Medicine by Alexandros G. Sfakianakis

Click image to enlargeCenters for Disease Control and Prevention (CDC) reports:· Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs· Each year, on average, 5 % to 20 % of the U.S. population gets the flu· You may be able to pass on flu to someone else before you know you are sick, as well as while you are sickA clinical trial testing the effectiveness of an investigational medication for the flu is now...

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Fri Jan 25, 2019 00:00

Flu (Influenza) - Meridian ID

ClinicalConnection.com New Clinical Trials

Fri Jan 25, 2019 00:00

Chronic Spontaneous Urticaria - Clearwater FL

Click image to enlargeLocal dermatologists are conducting a clinical research study to test the effectiveness and safety of an investigational injected medication for Chronic Spontaneous Urticaria.

ClinicalConnection.com New Clinical Trials

Fri Jan 25, 2019 00:00

Asthma - Raleigh NC

Calling all young people with ASTHMA!Everyone's asthma is different, so new treatments are always needed. Doctors need people like you to join a new research study, to test a new investigational asthma treatment. Can you help us? The RESPO Study for children with asthma * Is your child aged 5-17?* Have they had symptoms consistent with an asthma diagnosis for at least 6 months?* Are they accustomed to using an inhaler?

ClinicalConnection.com New Clinical Trials

Thu Jan 24, 2019 00:00

Primary Mitochondrial Myopathy - Atlanta GA

Click image to enlargeLocal doctors are seeking participants for a clinical research study to test the effectiveness and safety of an investigational product delivered through a pen injector to treat Primary Mitochondrial Myopathy. If you or a loved one has been diagnosed with PMM, you may qualify to participate.

ClinicalConnection.com New Clinical Trials

Thu Jan 24, 2019 00:00

Eczema - Norfolk VA

Click image to enlargeLocal doctors are recruiting volunteers for a clinical trial to evaluate the effectiveness of an investigational oral medication for moderate to severe atopic dermatitis (eczema). Take control of your health options and consider participating!

ClinicalConnection.com New Clinical Trials

Wed Jan 23, 2019 00:00

Osteoarthritis of the Knee - Miami FL

Clinical Research Study for Osteoarthritis of the Knee Are you or a loved one living with Osteoarthritis of the Knee, and seeking care options? You may be eligible to participate in a clinical research study, evaluating the safety and effectiveness of a new investigational medication, and receive study related care at no cost! See If You Or A Loved One Qualify!Participation Requirements You or a Loved One May Qualify If You Are between 40-80 years old Have been diagnosed with Osteoarthritis...

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Wed Jan 23, 2019 00:00

Depression - Jamaica NY

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ClinicalConnection.com New Clinical Trials

Tue Jan 22, 2019 00:00

Treatment Resistant Depression - Middleburg Heights OH

To evaluate the efficacy, safety, and tolerability of cariprazine 1.5 mg/day and 3 mg/daycompared with placebo as an adjunctive to antidepressant therapy (ADT) in patients with major depressivedisorder (MDD) who have had an inadequate response to antidepressants alone

ClinicalConnection.com New Clinical Trials

Tue Jan 22, 2019 00:00

Depression - Cherry Hill NJ

Depression...It interferes with the ability to work, sleep, eat and enjoy life. If you are experiencing symptoms of depression, a clinical research study may be your next step.

ClinicalConnection.com New Clinical Trials

Mon Jan 21, 2019 00:00

Flu (Influenza) - West Palm Beach CA

ClinicalConnection.com New Clinical Trials

Mon Jan 21, 2019 00:00

Anxiety - Cherry Hill NJ

Are you often worried, tense stressed, nervous, fearful or overly concerned? Always worrying about the what-ifs? If you are an adult experiencing symptoms of ANXIETY, you may be interested in participating in a clinical research study.

ClinicalConnection.com New Clinical Trials

Mon Jan 21, 2019 00:00

At Risk for Developing Symptoms of Alzheimer's Disease - Sherman Oaks CA

California Neuroscience Research is conducting a research study of an investigational medication vs. placebo (an inactive substance) in participants who are between 60 and 75 and at increased risk for developing symptoms of Alzheimer's Disease. Participation is voluntary.Participant has one office visit (+ phone follow-ups) for genetic testing. For those that are at increased risk of developing Alzheimer's Disease and meet other inclusion and exclusion criteria, there can be up to 8 years of treatment...

