825 research outputs found

    Botulinum toxin therapy: functional silencing of salivary disorders.

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    Botulinum toxin (BTX) is a neurotoxic protein produced by Clostridium botulinum, an anaerobic bacterium. BTX therapy is a safe and effective treatment when used for functional silencing of the salivary glands in disorders such as sialoceles and salivary fistulas that may have a post-traumatic or post-operative origin. BTX injections can be considered in sialoceles and salivary fistulas after the failure of or together with conservative treatments (e.g. antibiotics, pressure dressings, or serial aspirations). BTX treatment has a promising role in chronic sialadenitis. BTX therapy is highly successful in the treatment of gustatory sweating (Frey\u2019s syndrome), and could be considered the gold standard treatment for this neurological disorder

    Parotid fistula secondary to suppurative parotitis in a 13-year-old girl: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>The most common cause of parotid fistula is trauma, followed by malignancy, operative complications (parotidectomy or rhytidectomy) and infection. Acute suppurative parotitis can rarely produce parotid fistula. There are various treatment options available, however it is necessary to standardize the treatment according to the duration of history and the patient's general condition.</p> <p>Case report</p> <p>A 13-year-old Indo-Caucasian girl presented to us with a two-year history of clear watery discharge from a wound just above and behind the angle of her right jaw. A diagnosis of salivary (parotid) fistula was made based on clinical examination and investigations. The parotid fistula was successfully managed.</p> <p>Conclusion</p> <p>Parotid fistula secondary to suppurative parotitis is rare and difficult to manage successfully. Meticulous dissection, complete excision of the fistulous tract with closure of the parotid fascia and layered closure of the incision followed by application of a post-operative pressure bandage, anticholinergic agents and antibiotics contribute significantly to the successful management of this difficult clinical condition.</p

    ANSYS HFSS as a new numerical tool to study wave propagation inside anisotropic magnetized plasmas in the Ion Cylotron Range of Frequencies

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    The paper demonstrates the possibility to use ANSYS HFSS as a versatile simulating tool for antennas facing inhomogeneous anisotropic magnetized plasmas in the Ion Cyclotron Range of Frequencies (ICRF). The methodology used throughout the paper is first illustrated with a uniform plasma case. We then extend this method to 1D plasma density profiles where we perform a first benchmark against the ANTITER II code. The possibility to include more complex phenomena relevant to the ICRF field in future works like the lower hybrid resonance, the edge propagation of slow waves, sheaths and ponderomotive forces is also discussed. We finally present a 3D case for WEST and compare the radiation resistance calculated by the code to the experimental data. The main result of this paper - the implementation of a cold plasma medium in HFSS - is general and we hope it will also benefit to research fields besides controlled fusion.Comment: 15 pages, 14 figure

    Ion cyclotron resonance heating scenarios for DEMO

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    International audienceThe present paper offers an overview of the potential of ion cyclotron resonance heating (ICRH) or radio frequency (RF) heating for the DEMO machine. It is found that various suitable heating schemes are available. Similar to ITER and in view of the limited bandwidth of about 10M Hz that can be achieved to ensure optimal functioning of the launcher, it is proposed to make core second harmonic tritium heating the key ion heating scheme, assisted by fundamental cyclotron heating 3 He in the early phase of the discharge; for the present design of DEMO-with a static magnetic field strength of B o = 5.855T-that places the T and 3 He layers in the core for f = 60M Hz and suggests to center the bandwidth around that main operating frequency. In line with earlier studies for hot, dense plasmas in large-size magnetic confinement machines it is shown that good single pass absorption is achieved but that the size as well as operating density and temperature of the machine cause the electrons to absorb a non-negligible fraction of the power away from the core when core ion heating is aimed at. Current drive and alternative heating options are briefly discussed and a dedicated computation is done for the traveling wave antenna, proposed for DEMO in view of its compatibility with substantial antenna-plasma distances. The various tasks that ICRH can fulfill are briefly listed. Finally, the impact of transport and the sensitivity of the obtained results to changes in the machine parameters is commented on

