Success of minimally invasive salivary gland surgery-Quality of life, prognostic factors

Objective Goal of this study was to investigate, whether sialendoscopy in obstructive salivary gland disorders affects patients' oral health-related quality of life compared to healthy individuals, and to determine factors that might influence this relationship. Study design Retrospective observational study. Setting University of Kiel, Department of Otorhinolaryngology, Head and Neck Surgery. Subjects and methods A group of 130 patients, undergoing sialendoscopy between 01/2004 and 06/2017 was considered. Oral health-related quality of life was assessed using the OHIP-G14 (Oral Health Impact Profile) in combination with a custom-made questionnaire on satisfaction and success in relation to sialendoscopy. Results Oral health-related quality of life of patients without dentures or with removable dentures was significantly worse than in the healthy population, whereas the necessity of multiple additional follow-up treatments was associated with worse oral health-related quality of life. No essential predisposing factors were identified. Average satisfaction with the intervention was observed to be x̅ = 4.33 (SD = 3.69) on a visual analogue scale from 1 (=very satisfied) to 10 (=very unsatisfied). A longer follow-up period and a higher patients' age were positively related, whereas removal of salivary gland during follow-up was negatively related to satisfaction. In 113 cases (86.9%) long-term preservation was accomplished and 115 (88.5%) patients would repeat a sialendoscopy in case needed. Conclusion In summary, sialendoscopy resulted in long-term high subjective and objective success rates. However, oral health-related quality of life scores did not reach those levels found in the healthy population

Growth variability of the Greenland smoothcockle Serripes groenlandicus (Brugiere 1789) affected by glacier induced changes in the Kongsfjorden ecosystem

Climate change forces retreat of Arctic glaciers and release of increased quantities of melt water and terrigenous material into coastal habitats of the Arctic such as the Kongsfjorden Ecosystem. The effect of this glacier induced physical parameters on growth and abundance of the Greenland smoothcockle (Serripes groenlandicus, Bruguière 1798) were determined. Along Kongsfjorden, at five stations with increasing distance to the Kongsbreen glacier, specimen of the cockle were collected and physical parameters were measured. Effects on growth of S. groenlandicus were analyzed by measuring variability of annual increments obtained from cockles’ thin section. Towards the glacier front temperature and Chlorophyll a content of the water column decreased, whereas total suspended matter and sedimentation rates increased. Regression analysis revealed lowest growth rate at the station close to Kongsbreen. Average standard growth index (SGI) of S. groenlandicus was lowest at this station (-0.4884±0.1763 95%CI), highest at Ny Alesund (0.1523±0.1158 95%CI), and decreased towards the mouth of Kongsfjorden (-0.0217±0.0718 95%CI and -0.1310±0.0759 95%CI, respectively at the two outer stations). Multi regression analysis revealed a strong relationship between average SGI and temperature (P<0.001, R²=0.75) as well as total sedimented material (P=0.018, R²=0.80)

Validation of the EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis by disease content experts

The European League Against Rheumatism recommendations for the management of antineutrophil cytoplasmic antibody-associated vasculitis have been recently published. Unique to recommendation development, they were also voted on by members of a learned society. This paper explores the wider validity of the recommendations among people who self-identify as clinicians caring for patients with vasculitis. In addition to the task force, a learned society (European Vasculitis Society-EUVAS) was invited, through online survey, to rate independently the strength of evidence of each recommendation to obtain an indication of the agreement among the final target audience and ultimate end-users of the recommendations. The survey took place in June 2015. Of the 158 EUVAS members surveyed, there were 88 responses (55.7%). There was a large degree of agreement in the voting patterns between EUVAS survey participants and task force members. Notable exceptions were lower grades for the recommendation of the use of rituximab for remission induction in patients with eosinophilic granulomatosis with polyangiitis and for methotrexate and mycophenolate mofetil as remission maintenance agents in patients with granulomatosis with polyangiitis/microscopic polyangiitis by EUVAS members. These results are encouraging and suggest that the voting patterns of the task force are representative of the wider vasculitis community. We recommend future recommendations adopt this approach for data/expert-based treatment guidelines, especially for multisystem diseases

Validation of the EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis by disease content experts.