ClinicalConnection.com New Clinical Trials

Mon Jan 21, 2019 00:00

Type 1 Diabetes - Chattanooga TN

Living with Type 1 Diabetes?Consider the Gazelle StudyIf you are an adult between ages 18 and 65 living with type 1 diabetes, you may be eligible to take part in the GAZELLE clinical research trial. This trial will look at an investigational fast-acting insulin to see if it works as effectively as an existing fast-acting insulin already being used to treat diabetes.

ClinicalConnection.com New Clinical Trials

Mon Jan 21, 2019 00:00

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Pediatric Major Depression - Lauderdale Lakes FL

Research study needs children and adolescents struggling with Major Depressive DisorderIf you're struggling with Major Depressive Disorder (MDD), you may qualify for the Allergan clinical research study enrolling now. Local doctors are looking for children and adolescents male and female ages 7-17 who struggle with Major Depressive Disorder.

ClinicalConnection.com New Clinical Trials

Sun Jan 20, 2019 00:00

Crohn's Disease - Southfield MI

Do you or a loved one suffer from Crohn's Disease?What is Crohn's Disease? Crohn's disease is a type of inflammatory bowel disease or IBD that may affect any part of the gastrointestinal tract from mouth to the end of the digestive tract. Signs and symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, and weight loss. Other complications may occur outside the gastrointestinal tract and include anemia, skin rashes, arthritis, inflammation of the...

ClinicalConnection.com New Clinical Trials

Thu Jan 17, 2019 00:00

Cancer, Obesity/Overweight and Insomnia (COIN) Study - Baltimore MD

Click image to enlargeFLYERVolunteers are needed for a research study assessing the effectiveness of a sleep intervention prior to a web- and phone-based weight loss program. The study involves 6 in-person visits and approximately 18 phone/videosessions over an 8-month period.

ClinicalConnection.com New Clinical Trials

Thu Jan 17, 2019 00:00

Flu (Influenza) - Carrollton TX

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Wed Jan 16, 2019 00:00

Flu (Influenza) - Plano TX

ClinicalConnection.com New Clinical Trials

Wed Jan 16, 2019 00:00

Moderate to Severe Facial Acne - Raleigh NC

Facial Acne StudyDo you have facial acne?You may be a candidate for our clinical research study!We are currently enrolling qualified participants in a clinical research study for an investigational topical gel.To see if you or someone you know may qualify, contact us today!

ClinicalConnection.com New Clinical Trials

Wed Jan 16, 2019 00:00

Flu (Influenza) - Austin TX

ClinicalConnection.com New Clinical Trials

Wed Jan 16, 2019 00:00

Episodic Migraine Headaches - San Diego CA

Unhappy with the Pain and Inconvenience of Episodic Migraine Headaches?Consider Joining a Study of a Proposed New Type of Medicine.We're enrolling participants in a study of the safety and tolerability of an investigational medication for people with episodic migraine headaches.Qualified participants must:Be age 18-80Have a 1+ year history of migraines starting before age 50Have 4-14 migraines or probable migraines a month, on average, in the three months prior to joining the study

ClinicalConnection.com New Clinical Trials

Wed Jan 16, 2019 00:00

Type 1 Diabetes - Escondido CA

Click image to enlargeLocal doctors are conducting a clinical trial to test the effectiveness of an investigational liver-selective glucokinase activator for management of Type 1 Diabetes.

ClinicalConnection.com New Clinical Trials

Wed Jan 16, 2019 00:00

Healthy Volunteers - Flu Test Study - Fayetteville NC

Are you interested in participating in a research study of an investigational test to detect the flu?You or your child may qualify if you are experiencing symptoms of the flu.

ClinicalConnection.com New Clinical Trials

Tue Jan 15, 2019 00:00

Healthy Volunteers - Flu Test Study - San Diego CA

Flu Test Clinical Trial Participants WantedAre you interested in participating in a research study of an investigational test to detect the flu?You or your child may qualify if you are experiencing symptoms of the flu.

