Articulatory Contact Pressure during Bilabial Plosive Production in Esophageal and Tracheoesophageal Speech

Objectives: The present study investigated the articulatory contact pressure during the production of bilabial plosives by esophageal (ES), tracheoesophageal (TE), and laryngeal speakers. Methods: The peak contact pressure (PCP) during bilabial plosive production of /CVCVCVCVCV/ syllable strings of /p/ and /p^h/ was obtained from 10 ES, 10 TE, and 10 laryngeal speakers of Cantonese. PCP values were obtained by using a pressure transduction system (Iowa Oral Performance Instrument) during speech production. Results: The results showed that ES speakers exhibited a significantly greater PCP value than TE and laryngeal speakers, as revealed by cheek muscle compression force. In addition, the unaspirated bilabial plosive /p/ was associated with a greater PCP than its aspirated counterpart /p^h/. Conclusion: The current findings might support the hypothesis of over-exaggerated speech for better intelligibility among alaryngeal speakers. In addition, the increased oral muscular effort could be associated with a compensatory strategy for maintaining a high intraoral pressure or the unique air intake by ES speakers.
Folia Phoniatr Logop 2019;71:1–6

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The limited role of elective neck dissection in patients with cN0 salivary gland carcinoma

To evaluate whether elective neck dissection (END) was beneficial for cN0 patients with salivary gland carcinoma.

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The Effects of Le Fort I Osteotomy on Velopharyngeal Function in Cleft Patients

Maxillary retrusion is a common problem in patients with a cleft lip and palate (Semb and Shaw, 1996). The Le Fort I osteotomy is commonly used for the correction of maxillary deformities in cleft and noncleft patients. The need for a Le Fort I osteotomy varies according to the cleft type. In recent literature, the lowest frequency found for a Le Fort I osteotomy was 13% and was performed for an isolated cleft palate (CP) (Antonarakis et al., 2015), whereas patients with a unilateral cleft lip and palate (UCLP) or a bilateral cleft lip and palate (BCLP) exhibited higher frequencies of 40% to 76.5% (Daskalogiannakis and Mehta, 2009; Heliövaara and Rautio, 2011; Heliövaara et al., 2013).

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Impact of Parental Asthma, Prenatal Maternal Asthma Control and Vitamin D Status on Risk of Asthma and Recurrent Wheeze in 3‐Year Old Children

Abstract

Background

While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma, and the role of maternal asthma control in pregnancy on the risk for asthma in the child.

Objective

We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3‐year old children how prenatal and cord blood vitamin D status might affect this risk.

Methods

Data from 806 women, their partners (biologic fathers of the infant), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrialsgov identification number NCT00920621) were used for this cohort analysis. The parental report of physician‐diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for interval‐censored event times were used to estimate the main variables of interests and additional covariates on the outcome.

Results

The highest risk was observed among children with both parents being asthmatic relative to non‐asthmatic parents (aHR=2.30, 95%CI: 1.35‐3.84), and less so if only the mother was asthmatic (aHR=1.70, 95%CI: 1.17‐2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR=1.60, 95%CI: 1.02‐2.54). Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D≥30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient vitamin D status at birth (aHR=0.47, 95%CI: 0.27‐0.83).

Conclusion and Clinical Relevance

Careful attention to maternal asthma control, monitoring vitamin D status and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze.

This article is protected by copyright. All rights reserved.

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Imaging of liver fusion and vascular intra-hepatic shunts in omphalopagus conjoined twins: The role of a double CT study

Publication date: Available online 22 November 2018

Source: Clinical Imaging

Author(s): Antonino Barletta, Marina Pace, Lorenzo D'Antiga, Maurizio Cheli, Giovanna Mangili, Sandro Sironi

Abstract

Omphalopagus twins are joined ventrally in the umbilical region. In omphalopagus twins, liver's fusion is very frequent, being present in about 80% of cases. Two conjoined twins born in our Hospital were evaluated using plain x-rays, ultrasound (US), gastrointestinal xrays, Tc-99 hepatobiliary scintigraphy (SC) and contrast enhanced computed tomography (CT). There was no bony connection on conventional xrays, neither bowel communication on GI x-rays study. US demonstrated the fusion of left hepatic lobes and a not-quantifiable vascular shunt.