The European League Against Rheumatism recommendations for the management of antineutrophil cytoplasmic antibody-associated vasculitis have been recently published. Unique to recommendation development, they were also voted on by members of a learned society. This paper explores the wider validity of the recommendations among people who self-identify as clinicians caring for patients with vasculitis. In addition to the task force, a learned society (European Vasculitis Society-EUVAS) was invited, through online survey, to rate independently the strength of evidence of each recommendation to obtain an indication of the agreement among the final target audience and ultimate end-users of the recommendations. The survey took place in June 2015. Of the 158 EUVAS members surveyed, there were 88 responses (55.7%). There was a large degree of agreement in the voting patterns between EUVAS survey participants and task force members. Notable exceptions were lower grades for the recommendation of the use of rituximab for remission induction in patients with eosinophilic granulomatosis with polyangiitis and for methotrexate and mycophenolate mofetil as remission maintenance agents in patients with granulomatosis with polyangiitis/microscopic polyangiitis by EUVAS members. These results are encouraging and suggest that the voting patterns of the task force are representative of the wider vasculitis community. We recommend future recommendations adopt this approach for data/expert-based treatment guidelines, especially for multisystem diseases

Validation of the EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis by disease content experts

The European League Against Rheumatism (EULAR) recommendations for the management of small-vessel and medium-vessel vasculitides were recently updated, with a focus on antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis, and were coendorsed by the European Renal Association-European Dialysis and Transplant Association and European Vasculitis Society (EUVAS).1 The process for formation of such recommendations follows a standard methodology.2 3 Since ANCA-associated vasculitis can present to physicians from a wide range of specialities, a task force was convened with representation from different subspecialisations. Standard practice for voting on the recommendations was followed but, for the first time, they were also voted on by members of a learnt society, which in this case was the EUVAS. EUVAS allows members to join the Society from around the world and as such is an open collaboration of physicians which aims to promote research and education in vasculitis. Results from the Canadian Vasculitis Network revealed significant variations in practice highlighting the need for evidence-based management recommendations for ANCA-associated vasculitis.4 In addition, the publication of large collaborative trials, involving patients with ANCA-associated vasculitis, has advanced the evidence from which conclusions on treatment can be drawn. This paper explores the wider validity of the recommendations among people who self-identify as clinicians caring for patients with vasculitis

ANCA-associated vasculitis.

The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of disorders involving severe, systemic, small-vessel vasculitis and are characterized by the development of autoantibodies to the neutrophil proteins leukocyte proteinase 3 (PR3-ANCA) or myeloperoxidase (MPO-ANCA). The three AAV subgroups, namely granulomatosis with polyangiitis (GPA), microscopic polyangiitis and eosinophilic GPA (EGPA), are defined according to clinical features. However, genetic and other clinical findings suggest that these clinical syndromes may be better classified as PR3-positive AAV (PR3-AAV), MPO-positive AAV (MPO-AAV) and, for EGPA, by the presence or absence of ANCA (ANCA+ or ANCA-, respectively). Although any tissue can be involved in AAV, the upper and lower respiratory tract and kidneys are most commonly and severely affected. AAVs have a complex and unique pathogenesis, with evidence for a loss of tolerance to neutrophil proteins, which leads to ANCA-mediated neutrophil activation, recruitment and injury, with effector T cells also involved. Without therapy, prognosis is poor but treatments, typically immunosuppressants, have improved survival, albeit with considerable morbidity from glucocorticoids and other immunosuppressive medications. Current challenges include improving the measures of disease activity and risk of relapse, uncertainty about optimal therapy duration and a need for targeted therapies with fewer adverse effects. Meeting these challenges requires a more detailed knowledge of the fundamental biology of AAV as well as cooperative international research and clinical trials with meaningful input from patients

