Ramsay Hunt syndrome : long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment

Purpose To determine the long-term facial palsy outcome of Ramsay Hunt Syndrome by face-to-face grading by House-Brackmann Grading System, Facial Nerve Grading System 2.0, and Sunnybrook Facial Grading System concomitantly. To compare the applicability of the grading scales. To compare patients' self-assessed facial palsy outcome results to gradings performed by the investigator. To compare the face-to-face assessed facial palsy outcome to the initial palsy grade. Methods Fifty-seven patients self-assessed their facial palsy outcome and came to a one-time follow-up visit. The palsy outcome was graded by one investigator using the three above-mentioned grading systems concomitantly. The median time from syndrome onset to follow-up visit was 6.6 years. Result A good long-term face-to-face assessed palsy outcome was enjoyed by 84% of the patients. Trying to assess only one House-Brackmann grade to represent the palsy outcome was impossible for most patients. Facial Nerve Grading System 2.0 worked better, but needed adjustments and certain sequelae findings needed to be neglected for it to be executable. The Sunnybrook system worked the best. Nearly 20% of the patients assessed themselves differently from the investigator: both better and worse. Conclusion The Sunnybrook scale was the most applicable system used. With antiviral medication, the outcome of facial palsy in Ramsay Hunt syndrome starts to resemble that of Bell's palsy and emphasizes the importance of recognizing the syndrome and treating it accordingly. The results give hope to patients instead of the gloomy prospects that have stigmatized the syndrome.Peer reviewe

Facial palsy in children : long-term outcome assessed face-to-face and follow-up revealing high recurrence rate

Purpose To evaluate the long-term (minimum of 2 years from the palsy onset) outcome of pediatric facial palsy by patient questionnaire and face-to-face assessment by the Sunnybrook facial grading system, House-Brackmann grading system, and Facial Nerve Grading System 2.0. To compare the outcome results of self-assessment with the face-to-face assessment. To assess the applicability of the grading scales. To assess the palsy recurrence rate (minimum of a 10-year follow-up). Methods 46 consecutive pediatric facial palsy patients: 38 (83%) answered the questionnaire and 25 (54%) attended a follow-up visit. Chart review of 43 (93%) after a minimum of 10 years for the facial palsy recurrence rate assessment. Results Of the 25 patients assessed face-to-face, 68% had totally recovered but 35% of them additionally stated subjective sequelae in a self-assessment questionnaire. Good recovery was experienced by 80% of the patients. In a 10-year follow-up, 14% had experienced palsy recurrence, only one with a known cause. Sunnybrook was easy and logical to use, whereas House-Brackmann and the Facial Nerve Grading System 2.0 were incoherent. Conclusions Facial palsy in children does not heal as well as traditionally claimed if meticulously assessed face-to-face. Patients widely suffer from subjective sequelae affecting their quality of life. Palsy recurrence was high, much higher than previously reported even considering the whole lifetime. Of these three grading systems, Sunnybrook was the most applicable.Peer reviewe

Ramsay Hunt syndrome : characteristics and patient self-assessed long-term facial palsy outcome

Purpose To explore the characteristics, medical treatments, and long-term facial palsy outcome in Ramsay Hunt syndrome. Methods Patient questionnaire including self-assessment of long-term facial palsy outcome and retrospective chart review. Initial facial palsy grade was compared to self-assessed or patient record stated palsy outcome. Occurrence of different characteristics (blisters, hearing loss, vertigo, etc.) of the syndrome were assessed. Results Altogether 120 patients were included of which 81 answered the questionnaire. All but one patient had received virus medication (aciclovir, valaciclovir), and half received simultaneous corticosteroids. If the medication was started within 72 h of Ramsay Hunt diagnosis, facial palsy recovered totally or with only slight sequelae in over 80% of the patients. Only a minority of the patients experienced varicella blisters simultaneously with facial palsy, blisters more often preceded or followed the palsy. Approximately 20% of the patients had their blisters in hidden places in the ear canal or mouth. Conclusions The long-term outcome of facial palsy in medically treated Ramsay Hunt syndrome was approaching the outcome of Bell's palsy. It is crucial to ask and inform the patient about the blisters and look for them since, more often than not, the blisters precede or follow the palsy and can be in areas not easily seen.Peer reviewe

Vuokra-asunto Helsingissä sijoituksena ja kotina. Vuokranantaja- ja vuokralaiskyselyn tulokset