    Correlation between Apnea Severity and Sagittal Cephalometric Features in a Population of Patients with Polysomnographically Diagnosed Obstructive Sleep Apnea

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    Background and Objective: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder featuring a repeated closure of the upper airway during sleep. Craniofacial anatomy is a potential risk and worsening factor for OSA. This study aims to assess the relationship between cephalometric features of craniofacial morphology and OSA severity in a population of patients with OSA. Material and Methods: A sample of forty-two patients (n = 42, M = 76%, mean age = 57.8 ± 10.8) with a polysomnographically (PSG) confirmed diagnosis of OSA were recruited and underwent cephalometric evaluation of 16 cephalometric variables. In addition, the apnea–hypopnea index (AHI), oxygen desaturation (SatMin), Epworth sleepiness scale (ESS), and body mass index (BMI) were assessed. Then t-tests were performed to compare the values of all cephalometric variables between two AHI severity-based groups (mild-to-moderate = AHI ≤ 30; severe = AHI &gt; 30). Single- and multiple-variable regression analyses were performed to assess the associations between AHI scores and cephalometric features. Results: Mean AHI, SatMin, and BMI were 31.4 ev/h, 78.7%, and 28.1, respectively. The cephalometric variables were not significantly different between the two OSA-severity groups (p &gt; 0.05). Multiple-variable regression analyses showed that gonial angle and nasopharynx space were negatively associated with AHI, explaining 24.6% of the total variance. Conclusion: This investigation reported that severity of AHI scores in patients with OSA showed a negative correlation with gonial angle and nasopharynx space. As a general remark, although maxillofacial anatomy can be a predisposing factor for OSA, disease severity depends mainly upon other variables

    Predittori di efficacia nel trattamento dell'otite esterna maligna fungina: una review sistematica

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    Obiettivo dello studio è stato riassumere i dati della letteratura sugli aspetti clinici e la gestione abituale dell’otite esterna maligna fungina (OEMF), ed identificare possibili fattori predittivi di esito positivo del trattamento. Gli articoli sono stati inizialmente selezionati sulla base del titolo e degli abstract. Sono poi stati recuperati ed analizzati per intero seguendo criteri predeterminati. È stata stilata una lista di riferimento degli articoli selezionati per cercare eventuali pubblicazioni mancati. Gli studi raccolti sono stati infine valutati metodologicamente. Dei 143 articoli iniziali, ne sono stati selezionati 14 focalizzati sulla gestione dell’OEMF. La maggior parte di questi ha dimostrato una correlazione tra l’efficacia del trattamento, inteso come risoluzione dei sintomi, ed alcune variabili cliniche e di gestione della patologia quali l’astensione da procedure chirurgiche invasive, l’assenza di paralisi facciale, l’Aspergillus spp come patogeno causante e l’assenza di segni radiologici alla diagnosi e nel corso del follow-up. L’efficacia del trattamento dipende dalla valutazione dello stato dei nervi cranici, dal patogeno alla base e dai segni radiologici, più precisamente: l’assenza di paralisi facciale, l’Aspergillus spp e l’imaging negativo alla diagnosi e durante il follow-up correlano con la risoluzione dei sintomi. L’evidenza che il trattamento farmacologico possa associarsi ad un miglior outcome rispetto a procedure chirurgiche invasive potrebbe semplicemente riflettere il fatto che pazienti affetti da una patologia più avanzata richiedono un approccio più aggressivo mentre le forme più lievi possono essere trattate in modo conservativo. È necessario quindi prestare attenzione nell’interpretazione dei dati a causa della necessità di ulteriori studi sull’argomento

    Dysphagia in neurological diseases: a literature review

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    none4sirestrictedPanebianco, M; Rosario, Marchese-Ragona; Masiero, S; Restivo, DA.Panebianco, M; MARCHESE RAGONA, Rosario; Masiero, S; Restivo, Da

    Different IMRT solutions vs. 3D-Conformal Radiotherapy in early stage Hodgkin's lymphoma: dosimetric comparison and clinical considerations

