Total, Bioavailable, and Free 25(OH)D Relationship with Indices of Bone Health in Elderly: A Randomized Controlled Trial.

p.aythelady61 shared this article with you from Inoreader Total, Bioavailable, and Free 25(OH)D Relationship with Indices of Bone Health in Elderly: A Randomized Controlled Trial. Via The Journal of Clinical Endocrinology & Metabolism Related Articles Total, Bioavailable, and Free 25(OH)D Relationship with Indices of Bone Health in Elderly: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2020 Dec 06;: Authors: El Sabeh M, Ghanem P, Al-Shaar L, Rahme M, Baddoura R, Halaby G, Singh RJ, Vanderschueren D, Bouillon R, El-Hajj Fuleihan G Abstract CONTEXT: Questions regarding the superiority of free and bioavailable 25 hydroxy-vitamin D [25(OH)D] in predicting health outcomes remain unresolved. OBJECTIVE: This study investigates the impact of vitamin D variables, total, bioavailable or free 25(OH)D, on indices of bone and mineral metabolism, at baseline, and in response to two vitamin D doses. DESIGN: Our objectives are implemented as exploratory analyses on data collected in a 1-year, double blind, randomized controlled trial completed in July 2014. SETTING: Participants were recruited from 3 major hospitals in an ambulatory setting. PATIENTS OR OTHER PARTICIPANTS: Participants were elderly (>65 years), overweight, and had a baseline serum 25(OH)D between 10 and 30 ng/mL. 221 participants completed the study. INTERVENTION: Subjects were randomized to receive calcium and oral vitamin D3 (600IU/day or 3,750 IU/day) supplementation. RESULTS: Subjects who received the higher vitamin D dose had levels that were 1.3-1.4 folds higher than with the lower dose, for all variables (p-value < 0.001). Serum values of bioavailable and free 25(OH)D were associated with total 25(OH)D, with r values of 0.942 and 0.943, respectively (p-value <0.001). PTH was negatively associated with all vitamin D variables, with correlation coefficients ranging between -0.22 and -0.25; while calcium, and bone turnover markers (carboxy-terminal collagen crosslinks and osteocalcin) did not. Only total 25(OH)D had a positive relationship with % change BMD at the femoral neck at 12 months, while only free and bioavailable 25(OH) had a positive relationship with % change total body BMD at 12 months. CONCLUSION: Calculated free and bioavailable 25(OH)D do not appear to be superior to total 25(OH)D in predicting indices of bone health in an elderly population. PMID: 33280041 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Simultaneous gentamicin-mediated damage and Atoh1 overexpression promotes hair cell regeneration in the neonatal mouse utricle.

p.aythelady61 shared this article with you from Inoreader Simultaneous gentamicin-mediated damage and Atoh1 overexpression promotes hair cell regeneration in the neonatal mouse utricle. Via pubmed: hearing and balance Related Articles Simultaneous gentamicin-mediated damage and Atoh1 overexpression promotes hair cell regeneration in the neonatal mouse utricle. Exp Cell Res. 2020 Dec 03;:112395 Authors: Qian X, Ma R, Wang X, Xu X, Yang J, Chi F, Ren D Abstract Loss of hair cells from vestibular epithelium results in balance dysfunction. The current therapeutic regimen for vestibular diseases is limited. Upon injury or Atoh1 overexpression, hair cell replacement occurs rapidly in the mammalian utricle, suggesting a promising approach to induce vestibular hair cell regeneration. In this study, we applied simultaneous gentamicin-mediated hair cell ablation and Atoh1 overexpression to induce neonatal utricular hair cell formation in vitro. We confirmed that type I hair cells were the primary targets of gentamicin. Furthermore, injury and Atoh1 overexpression promoted hair cell regeneration in a timely and efficient manner through robust viral transfection. Hair cells regenerated with type II characteristics in the striola and type I/II characteristics in non-sensory regions. Rare EdU+/myosin7a+ cells in sensory regions and robust EdU+/myosin7a+ signals in ectopic regions indicate that transdifferentiation of supporting cells in situ, a nd mitosis and differentiation of non-sensory epithelial cells in ectopic regions, are sources of regenerative hair cells. Distinct regeneration patterns in in situ and ectopic regions suggested robust plasticity of vestibular non-sensory epithelium, generating more developed hair cell subtypes and thus providing a promising stem cell-like source of hair cells. These findings suggest that simultaneously causing injury and overexpressing Atoh1 promotes hair cell regeneration efficacy and maturity, thus expanding the understanding of ectopic plasticity in neonatal vestibular organs. PMID: 33279477 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population.

