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Δευτέρα 8 Μαρτίου 2021

Keratinocyte‐derived IL‐1β induces PPARG down‐regulation and PPARD up‐regulation in

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Abstract

Peroxisome proliferator‐activated receptors (PPARs) are a family of nuclear hormone receptors. In skin, PPARs modulate inflammation, lipid synthesis, keratinocyte differentiation and proliferation and thus are important for skin barrier homeostasis. Accordingly, PPAR expression is altered in various skin conditions that entail epidermal barrier impairment i.e. atopic dermatitis (AD) and psoriasis. Using human epidermal equivalents (HEEs) we established models of acute epidermal barrier impairment devoid of immune cells. We assessed PPAR and cytokine expression after barrier perturbation and examined effects of keratinocyte‐derived cytokines on PPAR expression. We show that acetone or SDS treatment causes graded impairment of epidermal barrier function. Furthermore, we demonstrate that besides IL‐1β and TNFα, IL‐33 and TSLP are highly relevant markers for acute epidermal barrier impairment. Both SDS‐ and acetone‐mediated epidermal barrier impairment reduce PPARG expression levels, whereas only SDS enhances PPARD expression. In line with findings in IL‐1β and TNFα treated HEEs, abrogation of IL‐1 signaling restores PPARG expression and limits the increase of PPARD expression in SDS‐induced epidermal barrier impairment. Thus, following epidermal barrier perturbation, keratinocyte‐derived IL‐1β and partly TNFα modulate PPARG and PPARD expression. These results emphasize a role for PPARγ and PPARβ/δ in acute epidermal barrier impairment with possible implications for diseases such as AD and psoriasis.

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Head and neck cancer and non‐steroidal anti‐inflammatory drugs: Systematic review and meta‐analysis

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Abstract

The objective was to assess the effects of non‐steroidal anti‐inflammatory drugs (NSAIDs) on head and neck cancer (HNC) outcomes. A systematic review was conducted following the PRISMA guidelines. The MEDLINE and the Cochrane Central Register databases were searched. Risk of bias was assessed by the Cochrane Collaboration's tool and by the Newcastle‐Ottawa Scale. Meta‐analyses were performed with the RevMan software. Seventeen articles met the inclusion criteria. Quality scores for observational studies ranged between 5 and 8 stars and the RCT was assessed as high risk of bias. NSAIDs use was associated with a 13% risk reduction of HNC (OR: 0.87 95% CI 0.77–0.99). NSAIDs use was associated with a 30% reduced cancer‐specific mortality and with a 40% decreased risk on disease‐recurrence. NSAIDs may have a modest protective effect on HNC risk and a positive impact on cancer‐specific survival and disease‐recurrence. The findings do not support a protective role of as pirin on HNC outcomes.

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Multi-Detector CT Instillation Dacryocystography and Its Role in the Diagnosis of Lacrimal Drainage System Blocks

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Abstract

To assess the use of Multi-detector computed tomography instillation dacryocystography (MDCT-DCG) and its role in the diagnosis of lacrimal drainage system (LDS) blocks. It is a prospective evaluation of Twenty-five cases presenting with symptoms with NLDO (nasolacrimal duct obstruction) assessed by MDCT-DCG. The study was conducted in LN medical college and JK hospital Bhopal (M.P) territory centre between January 2016 and January 2017. Various levels of LDS obstruction were detected, Lower canaliculus 12% common canaliculus in 20% patients, lacrimal sac in 12% junction between lacrimal sac and NLD in 40% and NLD obstruction in 16% patients. The most common CTDCG findings were dilated opacified lacrimal sac with no opacification of the nasolacrimal duct (NLD) in 40% patients. CTDCG is a non-invasive, quick, patient friendly, indispensable in the assessment of NLDO procedure that adds benefit in documentation and preoperative planning.

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Incidence and Clinical Analysis of Complications of Neck Dissection

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Abstract

The aim of the study was to assess and evaluate the incidence of complications related to type of neck dissection to different variables. Retrospective study was conducted on patients who reported to our craniofacial centre between 2010 and 2019 and underwent neck dissection for evaluation of complications related to it. Records of all patients were analysed for complications which were alienated into intra-operative, immediate post-operative (within 10 days) and post-operative complications. 256 patients, 141 male and 115 female aged between 25 and 70 years operated for squamous cell carcinoma were included. The overall incidence of complications was 32.8%. Intra-operative complications were haemorrhage 14%, nerve injury 5.4%, inadvertent internal jugular vein ligation 0.3%, chyle leak 0.3%. No incidence of carotid blow out. Immediate post-operative complications were hematoma formation 7%, salivary fistula in 2.3% and re-exploration was done in 1.5% c ases. Post-operative complications noted were wound dehiscence in 22.6%, infection in 20.7%, hematoma in 2.7%, salivary fistula in 11.7% and nerve injury in 0.3% cases. Neck dissection is a challenging and therapeutic procedure. Prevention of major complications like carotid blow-out, injury to brachial plexus, vagus nerve or hypoglossal nerve requires thorough knowledge of neck anatomy.