ClinicalConnection.com New Clinical Trials

Tue Jan 15, 2019 00:00

Depression - Oceanside CA

Is depression affecting your quality of life? Excell Research is seeking volunteers living with depression to participate in a local research study. You may qualify if you: Are between the ages of 18-75 years old Are currently taking an anti-depressant for at least 4 weeks with little to no improvement in symptoms Have tried an antidepressant (for at least 4 weeks) in the last 18 months with little to no improvement in symptoms Have been experiencing a depressive episode for 8 weeks or longer...

ClinicalConnection.com New Clinical Trials

Tue Jan 15, 2019 00:00

Healthy Volunteers - Flu Test Study - Chattanooga TN

Are you interested in participating in a research study of an investigational test to detect the flu?You or your child may qualify if you are experiencing symptoms of the flu.

ClinicalConnection.com New Clinical Trials

Tue Jan 15, 2019 00:00

Healthy Volunteers - Flu Test - Raleigh NC

Flu Test Clinical Trial Participants WantedYou or your child may qualify if you are experiencing symptoms of the flu.Flu Test Clinical Times:Thursday, Jan. 17 at 9:00 AM, 11:00 AM, 1:00 PMWeekly afterward:Monday, Wednesday, Friday at 9:00 AM, 11:00 AM, 1:00 PM

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Tue Jan 15, 2019 00:00

Migraine - Prairie Village KS

If you suffer with migraines and have between 4-14 migraines a month

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Παρασκευή 25 Ιανουαρίου 2019

Thyroid Hormone Receptor Alpha Mutations Lead to Epithelial Defects in the Adult Intestine in a Mouse Model of Resistance to Thyroid Hormone

Thyroid, Ahead of Print.

http://bit.ly/2RSGFVe

Trends, Determinants, and Associations of Treated Hypothyroidism in the United Kingdom, 2005–2014

Thyroid, Ahead of Print.

http://bit.ly/2CJ3zUO

The effectiveness of high-resolution ultrasound in the assessment of the carotid intima–media thickness for postirradiated neck

Abstract

Objective

The carotid intimal–medial thickness (CIMT) is a strong predictor of future cardiovascular events. We assessed the mean CIMT and evaluated associated factors in head and neck cancer (HNC) patients.

Materials and methods

Between January 2016 and March 2018, 70 volunteers underwent automatic ultrasound measurement of the common carotid artery CIMT. A mean CIMT ≥ 1.0 mm was regarded as an elevated risk for cardiovascular disease (CVD). We aimed to investigate the risk factors for an increased mean CIMT.

Results

We recruited 20 HNC survivors and 50 noncancer control individuals. Multiple linear regression analysis showed that old age (β = 0.006, 95% confidence interval, CI 0.004–0.008), increased weight (β = 0.003, 95% CI 0.001–0.005), hypertension (β = 0.10, 95% CI 0.03–0.17), and prior irradiation (β = 0.13, 95% CI 0.08–0.19) were positively correlated with the mean CIMT. From logistic regression analysis, it was shown that patients who underwent radiotherapy (OR 13.5, 95% CI 1.48–122.8) and who had higher bodyweight (OR 1.09, 95% CI 1.01–1.18) had a significantly higher risk of developing CVD.

Conclusion

Measurement of the mean CIMT using ultrasound could be useful for assessing CVD risk in HNC survivors after neck irradiation.

http://bit.ly/2FZfxgb

Editorial Board

Publication date: February 2019

Source: Auris Nasus Larynx, Volume 46, Issue 1

Author(s):

http://bit.ly/2S5nK97

Otolaryngologists adhere to evidence-based guidelines for chronic rhinosinusitis

Abstract

Purpose

To assess awareness of, opinion about and adherence to evidence-based guidelines on chronic rhinosinusitis among Dutch Otolaryngologists.

Methods

We assessed implementation of two guidelines, one Dutch and one European, that are both intended for diagnosis and treatment of patients with chronic rhinosinusitis. We invited 485 Otolaryngologists to fill out a questionnaire and report on their opinion on and adherence to the guidelines. The adherence was further tested by 4 clinical case scenarios, derived from guideline recommendations.