p.aythelady61 shared this article with you from Inoreader The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population. Via pubmed: speech and language Related Articles The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population. Folia Phoniatr Logop. 2020 Dec 04;:1-6 Authors: Galek KE, Bice EM Abstract BACKGROUND/AIMS: The effortful swallow is a common treatment intervention requiring increased intensity to facilitate adaptations and modify swallow kinematics. The type of feedback and bolus volume provided may influence the intensity of the effortful swallow. To determine the increased effortful swallow intensity, a clinician can collect the peak amplitude of an effortful swallow and a typical swallow and compute a "swallow effort ratio" (SER). Dividing the effortful swallow surface electromyography (sEMG) peak amplitude by the typical swallow sEMG peak amplitude derives the SER. A higher SER suggests increased intensity. An increase in the SER may have clinical relevance in swallowing therapy as a threshold of intensity is required to elicit neuroplastic change. The purpose of this investigation was to determine whether sEMG visual and clinician verbal feedback increases the SER. Additionally, the investigation examined whether the SER is influenced by different liquid bol us volumes. METHODS: Eighty-two nondysphagic, healthy adults were assigned at random to 2 groups. One group received no feedback, and the other received verbal and visual feedback while performing typical and effortful swallows at 3 liquid volumes. RESULTS: An analysis of covariance compared the typical and effortful peak swallow amplitudes among 3 volumes in the 2 feedback groups. There was a significant effect on the peak amplitude values by feedback group F(2, 79) = 22.82, p < 0.001. There were no differences in peak amplitude by volume regardless of feedback F(2, 78) = 0.413, p = 0.663. CONCLUSION: It appears that sEMG visual and clinician verbal feedback increases the SER, which may be a surrogate for intensity. An increased SER may have a positive effect on swallow intervention as intensity is known to influence outcomes of exercise and elicit neuroplastic change. PMID: 33279898 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pilot Evaluation of a Pragmatic Network for Integrated Care and Self-Management in Parkinson's Disease.

p.aythelady61 shared this article with you from Inoreader Pilot Evaluation of a Pragmatic Network for Integrated Care and Self-Management in Parkinson's Disease. Via pubmed: speech and language Pilot Evaluation of a Pragmatic Network for Integrated Care and Self-Management in Parkinson's Disease. Mov Disord. 2020 Oct 14;: Authors: Mestre TA, Kessler D, Côté D, Liddy C, Thavorn K, Taljaard M, Grimes D Abstract BACKGROUND: Parkinson's disease (PD) is a chronic neurodegenerative disorder that challenges care provision. A multidisciplinary care model needs to be impactful, feasible, and viable economically for widespread utilization. Supportive evidence is lacking. OBJECTIVE: The objective of this study was to evaluate the implementation and impact of a pragmatic network for PD care, the Integrated Parkinson Care Network (IPCN). METHODS: A 6-month, pre-post design, single-center, phase 2 study for complex interventions for patients with newly diagnosed (<1 year) and advanced (diagnosis >8 years) PD was used to assess a patient-centered care model based on integrated care, self-management support, and technology-enabled care. We comprehensively assessed the implementation of care paths, change in selected health and care quality outcomes after the Integrated Parkinson Care Network program, and costs analyses. RESULTS: We recruited 100 participants in 6 months. Overall, the top care priorities were speech and communication (33.7%), anxiety and depression (31.6%), and mobility, balance, and falls (29.6%), and the most commonly (>45%) used resources were speech-language pathology, community seniors services, and physiotherapy. Care priorities were met successfully in 90.6% of the cases, and there was a positive change in the Parkinson's Disease Questionnaire-8 (2.7; 95% confidence interval, 0.4-5.0; statistically significant in the advanced group), the perception of support for chronic care (Patient Assessment of Chronic Illness Case score, 1.1; 95% confidence interval, 0.9-1.4), and self-management (5As score, 1.2; 95% confidence interval, 1.0-1.4). The total cost of the Integrated Parkinson Care Network was C$1367 per patient. CONCLUSIONS: A pragmatic development of a care delivery network based on integrated care and self-management support is promising for its feasibility, impact, and a sustainable cost. © 2020 International Parkinson and Movement Disorder Society. PMID: 33280165 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing.

