Improving Community Understanding of Lyme Disease Prevention and Treatment in the Age of Misinformation in Digital Media

Approximately 30,000 cases of Lyme disease are reported to the CDC annually, but the CDC estimates that 300,000 individuals in the US become infected. The average cost of Lyme disease is $3,000 per patient over the course of the disease costing the US healthcare system approximately$1 billion per year ($712m –$1.3b). An additional $1 billion is spent annually on treating post-treatment Lyme disease syndrome. Despite the prevalence of Lyme disease and the availability of credible patient education materials, misconceptions and knowledge gaps are still evident among community members, media sources, and some providers. There is a need for continued community education and recommendations for evidence-based treatment for this disease.https://scholarworks.uvm.edu/fmclerk/1705/thumbnail.jp

Sprouty Proteins Inhibit Receptor-mediated Activation of Phosphatidylinositol-specific Phospholipase C

PLCγ03B3 binds Spry1 and Spry2. Overexpression of Spry decreased PLCγ03B3 activity and IP3 and DAG production, whereas Spry-deficient cells yielded more IP3. Spry overexpression inhibited T-cell receptor signaling and Spry1 null T-cells hyperproliferated with TCR ligation. Through action of PLCγ03B3, Spry may influence signaling through multiple receptors

radiofrequency surgery in the otorhinolaryngologic districts

conference on head and neck cance

Head and neck immunoglobulin G4 related disease: systematic review

Immunoglobulin G4 related disease is a recently described systemic syndrome. The head and neck region is the second most common site for presentation after the pancreas. METHODS: PubMed and the Cochrane Library were searched from 1995 to July 2017 for all the studies on immunoglobulin G4 related disease diagnosed in the head and neck compartment. Patient-specific data were extracted and basic statistical analysis was performed. RESULTS: Ninety-one patients were identified. Treatment was specified in 76 patients. Twenty patients received surgical treatment, eight of them in association with medical therapy. Fifty-six patients received medical treatment. The disease recurred in 25 per cent of patients treated with surgical treatment alone, in 3.6 per cent of patients treated with medical treatment alone and in 12.5 per cent of patients treated with both. All medical treatment protocols contained high-dose corticosteroids. CONCLUSION: Early and correct diagnosis can avoid unnecessary surgical treatment, and glucocorticoid therapy can improve the long-term prognosi

Activated Kras, but Not Hras or Nras, May Initiate Tumors of Endodermal Origin via Stem Cell Expansion▿

The three closely related human Ras genes, Hras, Nras, and Kras, are all widely expressed, engage a common set of downstream effectors, and can each exhibit oncogenic activity. However, the vast majority of activating Ras mutations in human tumors involve Kras. Moreover, Kras mutations are most frequently seen in tumors of endodermally derived tissues (lung, pancreas, and colon), suggesting that activated Kras may affect an endodermal progenitor to initiate oncogenesis. Using a culture model of retinoic acid (RA)-induced stem cell differentiation to endoderm, we determined that while activated HrasV12 promotes differentiation and growth arrest in these endodermal progenitors, KrasV12 promotes their proliferation. Furthermore, KrasV12-expressing endodermal progenitors fail to differentiate upon RA treatment and continue to proliferate and maintain stem cell characteristics. NrasV12 neither promotes nor prevents differentiation. A structure-function analysis demonstrated that these distinct effects of the Ras isoforms involve their variable C-terminal domains, implicating compartmentalized signaling, and revealed a requirement for several established Ras effectors. These findings indicate that activated Ras isoforms exert profoundly different effects on endodermal progenitors and that mutant Kras may initiate tumorigenesis by expanding a susceptible stem/progenitor cell population. These results potentially explain the high frequency of Kras mutations in tumors of endodermal origin

How we improve the transoral resection for oral and oropharyngeal cancer: the CO2 waveguide laser

PURPOSE: The main aim of this study was to evaluate the CO2 waveguide laser (CO2 WGL) with flexible fiber (Lumenis, Santa Clara, CA) in the treatment of oral and oropharyngeal cancers specifically focusing on the lateral thermal damage (LTD) induced by this instrument and therefore on the reliability of the analysis of frozen sections collected during margin mapping. METHODS: A total of 48 patients with oral and oropharyngeal cancers from T1 to T4a were prospectively enrolled in the study. We collected data about LTD, pathologic tumor and node stage (pTNM), surgical intervention, kind of reconstruction (no flap, local vs free flap), need for tracheotomy and time of removal, postoperative complications (such as bleeding, mucosal dehiscence, and fistula), need for feeding tube and time of removal. RESULTS: Mean LTD was 164.7\u2009\ub1\u200992.4 \u3bcm. Comparing frozen section histology before and after formalin embedding we found 5 true positives, 170 true negatives, 4 false positives and 4 false negatives, with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 55.6%, 98%, 55.6%, 98%, and 96.1%, respectively. CONCLUSION: CO2 WGL is a very manageable tool, which allows a precise cut. However, its high costs, the inability to re-use the fibers and its low coagulation capability must be considered

Transoral surgery (TOS) in oropharyngeal cancer: Different tools, a single mini-invasive philosophy

Surgery with or without adjust therapy and radiotherapy with or without chemotherapy have traditionally represented the possible treatment option for oropharyngeal cancer- The adverse effects of non surgical treatment and recent technical innovations have prompted a new interest in the surgical approach. However parallel to the possibility of achieving radical cancer clearance, we should remember the impact that the traditional open surgery has on the patient's cosmoses, functionality and quality of life. As a result, transoral surgery is an attractive option for oropharyngeal tumors. The therm transoral surgery only indicates that the tumor is accessed and resected via the oral cavity, but the surgeon can choose among different resection methods such as transoral laser microsurgery, transoral robotic surgery, transoral videolaryngoscopic surgery, endoscopic larynx-pharingeal surgery, and ultrasound transoral surgery. The aim of this paper is to review the recent literature on the transoral treatment of oropharyngeal cancer to standardize the terminology of transoral procedures analyzing the common aspects, main difference and future perspectives of the various forms of transoral surgery