mean 25(HO)Vitamin-D levels were 14.32 ± 4.23 ng/mL (7–24.6) and 29.38 ± 7.05 ng/mL (25–53.8) in study and control groups, respectively (p < 0.001). The mean NMC time was 11.15 ± 3.05 (6.3–17.6) and 8.40 ± 2.33 (6–13.2) in study and control groups, respectively (p < 0.001). The mean 25(HO)Vitamin-D level after the replacement protocol was 33.38 ± 10.03 and the mean NMC time was 9.56 ± 2.54 (p < 0.001).

Conclusion

The mean NMC time was significantly increased in patients with Vitamin-D deficiency which can be corrected after Vitamin-D replacement protocols. The prolonged mucociliary clearance might be one of the pathophysiologic pathways at increased upper respiratory tract infections, and sinonasal and ear infections in patients with Vitamin-D deficiency.



http://bit.ly/2QK4QzL

Impact of Le-Fort I osteotomy on anatomical and functional aspects of the nasal airway and on quality of life

Abstract

Objectives

Orthognathic surgery is a well-established procedure for skeletal deformities. Beneficial influences to the posterior airway space (PAS) have been described, but little is known about the subjective aesthetical and functional nasal aspects after orthognathic surgery. The aim of this study was to evaluate nasal airflow by anterior rhinomanometry and volumetric changes in the nasal airway space after mono- or bimaxillary surgery using cone-beam computed tomography (CBCT) and a new segmentation software. Furthermore, changes of patient's quality of life (QoL) should be assessed.

Methods

Ten patients (9 skeletal class malformation III, 1 skeletal class malformation I) were included. CBCT images, rhinological inspections and anterior rhinomanometries were performed before (T0) and after surgery (T1). All patients completed the FROI-17, the ROE and the SF-36 questionnaires.

Results

A significant postoperative gain for nasal airway volume compared with the baseline was shown (p < 0.014). No statistically significant differences between pre- and postoperative flow rates were found (p = 0.114). Pre- and postoperative cohorts did not differ in responses of disease-specific (ROE and FROI-17) and generic QoL questionnaires (SF-36).

Conclusion

Maxillary relocation surgery leads to a significant increase in nasal airway space. Subjectively, orthognathic patients did not experience any functional but psychosocial aspects after bimaxillary surgery.



http://bit.ly/2CjdHDr

Risk stratification models in human papillomavirus-associated oropharyngeal squamous cell carcinoma: the Nova Scotia distribution

Abstract

Objective

The incidence of oropharyngeal squamous cell carcinoma is increasing with a growing proportion of diagnoses associated with human papillomavirus (p16 + OSCC), which generally confers a favorable prognosis. For these reasons, novel risk stratification models specific to the p16 + OSCC population have recently been proposed to guide future research on treatment de-intensification for appropriate patients.

This study aimed to quantify patient risk distribution using multiple published risk models and investigate the hypothesis that the local p16 + OSCC population includes a smaller proportion of low-risk patients due to a high prevalence of concurrent tobacco exposure.

Methods

A retrospective cohort study was performed including patients diagnosed with p16 + OSCC in Nova Scotia between 2011 and 2015. Patient identification was obtained through the CCNS registry and an institutional database. Exclusion criteria included HPV negative status, second primary cases, incomplete data availability, and local recurrence cases.

Results

Following exclusion, 117 patients met study criteria. The majority had small primary tumors (70.9% ≤ T2) and advanced nodal status on presentation (60.7% ≥ N2b). Most patients had a positive smoking history (62.4%), with 53.0% of patients having a pack-year history greater than 10 pack-years. In four of the five risk stratification models, the majority of the study population fell into the lowest risk category. The risk stratification distribution of our local population was similar to the populations used to validate the published models, with the largest single category difference being 13.3% (range − 12.3 to + 13.3%).

Conclusions

This is the first study to compare multiple currently published risk stratification models to a local population and address the uncertainty of risk stratification in the Nova Scotian p16 + OSCC population. Despite a high prevalence of concurrent tobacco exposure, the study population was found to be overall low risk, with similar risk compared to model validation populations.



http://bit.ly/2FwtT7q

Regarding Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment



http://bit.ly/2M7EJCi

In response to Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment



http://bit.ly/2sqVT4B

In Response to Saliva Pepsin Detection and Proton Pump Inhibitor Response in Suspected Laryngopharyngeal Reflux



http://bit.ly/2M7EI1c

In Reference to Saliva Pepsin Detection and Proton Pump Inhibitor Response in Suspected Laryngopharyngeal Reflux



http://bit.ly/2sqDhBN

In Response to Letter to the Editor Regarding: Evaluation and Treatment of Pulsatile Tinnitus Associated With Sigmoid Sinus Wall Anomalies



http://bit.ly/2MaZkp2

Regarding Evaluation and Treatment of Pulsatile Tinnitus Associated With Sigmoid Sinus Wall Anomalies



http://bit.ly/2spGsK7

Long‐term Survival in Head and Neck Cancer: Impact of Site, Stage, Smoking, and Human Papillomavirus Status

Objectives/Hypothesis

Literature examining long‐term survival in head and neck squamous cell carcinoma (HNSCC) with human papillomavirus (HPV) status is lacking. We compare 10‐year overall survival (OS) rates for cases to population‐based controls.

Study Design

Prospective cohort study.

Methods

Cases surviving 5 years postdiagnosis were identified from the Carolina Head and Neck Cancer Study. We examined 10‐year survival by site, stage, p16, and treatment using Kaplan‐Meier and Cox proportional hazard models. Cases were compared to age‐matched, noncancer controls with stratification by p16 and smoking status.

Results

Ten‐year OS for HNSCC is less than controls. In 581 cases, OS differed between sites with p16+ oropharynx having the most favorable prognosis (87%), followed by oral cavity (69%), larynx (67%), p16− oropharynx (56%), and hypopharynx (51%). Initial stage, but not treatment, also impacted OS. When compared to controls matched on smoking status, the hazard ratio (HR) for death in p16+ oropharynx cases was 1.5 (95% confidence interval [CI]: 0.7‐3.1) for smokers and 2.4 (95% CI: 0.7‐8.8) for nonsmokers. Similarly, HR for death in non–HPV‐associated HNSCC was 2.2 (95% CI: 1.7‐3.0) for smokers and 2.4 (95% CI: 1.4‐4.9) for nonsmokers.

Conclusions

OS for HNSCC cases continues to decrease 5 years posttreatment, even after stratification by p16 and smoking status. Site, stage, smoking, and p16 status are significant factors. These data provide important prognostic information for HNSCC.

Level of Evidence

2 Laryngoscope, 2019



http://bit.ly/2M7b248