Results

166 (34%) completed the questionnaire. 99% of the respondents was aware of one or both guidelines. Most respondents (90%) consider the guidelines as directing or supportive for their clinical practice based on the clinical case scenarios, between 62 and 99% of the respondents act according to guidelines. Concerning diagnosis, CT-imaging is performed more and allergy testing less than recommended. Where multiple treatment options are recommended, the responses are more heterogeneous as a result of this. Nonetheless, high recommended treatment was chosen more often. Otolaryngologists were reluctant in surgical treatment as a first option, which is according to the guidelines.

Conclusions

Overall, both the EPOS and CBO guideline are well known among Dutch Otolaryngologists and 90% indicates that the guideline is important in their daily practice. Adherence to the guidelines is sufficient to high. If multiple treatment or diagnostic options are recommended this leads to a more heterogeneous response pattern. Recommendations with a high grade of recommendation were followed up most often.

http://bit.ly/2RhYhoA

Importancia de la cuantificación del desplazamiento hioideo en la valoración del estadio y evolución de la disfagia orofaríngea

Publication date: Available online 24 January 2019

Source: Acta Otorrinolaringológica Española

Author(s): Gemma Garmendia Merino, Helena Bascuñana Ambrós

Resumen

Introducción y objetivos

El objetivo de este trabajo es mostrar nuestra experiencia y consideraciones al cuantificar el desplazamiento hioideo, así como observar su correlación con las escalas cualitativas de valoración de la disfagia.

Métodos

Se mide el desplazamiento hioideo mediante el método descrito por el grupo de Molfenter y Steele 2014 en una serie de 14 pacientes con disfagia orofaríngea antes y después del tratamiento, y se valora su correlación con la Escala de penetración y aspiración de Rosenbek de 1996, y con la Functional Oral Intake Scale de Crary de 2005.

Resultados

Todos los pacientes variaron el desplazamiento total del hioides tras el tratamiento aplicado. Esta variación se correlacionó con las variaciones de la Escala de penetración y aspiración en todos los pacientes que presentaban aspiración o penetración. Sin embargo, las modificaciones del desplazamiento total hioideo no se correlacionaron con las variaciones de la Functional Oral Intake Scale.

Conclusiones

La mejora en el desplazamiento total del hioides es un indicador clínico de la mejora en la aspiración del paciente con disfagia orofaríngea, y puede ser utilizado en su diagnóstico y seguimiento. Sin embargo, no lo es como indicador de la tolerancia de la dieta oral.

Abstract

Introduction and objectives

The objective of this paper was to show our experience and considerations when quantifying hyoid bone displacement and to observe its correlation with the qualitative scales that evaluate dysphagia.

Methods

Hyoid displacement was assessed using the method described by Molfenter and Steele's group in 2014 in a series of 14 patients affected by oropharyngeal dysphagia. The degree of dysphagia was also qualitatively assessed with the Rosenbek Penetration and Aspiration Scale (PAS) of 1996 and with the Functional Oral Intake Scale (FOIS) of Crary of 2005. All assessments were done before and after treatment.

Results

All patients increased their hyoid bone total displacement after the treatment. These variations were highly correlated with the variations in the PAS scale with aspiration or penetration. However, the variations of hyoid bone displacement did not correlate with the FOIS scale.

Conclusions

The improvement in total hyoid bone displacement is a clinical indicator of improved aspiration of patients suffering dysphagia. However, the improvement of this displacement is not related to the oral intake tolerance of the patients.

http://bit.ly/2FPWwNO

Systematic review and meta‐analysis of the impact of dosimetry to dysphagia and aspiration related structures

Abstract

Background

Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta‐analysis demonstrates the effect that radiation has on swallowing.

Methods

Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta‐analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies.

Results

The majority of the papers found a correlation between radiation dose to the swallowing structures and dysphagia, however a meta‐analysis found the studies carried a significant degree of heterogeneity. The appraisal demonstrates the need for large‐scale studies using a randomized design and instrumental dysphagia assessments.

