Tongue lesions in psoriasis: a controlled study

BACKGROUND: Our objective was to study tongue lesions and their significance in psoriatic patients. METHODS: The oral mucosa was examined in 200 psoriatic patients presenting to Razi Hospital in Tehran, Iran, and 200 matched controls. RESULTS: Fissured tongue (FT) and benign migratory glossitis (BMG) were the two most frequent findings. FT was seen more frequently in psoriatic patients (n = 66, 33%) than the control group (n = 19, 9.5%) [odds ratio (OR): 4.69; 95% confidence interval (CI): 2.61–8.52] (p-value < 0.0001). BMG, too, was significantly more frequent in psoriatic patients (28 cases, 14%) than the control group (12 cases, 6%) (OR: 2.55; 95% CI: 1.20–5.50) (p-value < 0.012). In 11 patients (5.5%), FT and BMG coexisted. FT was more frequent in pustular psoriasis (7 cases, 53.8%) than erythemato-squamous types (56 cases, 30.4%). On the other hand, the frequency of BMG increased with the severity of psoriasis in plaque-type psoriasis assessed by psoriasis area and severity index (PASI) score. CONCLUSIONS: Nonspecific tongue lesions are frequently observed in psoriasis. Further studies are recommended to substantiate the clinical significance of these seemingly nonspecific findings in suspected psoriatic cases

Vocal Learning and Auditory-Vocal Feedback

Vocal learning is usually studied in songbirds and humans, species that can form auditory templates by listening to acoustic models and then learn to vocalize to match the template. Most other species are thought to develop vocalizations without auditory feedback. However, auditory input influences the acoustic structure of vocalizations in a broad distribution of birds and mammals. Vocalizations are dened here as sounds generated by forcing air past vibrating membranes. A vocal motor program may generate vocalizations such as crying or laughter, but auditory feedback may be required for matching precise acoustic features of vocalizations. This chapter discriminates limited vocal learning, which uses auditory input to fine-tune acoustic features of an inherited auditory template, from complex vocal learning, in which novel sounds are learned by matching a learned auditory template. Two or three songbird taxa and four or ve mammalian taxa are known for complex vocal learning. A broader range of mammals converge in the acoustic structure of vocalizations when in socially interacting groups, which qualifies as limited vocal learning. All birds and mammals tested use auditory-vocal feedback to adjust their vocalizations to compensate for the effects of noise, and many species modulate their signals as the costs and benefits of communicating vary. This chapter asks whether some auditory-vocal feedback may have provided neural substrates for the evolution of vocal learning. Progress will require more precise definitions of different forms of vocal learning, broad comparative review of their presence and absence, and behavioral and neurobiological investigations into the mechanisms underlying the skills.PostprintPeer reviewe

Hirschsprung\u2019s Disease

Hirschsprung\u2019s disease (HD) or \u201ccongenital megacolon\u201d is a congenital developmental disorder characterized by the absence of ganglion cells in the distal intestine with variable proximal extension. HD affects approximately 1 / 5,000 live births and is more common in males (M: F = 4: 1). According to the proximal extension is possible to indentify different forms of HD: ultrashort, short segment or classical form, long segment and total colonic aganglia. Most children with HD (50-90%) are diagnosed in the neonatal period. Typically the infant with HD is born at term and present with failure to pass meconium.When there is a clinical suspicion of HD, diagnostic investigations to be performed include: radiologic evaluation (plain radiographs, barium enema), anorectal manometry, rectal full-thickness biopsy or serum-muscle and / or rectal biopsy by suction (Rectal Suction biopsy - RSB).There are numerous surgical techniques described for the treatment of HD. The most commonly performed, and therefore considered \u201cthe major pull-through procedures\u201d, are: Swenson rectosigmoidectomy, Duhamel retrorectal transanal pull-through, Rehbein pull-through with anterior colorectal anastomosis, Soave rectosigmoidectomy with aseptic endorectal colon pull-through.Early postoperative complication is represented by colo-anal anastomosis dehiscence (3.2%) which, if not massive, is solvable conservatively. Late postoperative complications are HAEC and colo-anal anastomosis stenosis.On rare occasions the child may require a RedoPT procedure. Indication for RedoPT in the recent review was most commonly for a retained aganglionosis/transition zone pathology (RA/TZP; 71% overall ). Other indications included stricture/obstructing Duhamel pouch (19%), excessively tight cuff (8%), twisted-PT (4%). Operative approach can vary widely and is heavily dependent on type of complication, underlying pathology, previous surgical history as well as surgeon preference as to the type of repair. Complications are quite similar after redo-PT compared to primary PT in experienced hands but stooling outcomes are significantly worse compared to those after a primaryPT. Importantly, continence is still retained in the majority of children