p.aythelady61 shared this article with you from Inoreader Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing. Via Skull Base Related Articles Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing. Laryngoscope. 2020 Sep 10;: Authors: Pistochini A, Russo F, Coden E, Sileo G, Battaglia P, Bignami M, Volpi L, Castelnuovo P Abstract OBJECTIVES/HYPOTHESIS: Although the Hadad-Bassagusteguy flap represents the first choice for middle and posterior skull base reconstruction and coverage of exposed bony areas, in some cases it is unavailable. The aim of this study is to describe, as an alternative option in selected cases, a modified posterior pedicle middle turbinate flap (mPPMTF) extended to the lacrimal area. Anatomical features, step-by-step harvesting technique, and surgical applications are presented. STUDY DESIGN: Anatomic dissection study and case report. METHODS: Four mPPMTFs were raised in two fresh-frozen cadaver heads. A study of the vascular supply and measurements of length, width, and area of the flap were performed. The ability of the flap to cover the ventral skull base, particularly the upper clivus area, was tested. A clinical case in which an mPPMTF was used for clivus resurfacing after osteoradionecrosis is reported. RESULTS: The vascular supply of the mPPMTF was identified as the middle turbinate branch of the sphenopalatine artery. The flap had a mean length of 6.92 cm, mean maximum width of 1.08 cm, and mean total area of 5.33 cm2 . The flap was able to reach the upper clivus, with a clival coverage ratio of 70.66%. In the clinical case, good surgical outcomes were observed, with accelerated re-epithelization without complications. CONCLUSIONS: The mPPMTF represents an alternative to the Hadad-Bassagusteguy flap for posterior cranial fossa and nasopharynx resurfacing. The main drawbacks are its technically demanding and time-consuming harvesting. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020. PMID: 33280115 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Amphotericin B, fluconazole, and nystatin as development inhibitors of Candida albicans biofilms on a dental prosthesis reline material: Analytical models in vitro.

p.aythelady61 shared this article with you from Inoreader Amphotericin B, fluconazole, and nystatin as development inhibitors of Candida albicans biofilms on a dental prosthesis reline material: Analytical models in vitro. Via Oral Mucositis Related Articles Amphotericin B, fluconazole, and nystatin as development inhibitors of Candida albicans biofilms on a dental prosthesis reline material: Analytical models in vitro. J Prosthet Dent. 2020 Dec 02;: Authors: Bassi RC, Boriollo MFG Abstract STATEMENT OF PROBLEM: The use of antifungals has been suggested during the treatment of denture stomatitis associated with Candida albicans biofilms. However, how time, material surface, and substrates present during adhesion and biofilm development can influence clinical treatment is unclear. PURPOSE: The purpose of this in vitro study was to investigate the growth kinetics of C. albicans biofilms on surfaces of specimens under the influence of adsorbed films and to evaluate the antibiofilm efficacy of antifungal agents: amphotericin B, fluconazole, and nystatin. MATERIAL AND METHODS: Specimens of Silagum-Comfort Soft Relining were submerged in preconditioning systems: phosphate-buffered saline, artificial saliva, fetal bovine serum, and artificial saliva+fetal bovine serum. Planktonic cells were incubated (phosphate-buffered saline+specimens) for 1.5 hours (adhesion phase) and washed with phosphate-buffered saline solution. The specimens were then incubated (YNB+glucose) for 8, 24, and 48 hours (initial, intermediate, and maturation phases). The biofilm sessile minimum inhibitory concentration was determined by the broth microdilution method (7.81 to 500 μg/mL). The metabolic activity of the biofilms was tested by colorimetric assay (cell metabolic activity). Cell viability, relative biomass (μm3), and the thickness of the biofilm (μm) were evaluated by confocal laser scanning microscopy. RESULTS: The highest bioactivity was recorded in the presence of fetal bovine serum. Biofilms treated with fluconazole and amphotericin B were partially inhibited in a dose-dependent manner. Nystatin inhibited metabolic activity mainly from ≥15.63 or 62.5 μg/mL. Variations in magnitude parameters (relative biomass and thickness) were observed depending on the development phases of biofilms, whereas biological parameters (percentage of nonviable cells) were constant throughout the formation of C. albicans biofilms. CONCLUSIONS: The data suggest that partial (fluconazole and amphotericin B) or more effective (nystatin) reduction of metabolic activity of C. albicans biofilms occurred depending on the time and the antifungal and its concentrations. PMID: 33279153 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiation Induced Mucositis: What the Radiologist Needs to Know.