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Allergische Reaktionen auf COVID-19-Impfungen – Was HNO-Ärzte wissen sollten – Teil 1: Immunologische Grundlagen von Allergien auf Impfstoffe, Immunmechanismen von allergischen und pseudoallergischen Reaktionen; Teil 2: Charakteristika der mRNA-Impfstoffe BNT162b2- und mRNA-1273 zur Prophylaxe von COVID-19 und assoziierte Immunphänomene; Teil 3: Praktische Aspekte der Prophylaxe, Diagnostik und Therapie von Allergien auf COVID-19-Impfstoffe

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Laryngorhinootologie
DOI: 10.1055/a-1397-0754

Obwohl allergische Reaktionen auf mRNA-COVID-19-Impfstoffe selten sind, ist durch die hohe Zahl der durchzuführenden Impfungen mit Anaphylaxien bei Personen zu rechnen, die zuvor auf Impfstoffkomponenten sensibilisiert wurden. Dargelegt werden hier praktische Aspekte zu diagnostischen Möglichkeiten, zur Prävention, zum Erkennen und zur Therapie einer anaphylaktischen Reaktion. Risikopopulationen, die nicht geimpft werden sollten oder die eine allergologische Abklärung vor Impfung benötigen, werden besprochen. Patienten mit Allergien des atopischen Formenkreises sowie Insektengiftallergiker zeigen aus allergologischer Sicht kein erhöhtes Risiko für eine Anaphylaxie durch eine COVID-Impfung.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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

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Direct Tissue PCR and Genotyping for Species Identification in a Case of Laryngeal Blastomycosis

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Ear Nose Throat J. 2021 Mar 8:145561321991342. doi: 10.1177/0145561321991342. Online ahead of print.

ABSTRACT

Otolaryngologic manifestations of infection with Blastomyces species are extremely rare and restricted geographically to recognized endemic regions. Here, we describe a case of laryngeal blastomycosis that presented as slowly progressive dysphonia. While a preliminary diagnosis was made using routine histopathology, a species identification of Blastomyces d ermatitidis was made using polymerase chain reaction amplification and rapid genotyping without the need for fungal culture. All symptoms resolved following 1 month of antifungal therapy. Rapid molecular differentiation of B dermatitidis from Blastomyces gilchristii provides important insights into pathogenesis given recent recognition of differences in clinical spectra.

PMID:33683980 | DOI:10.1177/0145561321991342

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Cochlear Nerve Canal Stenosis: Association With MYH14 and MYH9 Genes

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Ear Nose Throat J. 2021 Mar 8:145561321996839. doi: 10.1177/0145561321996839. Online ahead of print.

ABSTRACT

The bony cochlear nerve canal transmits the cochlear nerve as it passes from the fundus of the internal auditory canal to the cochlea. Stenosis of the cochlear nerve canal, defined as a diameter less than 1.0 mm in transverse diameter, is associated with inner ear anomalies and severe to profound congenital hearing loss. We describe an 11-month-old infant with nonsyn dromic congenital sensorineural hearing loss with cochlear nerve canal stenosis. Next-generation sequencing revealed heterozygous mutations in MYH9 and MYH14, encoding for the inner ear proteins myosin heavy chain IIA and IIC. The patient's hearing was rehabilitated with bilateral cochlear implantation.

PMID:33683976 | DOI:10.1177/0145561321996839

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Solitary Fibrous Tumor of the External Auditory Canal

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Ear Nose Throat J. 2021 Mar 8:145561321997539. doi: 10.1177/0145561321997539. Online ahead of print.

ABSTRACT

Solitary fibrous tumors (SFTs) originating from the external auditory canal are uncommon; only few cases have been reported in the literature. In this article, we report a case of a 35-year-old man who presented with a 6-month history of a gradual swelling in the entrance of the left external auditory meatus associated with hearing loss. The tumor was surgically remo ved, and histological examination showed spindle-cell proliferation with a collagenous stroma. Immunohistochemically, the tumor cells were positive for CD34 confirming the diagnosis of an SFT. Although SFTs are benign, complications such as relapses and metastasis after excision were reported. Thus, a careful and long follow-up is recommended.

PMID:33683977 | DOI:10.1177/0145561321997539

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Use of Off-Label Nasal Steroid Irrigations in Long-Term Management of Chronic Rhinosinusitis

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Ear Nose Throat J. 2021 Mar 8:145561321998521. doi: 10.1177/0145561321998521. Online ahead of print.