Associational resistance of fouled blue mussels (Mytilus edulis) against starfish (Asterias rubens) predation: relative importance of structural and chemical properties of the epibionts

Several epibiotic species reduce starfish (Asterias rubens) preference for the blue mussel Mytilus edulis in the Baltic. The aim of this study was to reveal whether this associational resistance was caused by structural or chemical aspects of the different epibionts. To assess structural epibiont effects, an in situ experiment was conducted with unfouled mussels and mussels equipped with artificial epibionts ('dummies') exposed to natural predation by A. rubens. The chemically inert dummies closely matched the structural properties of the locally common epibionts Balanus improvisus (barnacle), Ceramium strictum (red alga), Halichondria panicea (sponge), and Laomedea flexuosa (hydrozoan). Starfish fed indiscriminately in all treatments. Chemical effects of epibionts on the attractiveness of mussels for A. rubens were investigated by incorporating freeze-dried epibionts or mussel tissue into Phytagel pellets at natural concentrations. Starfish were allowed to choose among these structurally similar but chemically different prey items in an in vitro experiment. The predators exhibited significant preferences among the food pellets, which closely matched their preferences for corresponding natural mussel-epibiont associations. Thus, chemical aspects of epibionts appear to play a larger role in this associational resistance than do structural aspects. Implications of these indirect interactions for benthic communities are discussed

Hard-bottom succession of subtidal epibenthic communities colonizing hidden and exposed surfaces off northern Chile

The biodiversity of hard-bottom substrata comprises species growing on exposed rock and in hidden microhabitats, such as cracks and crevices. This study examines the succession of epibenthic organisms colonizing an artificial substratum with one surface exposed and one surface hidden on a vertical wall off northern Chile. On each sampling date species coverage of three replicate panels on both surfaces was assessed. The hidden surface was dominated in terms of coverage by the bryozoans Membranipora isabelleana and Lagenicella variabilis, while algae were absent. In contrast, the exposed surface was dominated by encrusting red corallines and the red alga Rhodymenia corallina. At the end of the experimental period both surfaces were dominated by colonial suspension feeders, but showed a different community structure and successional pattern. On the exposed surface, competitive exclusion was identified as an important aspect of succession, whereas on the hidden surface this pattern was not observed. These findings have implications for overall biodiversity, because pioneer species that are not able to survive long periods on exposed surfaces become restricted to hidden surfaces, from where they spread laterally. Thus, hidden microhabitats provide refuges for certain species, and may play an important role in the overall succession on rock faces. We conclude that examination of hidden microhabitats is necessary in order to fully understand succession in hard-bottom habitats

Indirect Effects of Epibiosis on Host Mortality: Seastar Predation on Differently Fouled Mussels

In situ experiments were run with the seastar Asterias rubens to investigate the influence of epibiosis on predation preferences. Mussels (Mytilus edulis) monospecifically fouled by different epibiont species (the barnacle Balanus improvisus, the red filamentous alga Ceramium strictum, the sponge Halichondria panicea and the hydrozoan Laomedea flexuosa) and macroscopically clean mussels were exposed and seastar predation was monitored by SCUBA. Asterias rubens preferred macroscopical unfouled mussels as prey. Fouling generally reduced predation pressure on the mussel hosts (associational resistance). Barnacles protected mussels less efficiently than hydrozoans or algae. We hypothesize that in top-down controlled communities this influence of epibiosis on predation pressure should affect mussel community patterns. A survey of natural mussel epibiont distribution in the presence or absence of A. rubens showed that the prevalence of differently fouled mussels differed between predation-exposed and predation-protected habitats. Natural mussel-epibiont associations reflected the preferential predation of the major local predators. Additionally, higher epibiotic diversity and evenness could be observed at locations accessible to benthic predators as compared with habitats protected from predation. As blue mussels and seastars are important structuring and controlling elements in the shallow water community of Kiel Fjord, major consequences of epibiosis on the entire system are discussed