p.aythelady61 shared this article with you from Inoreader Radiation Induced Mucositis: What the Radiologist Needs to Know. Via Oral Mucositis Related Articles Radiation Induced Mucositis: What the Radiologist Needs to Know. Curr Probl Diagn Radiol. 2020 Nov 15;: Authors: Rao D, Behzadi F, Le RT, Dagan R, Fiester P Abstract Radiation induced oral mucositis (RIOM) is a common and debilitating complication of radiation therapy for head and neck cancers. RIOM can lead to oral pain, dysphagia, and reduced oral intake, which can be severe enough to necessitate placement of a feeding tube or utilization of total parenteral nutrition. When severe, RIOM can cause premature termination of radiation therapy and can alter treatment plans leading to suboptimal treatment doses. While patient reporting of RIOM symptoms has been the gold standard of documenting RIOM progression, little has been described in the radiology literature concerning the typical imaging findings of RIOM. Herein, we review the pathophysiology and clinical presentation that underlies the development of RIOM with illustrative cases to highlight the relevant imaging findings related to RIOM for the practicing radiologist. PMID: 33279307 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of the Modena bleeding score in endoscopic sinus surgery.

p.aythelady61 shared this article with you from Inoreader Validation of the Modena bleeding score in endoscopic sinus surgery. Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Related Articles Validation of the Modena bleeding score in endoscopic sinus surgery. Braz J Otorhinolaryngol. 2020 Sep 30;: Authors: Alicandri-Ciufelli M, Pingani L, Maccarrone F, Anschuetz L, Mariano D, Galeazzi GM, Presutti L, Molinari G Abstract INTRODUCTION: The Modena bleeding score is a categorical rating scale that allows the assessment of the surgical field in relation to bleeding during endoscopic surgery. It has recently been presented and validated in the field of endoscopic ear surgery by the present authors. The Modena bleeding score provides five grades for rating the surgical field during endoscopic procedures (from grade 1 - no bleeding to grade 5 - bleeding that prevents every surgical procedure except those dedicated to bleeding control). OBJECTIVE: The aim of this study was to validate the Modena bleeding score in the setting of endoscopic sinus surgery. METHODS: Fifteen three-minute videos of endoscopic sinus surgery procedures (each containing three bleeding situations) were evaluated by 15 specialists, using the Modena bleeding score. Intra and inter-rater reliability were assessed, and the clinical validity of the Modena bleeding score was calculated using a referent standard. RESULTS: The data analysis showed an intra-rater reliability ranging from 0.6336 to 0.861. The inter-rater reliability ranged from 0.676 to 0.844. The clinical validity was α = 0.70; confidence limits: 0.64 - 0.75, corresponding to substantial agreement. CONCLUSION: The Modena bleeding score is an effective method to score bleeding during endoscopic sinus surgery. Its application in future research could facilitate the performance and efficacy assessment of surgical techniques, materials or devices aimed to bleeding control during endoscopic sinus surgery. PMID: 33279423 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy.

p.aythelady61 shared this article with you from Inoreader Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy. Via Larynx Related Articles Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy. Laryngoscope. 2020 Sep 10;: Authors: Lu YA, Pei YC, Chuang HF, Lin LY, Hsin LJ, Kang CJ, Huang SF, Chiang HC, Tsao CK, Fang TJ Abstract OBJECTIVE: Traditionally, after total laryngopharyngectomy (TLP), patients cannot speak without a prosthesis or an artificial larynx. In Taiwan, most patients use a commercialized pneumatic laryngeal device (PLD). Phonatory tube reconstruction with the anterolateral thigh (ALT) flap is a novel, modified version of synchronous digestive and phonatory reconstruction involving a free muscular cutaneous flap. This study reviewed and compared speech performance between patients who underwent novel flap reconstruction and conventional PLD users. METHOD: We retrospectively reviewed patients with laryngeal or hypopharyngeal cancer who underwent TLP from August 2017 to September 2019. The voice handicap index (VHI), speech intelligibility, acoustic and aerodynamic analysis results, and speech range profile (SRP) were compared between patients who underwent ALT phonatory tube reconstruction (ALT group) and those using PLDs (PLD group). RESULTS: Twenty patients were included; 13 patients were included in the ALT group, and 7 patients were included in the PLD group. Compared to the PLD group, the ALT group had a better fundamental frequency range (P < .001) and semitone range (P < .001) during speech but showed worse jitter, shimmer, and harmonic-to-noise ratios. The two groups showed comparable VHI and speech intelligibility performance. CONCLUSIONS: The ALT phonatory tube, a novel flap for reconstruction, can restore digestive and voice functions simultaneously. Compared with PLD use, ALT phonatory tube reconstruction yields an improved speech range and comparable levels of voice handicap and speech intelligibility, suggesting that the technique is a good alternative for patients after TLP. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020. PMID: 33280117 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric laryngeal tumors