Conclusions

Radiation dose to dysphagia and aspiration structures is correlated with incidence of dysphagia and aspiration. The variables in this population contribute to the heterogeneity within and cross studies and future studies should consider controlling for this.

http://bit.ly/2CKh32l

Rationale and budget impact of bimonthly use of Cetuximab in patients with recurrent and/or metastatic head and neck cancer

Abstract

Background

In recurrent and/or metastatic head and neck squamous cell cancer, Cetuximab is administered once a week, followed by weekly doses. We present the clinical rationale of a different schedule of maintenance Cetuximab and we estimate the potential economic benefits on the health care budget from a societal perspective in Italy.

Methods

A budget impact (BI) excel‐based model was developed comparing a base case scenario of 100% weekly administration with a dose of 250 mg/m² to an every‐other‐week (EOW) administration at 50% or 100% with a dose of 500 mg/m².

Results

In the EOW, 50% scenario it was calculated a cost reduction of €347 000 of which 70% attributable to indirect costs, increasing to €694 000 after 4 months.

Conclusions

In our analysis, we showed that this simplified schedule could also reduce the costs of treatments both for the health system (direct costs) and for the society (indirect costs).

http://bit.ly/2RNL37T

Response to Letter to the Editor regarding follow‐up for NIFTP

http://bit.ly/2CFWmVo

Pre-auricular Sinus with Post-auricular Extension: An Uncommon Variant

Abstract

Pre-auricular sinus usually presents in front of the auricle without any diagnostic dilemma. But confusion arises when it presents with post-auricular swelling, abscess or discharging sinus. Here we describe series of pre-auricular sinus with post-auricular extension, a "variant type" of pre-auricular sinus and their management. A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from April 2015 to March 2018. After control of infection and proper pre-operative investigations patients, sinus was excised using bi-directional approach. The sinus tract along with a thin rim of conchal cartilage and pre and post-auricular cuff of skin was excised in toto. Among 76 cases of pre-auricular sinus, seven had "variant type". There were five males and two females in the variant group. Five patients were in the first decade of life and two patients were in the second decade of life. Four patients presented with post-auricular scar, two patients presented with post-auricular discharging sinus and one patient presented with post-auricular abscess. Wound healing was perfectly normal in all patients. None had recurrence till 1 year follow up. Pre-auricular sinus may present as "variant type" with post-auricular abscess or discharging sinus. So when a patient presents with post-auricular abscess or discharging sinus, pre-auricular region and pinna should be examined carefully. This helps to avoid unnecessary investigations and interventions which only complicate future management of these patients.

http://bit.ly/2FNGsw8

Comparison of Functional Organ Preservation by Concomitant Boost Radiotherapy Versus Concurrent Chemoradiation in Locally Advanced Carcinoma of Larynx or Hypopharynx: A Prospective Randomized Study

Abstract

Functional organ preservation is a major challenge in management of advanced laryngeal and hypopharyngeal carcinoma. Although ideal approach is a subject of much debate, radiotherapy with or without chemotherapy is most commonly used modality. This randomized study was conducted to compare functional organ preservation by chemoradiation (CRT) versus concomitant boost radiotherapy (CBRT). A total of 40 patients with advanced (stage III/stage IVa) laryngeal and hypopharyngeal cancer were randomized to receive either CRT (n = 20) to a dose of 66 Gy in 33 fractions over 6.5 weeks with concurrent cisplatin (100 mg/m² on days 1, 22 and 43) or CBRT (n = 20) to a dose of 67.5 Gy in 40 fractions over 5 weeks. Patients were assessed for organ preservation rate, toxicities, voice and swallowing functions utilizing Voice Related Quality of Life (VRQOL) and MD Anderson Dysphagia Inventory (MDADI) scores, respectively, for minimum follow up of 6 months. Organ preservation rate (intact disease free larynx) at 6 months post treatment was observed in 100% in CRT arm and 95% in CBRT arm. There was no significant difference in mucositis and dermatitis in two arms (p = 0.82 and 0.78, respectively). Dysphagia was observed more in CRT arm (n = 12 vs n = 6). Late toxicities grade 3 xerostomia, grade 2 dysguesia, were seen significantly more in CRT arm. There was no statistical difference between the two arms in terms of VRQOL (p = 0.55) and MDADI scores (p = 0.13). In CRT arm 13 patients complete response and in CBRT arm 12 patients had complete response. Accelerated fractionation with concomitant boost schedule is as effective as CRT in anatomical and functional preservation of larynx. The toxicities, voice and dysphagia related quality of life is comparable.