Normal biliary function was demonstrated by Tc-99 SC. The first CT scan (twin A) showed irregular lobules in the site of hepatic fusion, a portoportal shunt and a venous vessel to the inferior vena cava of twin B. Only the second CT scan (twin B) showed an arterio-arterial partiallyextrahepatic shunts. The double CT scan allows to increase the probability of a correct individuation and description of vascular shunts for an effective preoperatory assessment. The omphalopagus twins in our case underwent planned surgical separation at 5 months of age. The surgery lasted 5 h and was not affected by any intraoperative complications.

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Chronic Rhinosinusitis in Elderly Patients is Associated with an Exaggerated Neutrophilic Pro-Inflammatory Response to Pathogenic Bacteria

Publication date: Available online 22 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Justin C. Morse, Ping Li, Kim A. Ely, Meghan H. Shilts, Todd J. Wannemuehler, Li-Ching Huang, Quanhu Sheng, Naweed I. Chowdhury, Rakesh K. Chandra, Suman R. Das, Justin H. Turner

Abstract

Background

Potential effects of aging on chronic rhinosinusitis (CRS) pathophysiology have not been well defined, but may have important ramifications given a rapidly aging U.S. and world population.

Objective

The goal of the current study was to determine whether advanced age is associated with specific inflammatory CRS endotypes or immune signatures.

Methods

Seventeen mucus cytokines and inflammatory mediators were measured in 147 CRS patients. Hierarchical cluster analysis was used to identify and characterize inflammatory CRS endotypes as well as determine whether age was associated with specific immune signatures.

Results

A CRS endotype with a pro-inflammatory, neutrophilic immune signature was enriched with older patients. In the overall cohort, patients 60 years and older had elevated mucus levels of IL-1β, IL-6, IL-8, and TNF-α when compared to their younger counterparts. Increases in pro-inflammatory cytokines were associated with both tissue neutrophilia and symptomatic bacterial infection/colonization in aged patients.

Conclusions

Aged CRS patients have a unique inflammatory signature that corresponds to a neutrophilic pro-inflammatory response. Neutrophil-driven inflammation in aged CRS patients may be less likely to respond to corticosteroids and may be closely linked with chronic microbial infection or colonization.

Graphical abstract

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BOLD-fMRI reveals the association between renal oxygenation and functional connectivity in the aging brain

Publication date: Available online 22 November 2018

Source: NeuroImage

Author(s): Hechun Li, Weifang Cao, Xingxing Zhang, Bo Sun, Sisi Jiang, Jianfu Li, Chang Liu, Wenjie Yin, Yu Wu, Tiejun Liu, Dezhong Yao, Cheng Luo

Abstract

Aging is accompanied by a decline in physical and cognitive function. Vascular aging may provide a major influence on these measures. The purpose of this study was to explore the relationship between renal oxygenation and functional connectivity of the aging brain because of the anatomic and hemodynamic similarities between cerebral and renal vessels. Fifty-two healthy older adults were recruited to undergo a BOLD-fMRI scan of the brain and kidneys, and forty-four healthy younger subjects were recruited as the control group. First, cerebral functional connectivity density (FCD) was used to evaluate functional connectivity. Renal medullary and cortical R2* values were extracted respectively, and the ratio of medullary and cortical R2* values (MCR) was calculated. Then, the association between brain FCD and renal MCR was analyzed. Compared with younger adults, the elderly group showed higher renal medullary R2* and MCR, which might reflect a slight abnormality of renal oxygenation with aging. The older subjects also showed enhanced FCD in bilateral motor-related regions and decreased FCD in regions of the default mode network (DMN). The findings indicated that the functional connectivity in the DMN and motor cortices was vulnerable to aging. Moreover, the altered brain FCD values in the watershed regions, DMN and motor cortices were significantly correlated with the renal MCR value in the elderly group. The association between renal oxygenation abnormalities and spontaneous activity in the brain might reflect vascular aging and its influence on the kidney and brain during aging to some extent. This study provided a new perspective for understanding the relationship between tissue oxygenation and brain functional connectivity.

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