p.aythelady61 shared this article with you from Inoreader Pediatric laryngeal tumors and demographics, management, and survival in laryngeal squamous cell carcinoma. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Pediatric laryngeal tumors and demographics, management, and survival in laryngeal squamous cell carcinoma. Int J Pediatr Otorhinolaryngol. 2020 Nov 18;140:110507 Authors: Forsyth AM, Camilon PR, Tracy L, Levi JR Abstract OBJECTIVES: To evaluate the prevalence and features of pediatric laryngeal malignancies and to review the demographics, management, and survival of pediatric patients with laryngeal squamous cell carcinoma as compared to adult patients. METHODS: Patients aged 0 (younger than 1) to 18 with laryngeal malignancy identified in the Surveillance, Epidemiology, and End Results (SEER) database were included from 1973 to 2016 published April 2019. Diagnosis of malignant laryngeal tumor was made using the 3rd edition of the International Classification of Diseases for Oncology (ICDO-3) code: C32.0 Glottis, C32.1 Supraglottis, C32.2Subglottis, andC32.9 Larynx primary site. RESULTS: 23 cases of pediatric laryngeal malignancies were identified. 16 cases were squamous cell carcinomas and 7 were other histologic types. Pediatric laryngeal SCC tended to be diagnosed in adolescence (mean age 14.8 years, range younger than 1 to 18, 82.6% of cases were age 12 and above). Management of laryngeal SCC included no recorded treatment (18.8%), primary radiation (18.8%), primary surgery (12.5%), radiation and surgery (25%), radiation and chemotherapy combined (18.8%), and surgery with radiation and chemotherapy (12.5%). Surgeries were local excision, excision and lymphnode dissection, as well as total laryngectomy, and not otherwise specified. The 2-year and 5-year overall and disease-specific survivals were 78.6%. CONCLUSIONS: Pediatric laryngeal cancer is rare. Squamous cell carcinoma is the most commonly diagnosed malignant laryngeal histology affecting pediatric patients. Despite different risk factors, survival rates remain similar for pediatric patients with laryngeal squamous cell carcinoma as compared to adults. Physicians should include laryngeal cancer in the differential for pediatric patients with hoarseness, dysphagia, and progressive airway obstruction to avoid a late diagnosis. PMID: 33279850 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population.

p.aythelady61 shared this article with you from Inoreader The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population. Via swallowing exercises Related Articles The Influence of Surface Electromyography Visual and Clinician Verbal Feedback on Swallow Effort Ratio at Different Bolus Volumes in a Healthy Population. Folia Phoniatr Logop. 2020 Dec 04;:1-6 Authors: Galek KE, Bice EM Abstract BACKGROUND/AIMS: The effortful swallow is a common treatment intervention requiring increased intensity to facilitate adaptations and modify swallow kinematics. The type of feedback and bolus volume provided may influence the intensity of the effortful swallow. To determine the increased effortful swallow intensity, a clinician can collect the peak amplitude of an effortful swallow and a typical swallow and compute a "swallow effort ratio" (SER). Dividing the effortful swallow surface electromyography (sEMG) peak amplitude by the typical swallow sEMG peak amplitude derives the SER. A higher SER suggests increased intensity. An increase in the SER may have clinical relevance in swallowing therapy as a threshold of intensity is required to elicit neuroplastic change. The purpose of this investigation was to determine whether sEMG visual and clinician verbal feedback increases the SER. Additionally, the investigation examined whether the SER is influenced by different liquid bol us volumes. METHODS: Eighty-two nondysphagic, healthy adults were assigned at random to 2 groups. One group received no feedback, and the other received verbal and visual feedback while performing typical and effortful swallows at 3 liquid volumes. RESULTS: An analysis of covariance compared the typical and effortful peak swallow amplitudes among 3 volumes in the 2 feedback groups. There was a significant effect on the peak amplitude values by feedback group F(2, 79) = 22.82, p < 0.001. There were no differences in peak amplitude by volume regardless of feedback F(2, 78) = 0.413, p = 0.663. CONCLUSION: It appears that sEMG visual and clinician verbal feedback increases the SER, which may be a surrogate for intensity. An increased SER may have a positive effect on swallow intervention as intensity is known to influence outcomes of exercise and elicit neuroplastic change. PMID: 33279898 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.