ABSTRACT

OBJECTIVE: Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinuses and mucosa. Topical nasal corticosteroids are a mainstay treatment for CRS by reducing sinonasal inflammation and improving mucociliary clearance. However, topical corticosteroids have limited paranasal distribution, and patient response to treatment has been variable in rando mized controlled trials (RCT). Thus, there is significant interest in evaluating the efficacy of nasal steroids delivered by nasal irrigation in order to improve penetration and absorption of topical steroids into the sinonasal mucosa. In this review, we discuss the use of off-label nasal steroid irrigations in the management of CRS.

METHODS: A review of clinical trials evaluating the use of nasal steroid irrigations for CRS in the PubMed electronic database was performed.

RESULTS: Of the 12 clinical studies identified, 10 evaluated budesonide irrigations while the remaining 2 focused on mometasone. The overwhelming majority of studies for both budesonide and mometasone supported the use of nasal irrigations with corticosteroids over nasal corticosteroid sprays alone. However, the heterogeneity in study design, patient cohort, and volume of steroid irrigation limit the interpretations of these studies.

CONCLUSIONS: Nasal irrigation with corticosteroids is beneficia l and safe for the treatment of CRS. Future RCTs controlling for type of surgical intervention, CRS pheno- and endo-type, as well as dosing and duration of nasal corticosteroid irrigations are warranted.

PMID:33683979 | DOI:10.1177/0145561321998521

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Reconstruction of Anterior Mandibular Defect Using Submental Island Flap Pedicled With Mental Artery

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Ear Nose Throat J. 2021 Mar 8:145561320987039. doi: 10.1177/0145561320987039. Online ahead of print.

ABSTRACT

Gingival carcinoma is a common malignant tumor occurring in the anterior area of the mandible, which can be derived from the epithelium of gingival mucosa. Surgical extended resection is the main treatment of gingival cancer, which can lead to anterior mandibular defect including mouth floor and mandible and mucosa of lower lip. According to the size of the defect, t he common repair method is free musculocutaneous flap with vascular pedicle or pedicle flap. We present a method of repairing mandibular anterior tooth defect with an island flap pedicled with the mental artery.

PMID:33683978 | DOI:10.1177/0145561320987039

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Patients with non-idiopathic sudden sensorineural hearing loss show hearing improvement more often than patients with idiopathic sudden sensorineural hearing loss

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Eur Arch Otorhinolaryngol. 2021 Mar 8. doi: 10.1007/s00405-021-06691-y. Online ahead of print.

ABSTRACT

INTRODUCTION: To compare inpatient treated patients with idiopathic (ISSNHL) and non-idiopathic sudden sensorineural hearing loss (NISSNHL) regarding frequency, hearing loss, treatment and outcome.

METHODS: All 574 inpatient patients (51% male, median age: 60 years) with ISSNHL and NISSNHL, who were treated in federal state Thuringia in 2011 and 2012, were included retrospectively. Univariate and multivariate statistical analyses were performed.

RESULTS: ISSNHL was diagnosed in 490 patients (85%), NISSNHL in 84 patients (15%). 49% of these cases had hearing loss due to acute otitis media, 37% through varicella-zoster infection or Lyme disease, 10% through Menière disease and 7% due to other reasons. Patients with ISSNHL and NISSNHL showed no difference between age, gender, side of hearing loss, presence of tinnitus or ve rtigo and their comorbidities. 45% of patients with ISSNHL and 62% with NISSNHL had an outpatient treatment prior to inpatient treatment (p < 0.001). The mean interval between onset of hearing loss to inpatient treatment was shorter in ISSNHL (7.7 days) than in NISSNHL (8.9 days; p = 0.02). The initial hearing loss of the three most affected frequencies in pure-tone average (3PTAmax) scaled 72.9 dBHL ± 31.3 dBHL in ISSNHL and 67.4 dBHL ± 30.5 dBHL in NISSNHL. In the case of acute otitis media, 3PTAmax (59.7 dBHL ± 24.6 dBHL) was lower than in the case of varicella-zoster infection or Lyme disease (80.11 dBHL ± 34.19 dBHL; p = 0.015). Mean absolute hearing gain (Δ3PTAmaxabs) was 8.1 dB ± 18.8 dB in patients with ISSNHL, and not different in NISSNHL patients with 10.2 dB ± 17.6 dB. A Δ3PTAmaxabs ≥ 10 dB was reached in 34.3% of the patients with ISSNHL and to a significantly higher rate of 48.8% in NISSNHL patients (p = 0.011).

CONCLUSIONS: ISSN HL and NISSNHL show no relevant baseline differences. ISSNHL tends to have a higher initial hearing loss. NISSHNL shows a better outcome than ISSNHL.

PMID:33683448 | DOI:10.1007/s00405-021-06691-y

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