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    Background: Radiotherapy in Hodgkin's Lymphoma (HL) is currently evolving with new attempts to further reduce radiation volumes to the involved-node concept (Involved Nodes Radiation Therapy, INRT) and with the use of intensity modulated radiotherapy (IMRT). Currently, IMRT can be planned and delivered with several techniques, and its role is not completely clear. We designed a planning study on a typical dataset drawn from clinical routine with the aim of comparing different IMRT solutions in terms of plan quality and treatment delivery efficiency.Methods: A total of 10 young female patients affected with early stage mediastinal HL and treated with 30 Gy INRT after ABVD-based chemotherapy were selected from our database. Five different treatment techniques were compared: 3D-CRT, VMAT (single arc), B-VMAT (" butterfly" , multiple arcs), Helical Tomotherapy (HT) and Tomodirect (TD). Beam energy was 6 MV, and all IMRT planning solutions were optimized by inverse planning with specific dose-volume constraints on OAR (breasts, lungs, thyroid gland, coronary ostia, heart). Dose-Volume Histograms (DVHs) and Conformity Number (CN) were calculated and then compared, both for target and OAR by a statistical analysis (Wilcoxon's Test).Results: PTV coverage was reached for all plans (V95% ≥ 95%); highest mean CN were obtained with HT (0.77) and VMAT (0.76). B-VMAT showed intermediate CN mean values (0.67), while the lowest CN were obtained with TD (0.30) and 3D-CRT techniques (0.30). A trend of inverse correlation between higher CN and larger healthy tissues volumes receiving low radiation doses was shown for lungs and breasts. For thyroid gland and heart/coronary ostia, HT, VMAT and B-VMAT techniques allowed a better sparing in terms of both Dmean and volumes receiving intermediate-high doses compared to 3D-CRT and TD.Conclusions: IMRT techniques showed superior target coverage and OAR sparing, with, as an expected consequence, larger volumes of healthy tissues (lungs, breasts) receiving low doses. Among the different IMRT techniques, HT and VMAT showed higher levels of conformation; B-VMAT and HT emerged as the planning solutions able to achieve the most balanced compromise between higher conformation around the target and smaller volumes of OAR exposed to lower doses (typical of 3D-CRT). © 2012 Fiandra et al.; licensee BioMed Central Ltd

    Fibroblast growth factor 2-antagonist activity of a long-pentraxin 3-derived antiangiogenic pentapeptide.

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    Fibroblast growth factor-2 (FGF2) plays a major role in angiogenesis. The pattern recognition receptor long-pentraxin 3 (PTX3) inhibits the angiogenic activity of FGF2. To identify novel FGF2-antagonistic peptide(s), four acetylated (Ac) synthetic peptides overlapping the FGF2-binding region PTX3-(97-110) were assessed for their FGF2-binding capacity. Among them, the shortest pentapeptide Ac-ARPCA-NH(2) (PTX3-[100-104]) inhibits the interaction of FGF2 with PTX3 immobilized to a BIAcore sensorchip and suppresses FGF2-dependent proliferation in endothelial cells, without affecting the activity of unrelated mitogens. Also, Ac-ARPCA-NH(2) inhibits angiogenesis triggered by FGF2 or by tumorigenic FGF2-overexpressing murine endothelial cells in chick and zebrafish embryos, respectively. Accordingly, the peptide hampers the binding of FGF2 to Chinese Hamster ovary cells overexpressing the tyrosine-kinase FGF receptor-1 (FGFR1) and to recombinant FGFR1 immobilized to a BIAcore sensorchip without affecting heparin interaction. In all the assays the mutated Ac-ARPSA-NH(2) peptide was ineffective. In keeping with the observation that hydrophobic interactions dominate the interface between FGF2 and the FGF-binding domain of the Ig-like loop D2 of FGFR1, amino acid substitutions in Ac-ARPCA-NH(2) and saturation transfer difference-nuclear magnetic resonance analysis of its mode of interaction with FGF2 implicate the hydrophobic methyl groups of the pentapeptide in FGF2 binding. These results will provide the basis for the design of novel PTX3-derived anti-angiogenic FGF2 antagonists
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