Julkaisussa esitellään tuloksia tutkimuksesta, joka selvitti Helsingin vuokramarkkinoiden toimivuutta sekä vuokralaisten että vuokranantajien näkökulmasta. Tutkimus rajoittui vähemmän tutkittuihin markkinavuokraisiin eli muihin kuin valtion tukemiin arava- tai korkotukivuokra-asuntoihin, joiden merkitys etenkin kaupunkiseuduilla on suuri.  Selvitys tuo tietoa myös yksityisten vuokranantajien tuotto-odotuksista ja vuokraustoiminnan kokemuksista. Raportissa etsitään vastauksia mm. seuraaviin kysymyksiin: Millaisia ovat vuokra-asuntojen kysyjät, ja mikä on vaikuttanut vuokra-asunnon valintaan asumismuodoksi? Millaisia ovat vuokra-asukkaiden taloudelliset mahdollisuudet? Millaisia asuntoja halutaan käytettävissä olevilla tuloilla? Onko asuntojen varustetaso tarkoituksenmukainen? Kuinka suunnitelmallista toimintaa asuntosijoittaminen on? Millaiseen asuntoon vuokranantajan kannattaa sijoittaa

In vitro Effects of Bacterial Exposure on Secretion of Zonulin Family Peptides and Their Detection in Human Tissue Samples

Commercially available ELISAs for zonulin (pre-haptoglobin 2), a protein with tight junction regulatory activity in the epithelia, were recently shown to recognize other proteins that are structurally and functionally related to zonulin, termed zonulin family peptides (ZFPs). With little or no information about the identity and property of ZFPs, various commercial zonulin ELISA kits are widely utilized in research as a marker of intestinal permeability. Bacterial exposure is a known trigger for the secretion of zonulin, but it remains unclear whether distinct bacteria differ in their capability to stimulate zonulin secretion. We hypothesized that ZFPs are similar to zonulin regarding response to bacterial exposure and aimed to compare the effects of non-pathogenic, Gram-negative bacteria (Escherichia coli RY13 and E. coli K12 DH5α) and probiotic, Gram-positive bacteria (Lactobacillus rhamnosus GG and Bifidobacterium bifidum) on ZFP secretion in an in vitro model. Additionally, utilizing samples from human clinical trials, we correlated circulating levels of ZFPs to the gut bacteria and determined the presence of ZFPs in various human tissues. Unexpectedly, we found that the ZFPs quantified by the widely used IDK® Zonulin ELISA kits are specifically triggered by the exposure to live Lactobacillus rhamnosus GG in HT-29 cells, associated with absolute abundances of intestinal Lactobacillus and Bifidobacterium in adults, and are copious in the small intestine but undetectable in the liver or adipose tissue. These characteristics appear to be different from zonulin and highlight the need for further characterization of ZFPs recognized by commercially available and widely used “zonulin” ELISAs.Peer reviewe

NÄKÖKULMIA AVOIMEEN DATAAN – YLIOPISTON ROOLI TOIMIVAMMAN ARJEN JA PAREMPIEN PALVELUJEN KEHITTÄMISESSÄ KANSALAISILLE

Turun yliopistossa on meneillään All Eyes on Data -keskustelusarja, jonka puitteissa käsitellään datanhallintaa, analysointia ja hyödyntämistä monista eri näkökulmista. Yliopistoissa tuotettujen tutkimusaineistojen hyödyntäminen liiketoiminnan kehittämisessä nousi teemaksi viime vuoden joulukuun avoimessa tilaisuudessa, johon osallistui noin 80 henkeä korkeakouluista, yrityksistä ja kuntasektorilta. Tilaisuudessa haastettiin tutkijoita pohtimaan, millainen rooli heidän tutkimusaineistollaan voisi olla toimivamman arjen ja laadukkaampien palvelujen ja tuotteiden kehittämisessä kansalaisille

Näkökulmia avoimeen dataan - Yliopiston rooli toimivamman arjen ja parempien palvelujen kehittämisessä kansalaisille

Turun yliopistossa on meneillään All Eyes on Data -keskustelusarja, jonka puitteissa käsitellään datanhallintaa, analysointia ja hyödyntämistä monista eri näkökulmista. Yliopistoissa tuotettujen tutkimusaineistojen hyödyntäminen liiketoiminnan kehittämisessä nousi teemaksi viime vuoden joulukuun avoimessa tilaisuudessa, johon osallistui noin 80 henkeä korkeakouluista, yrityksistä ja kuntasektorilta. Tilaisuudessa haastettiin tutkijoita pohtimaan, millainen rooli heidän tutkimusaineistollaan voisi olla toimivamman arjen ja laadukkaampien palvelujen ja tuotteiden kehittämisessä kansalaisille.</p

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival