Hyper-IgE syndrome (HIES) is a rare multisystem disorder with both immunologic and nonimmunological features. It is characterized by extremely elevated IgE serum levels, eczema, and recurrent skin ...and pulmonary infections. Dental anomalies are often included, such as retention of deciduous teeth together with ectopic eruption or noneruption of permanent teeth. Severe susceptibility to caries and mycotic infections, insufficient transversal diameter of the palate, mucosal plaques, and fissures typically located on the tongue and on the palate are often present. The aim of this study was to review the literature and to report a 6-year observation of 6 patients with HIES (aged 8-39 years) with focus on their oral problems and the treatment provided. The importance of the role of the dentist both in early diagnosis of this syndrome and in monitoring oral conditions was stressed. The dentist can prevent infective complications and intercept the development of malocclusion with a reduction of the need for complex treatment.
Background
The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) ...allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child. The aims of the present study were to evaluate the long-term effectiveness and safety profile of OIT with raw HE, and to assess the course and prognostic value of skin-prick tests (SPT) and serum-specific HE-IgEs in this study population.
Methods
Of the 20 children who were recalled, 2 dropped out, which left 18 to be evaluated. Information on their HE intake was recorded, and SPTs with HE allergen extracts and with raw and hard-boiled HE were performed. Ovomucoid- and ovalbumin-specific IgE levels were also measured.
Results
At the first (2.5-year) and second (7-year) follow-ups, 87.5% of the children in the OIT-G who tolerated raw HE were still tolerant, whereas the children in the C-G were significantly less tolerant. Overall, cutaneous sensitivity to HE significantly decreased after the 6-month desensitization period and at both follow-ups with regard to the OIT-G but not with regard to the C-G. A significant reduction in serum ovomucoid- and ovalbumin-specific IgE levels was seen in both the OIT-G and the C-G.
Conclusion
Clinical raw HE tolerance induced by OTT persists over time. Negativization of SPTs could be considered a more reliable prognostic indicator of clinical tolerance to raw HE than the reduction in specific-HE IgE levels. Raw-HE OIT would seem to be a promising method to treat HE allergy.
This paper presents an application of an innovative methodological tool for the integrated assessment of farming systems (Multi-Objective Multiple-Scale Integrated Representation). It describes the ...effect of rural development in parallel on economic and ecological reading at different levels: household, village, and the "commune" comprising 3 villages. Socio-economic and environmental indicators are organized into integrated packages across scales. This is an ex-post facto analysis of a program of rural development implemented in the Central Vietnamese uplands in 1995 by the central government with the collaboration of FAO. We conclude that two classic problems can only be faced by using an integrated analysis across levels: "Large scale" generalizations can miss important "location-specific" characteristics, and exclusive focus on "location specific" issues carries the risk of loosing the "big picture."
To produce and validate a simple, systematic and reproducible subclassification system for uterine anomalies previously classified by the American Ferility Society as Class V and VI to achieve a ...precise definition of each uterine anomaly, confirm the feasibility and safety of surgical correction of the anomalies, determine the type of hysteroscopic treatment, and provide a standard by which patient selection, treatment, and reproductive outcomes can be compared between centers.
Descriptive study (Canadian Task Force Classification III).
Department of obstetrics and gynecology of a private clinic (hospital).
Eighty-nine patients undergoing office hysteroscopy to assess partial or complete "double" uterine cavity.
All patients underwent 3-dimensional ultrasound. Data from hysteroscopy and untrasonography were combined to produce a geometric model comprising uterine septum length (Z variable) and fundus depth (Y variable) through which a new subclassification of the uterine anomalies was elaborated.
One patient with a bicornuate uterus detected at ultrasonography was excluded from the study. The remaining 88 patients were classified according to our subclassification system. Seventy-three patients categorized as having Z 2 cm or greater (septum intersecting one-third of the uterine cavity or more) and Y more than 0 cm (normal or straight uterine fundus) underwent resectoscopic metroplasty without laparoscopic control. Twelve patients categorized as A1 (normal uterine fundus and septum < or =0.5 cm) underwent office metroplasty. Two patients categorized as B1 (straight fundus and septum < or =0.5 cm) and 1 categorized as C1 (concave fundus and septum < or =0.5 cm) were not considered candidates for surgery. Second-look hysteroscopy confirmed complete removal of the septum in the 12 patients who underwent office metroplasty (100%) and in 70 of 73 patients (96%) who underwent resectoscopic metroplasty. Comparison of these data with data retrospectively obtained in 596 women who had undergone traditional resectoscopic metroplasty under laparoscopic control did not demonstrate any significant difference in success and complication rates.
Our outpatient subclassification system may address a precise diagnosis and a thorough categorization of patients with a partial or complete double uterine cavity, enabling safe and effective metroplasty without use of laparoscopy.
Abstract Background Atlantoaxial degenerative articular cysts are rare lesions that can cause extradural compression of the cervicomedullary junction. When symptomatic, they usually require surgical ...treatment. We report an unusual case of spontaneous regression of an atlantoaxial degenerative articular cyst after conservative treatment with an external cervical brace along with a systemic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids. We also discuss the potential pathogenetic mechanisms involved. Purpose To describe a case of significant volume reduction of an atlantoaxial articular degenerative cyst in a patient treated with a Philadelphia collar and anti-inflammatory drugs. Study design Case report with analysis of the literature. Methods A 80-year-old patient was admitted to our institution with a history of progressive tetraparesis, ataxic gait, and cervical pain. A cervical spine magnetic resonance imaging (MRI) scan showed an extradural mass lesion behind the dens of C2 causing significant compression of the cervicomedullary junction, suggesting the diagnosis of atlantoaxial degenerative articular cyst. The patient refused surgery in favour of a conservative treatment with a Philadelphia collar and a short-term course of NSAIDs and corticosteroids. Results After 6 weeks, the patient's neurological condition improved, and a 6-month follow-up cervical spine MRI scan revealed an almost complete regression of the atlantoaxial cystic lesion. At a 1-year follow-up, his clinical condition was further improved. Conclusions Atlantoaxial articular degenerative cysts are rare lesions that should be included in the differential diagnosis of those extradural lesions that can cause a ventral or ventrolateral compression of the cervicomedullary junction. They most commonly occur in elderly female patients affected by diffuse arthrosic degeneration of the cervical spine, with or without clear radiological signs of atlantoaxial instability, and have a typical appearance on MRI imaging. Surgery, with direct excision of the cyst and/or a C1–C2 fusion, is the first treatment of choice. Nevertheless, our report points out the possibility of a significant spontaneous regression of these lesions following a simple conservative strategy based on the use of an external cervical brace together with a systemic anti-inflammatory therapy.
Sustainability requires the redefinition of the terms of reference for agricultural activities, which must be based on the recognition of multi-functional land use and the complex role that ...agriculture plays in society. The ability to renegotiate new terms of reference for agriculture, in turn, requires new analytical tools for agriculture analysis to be able to embrace the 'complexity revolution'. This paper presents a novel approach and a tool for integrated analysis of rural development: Multi-Objective Integrated Representation (MOIR). This tool is based on an integrated set of indicators reflecting non-equivalent views of farming systems and their performance (economic, environmental, social), at different scales (household, community, national). The approach helps to establish relations among the changes in values of different indicators. This facilitates a discussion of sustainability trade-offs associated with different scenarios, even when these trade-offs are not commensurable.
Summary Objective To examine intra- and interrater reliability of thickness and cross-sectional area (CSA) measurements of the supraspinatus muscle using rehabilitative ultrasound imaging (RUSI). ...Methods Two physical therapists acquired b-mode images of the supraspinatus muscles in twenty-five healthy subjects. Thickness and CSA were measured. Intra- and interrater reliability were examined. Results Intrarater reliability for thickness was high, (ICC1.1 0.91) for rater 1 and (ICC1.1 0.92) for rater 2. Intrarater reliability for CSA was also high, (ICC1.1 0.90) for rater 1 and (ICC1.1 0.85) for rater 2. Interrater reliability for the thickness was high, (ICC3.1 0.86). For CSA, interrater reliability was moderate, (ICC3.1 0.70). Conclusion Supraspinatus muscle thickness and CSA can be reliably measured by physical therapists in healthy subjects. These findings confirm that RUSI has an interesting potential for physiotherapy clinical practice, especially to assess morphometric changes in skeletal muscles. Further research is needed in subjects with shoulder disorders.
PDF