http://bit.ly/2G0xBXs

Πέμπτη 24 Ιανουαρίου 2019

Editorial Board

http://bit.ly/2B4wSRt

Eine seltene Ursache der chronischen Otitis media

Laryngo-Rhino-Otol
DOI: 10.1055/a-0829-6950

Article in Thieme eJournals:
Table of contents | Full text

http://bit.ly/2TeIJn1

Eine Gruppenintervention zur Förderung der Arbeitsfähigkeit für Patienten mit Kopf-Hals-Tumoren

Laryngo-Rhino-Otol
DOI: 10.1055/a-0829-6885

Einleitung Trotz hoher Belastung nimmt ein Großteil der Patienten mit Kopf-Hals-Tumoren keine psychosoziale Versorgung in Anspruch. Diese Patienten haben darüber hinaus ein höheres Risiko als andere Krebspatienten, nicht wieder in den Beruf zurückzukehren. Daher wurde eine Gruppenintervention entwickelt, die sich an Patienten mit Kopf-Hals-Tumoren richtet und deren Arbeitsfähigkeit, Lebensqualität, Selbstwirksamkeit und psychisches Wohlbefinden fördern soll. Material und Methoden In einem randomisiert-kontrollierten Design erhalten die Patienten eine Gruppenintervention oder eine sozialrechtliche Beratung. Eingeschlossen werden männliche Patienten mit Kopf-Hals-Tumoren mit hoher psychischer und arbeitsbezogener Belastung. Die Gruppenintervention besteht aus acht Sitzungen. Die Gruppen werden von einer Psychotherapeutin und einem ehemals Betroffenen eines Kopf-Hals-Tumors (sogenannter Peer) geleitet. Die Umsetzbarkeit und Akzeptanz der Intervention wurde anhand einer Pilotgruppe getestet. Die Teilnehmer der Pilotgruppe evaluierten jede Sitzung und wurden nach Abschluss der Intervention in halbstrukturierten Interviews zur Intervention befragt. Ergebnisse Von 113 Patienten persönlich angesprochenen Patienten nahmen zehn Patienten an einem Screening-Gespräch teil. Davon nahmen vier Patienten an der Pilotgruppe teil. Die Patienten gaben an, dass sich die Gruppenintervention gut mit ihrem Alltag vereinbaren ließe und dass sie die Gruppe insgesamt positiv wahrgenommen hätten. Drei Patienten betonten die Wichtigkeit des Peers. Diskussion Vor allem der Peers als Identifikationsfigur ist von zentraler Bedeutung. Zur Verbesserung der Rekrutierungszahlen sollen Einschlusskriterien erweitert und der Teilnahmeaufwand reduziert werden.
[...]

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

http://bit.ly/2B5daFc

No Evidence of Broadband Noise Having Any Harmful Effect on Hearing

To the Editor Attarha et al recommended that sound therapies using white noise should be avoided as treatments for tinnitus. This advice might stem from the authors' collective lack of clinical experience assessing and treating patients with tinnitus, or from their unfamiliarity with tinnitus management techniques and associated literature. In any case, before recommending that white noise should be avoided by patients with tinnitus, Attarha et al should become more familiar with how a variety of sound therapies—including broadband sounds—often help this patient population.

http://bit.ly/2FMXWsK

Bullous Pemphigoid Presenting as Oropharyngeal Hemorrhage

This is a case report of a man who presented with oropharyngeal hemorrhage and impending airway compromise as the initial presentation of mucosal bullous pemphigoid.

http://bit.ly/2FVKNwA

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Σάββατο 26 Ιανουαρίου 2019

Παρασκευή 25 Ιανουαρίου 2019

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Πέμπτη 24 Ιανουαρίου 2019