Successful treatment of four types of chronic urticaria with anti-IgE omalizumab in the same patient

Urticaria is a skin disorder that is characterized by the appearance of wheals (hives), angioedema or both1. Chronic urticaria (CU) is defined as wheals (with or without angioedema) that persists for ≥6 weeks, and is further classified into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU)1. In most cases of CU a trigger cannot be identified. These cases are defined as CSU. The term inducible urticaria is used when a specific trigger can be linked to the development of CU.

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Antibiotic choice and MRSA rate in children who are hospitalized for atopic dermatitis

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition of childhood. It is associated with allergic co-morbities including asthma and allergic rhinitis. AD patients are also affected by sleep deprivation and psychosocial problems. Those with uncontrolled AD may require hospitalization.1 Previous studies have shown that about 70% of children who were treated inpatient for AD exacerbation were given an antibiotic.2,3 However, information on the choice of antibiotics used to treat AD exacerbation is limited.

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Transcutaneous Electrical Nerve Stimulation Combined With Voice Therapy in Women With Muscle Tension Dysphonia

The purpose of the present study was to investigate the effect of Voice Therapy (VT) with and without Transcutaneous Electrical Nerve Stimulation (TENS) in women with Muscle Tension Dysphonia (MTD).

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Comparison of Maximum Oxygen Uptake and Rating Perceived Exertion in Woman's Kabaddi Athletes (Without Breathy Voice to Severe Breathy Voice)

There is limited research on voice problems of athletes, especially Kabaddi athletes who use their voice during Kabaddi exercises and may damage their vocal folds and impair their voice quality. The present study aimed to compare maximum oxygen uptake (VO2max) and rating perceived exertion (RPE) in Woman's Kabaddi athletes without breathy voice (BV) to severe BV.

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Image Quality and ADC Assessment in Turbo Spin-Echo and Echo-Planar Diffusion-Weighted MR Imaging of Tumors of the Head and Neck

Publication date: Available online 6 December 2018

Source: Academic Radiology

Author(s): Wannakamon Panyarak, Toru Chikui, Yasuo Yamashita, Takeshi Kamitani, Kazunori Yoshiura

Rationale and Objectives

We aimed to compare the distortion ratio (DR), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between turbo spin-echo (TSE)-diffusion-weighted imaging (DWI) and echo-planar imaging (EPI)-DWI of the orofacial region and prove the usefulness of TSE-DWI for the differential diagnosis of orofacial lesions.

Materials and methods

The DR, SNR, and CNR of both sequences were compared in 42 cases. Then, the apparent diffusion coefficient (ADC) of various orofacial lesions obtained by TSE-DWI was investigated in 143 lesions.

Results

In the first study, 38 of 42 cases were analyzed. TSE-DWI showed a significantly lower DR (p < 0.05) and higher SNR and CNR than EPI-DWI (p < 0.05), indicating the superiority of TSE-DWI. In the second study, 114 cases (79.3%) were successfully analyzed. When lesions were divided into cysts, benign tumors, squamous cell carcinoma, malignant lymphoma, and other malignant tumors (OT), significant differences were observed in all pairs of lesions (p < 0.05) except squamous cell carcinoma and OT (p = 0.877). The area under the curve for distinguishing benign from malignant tumors was 0.80 with a cutoff ADC of 1.29 × 10^-3 mm²/s.

Conclusion

TSE-DWI produced better quality images than EPI-DWI. TSE-DWI yields the high possibility of obtaining ADC in the orofacial region, and this value was considered useful for the differential diagnosis of orofacial lesions.

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Quantification of Hemodynamic Changes in Chronic Liver Disease: Correlation of Perfusion-CT Data with Histopathologic Staging of Fibrosis

Publication date: Available online 6 December 2018

Source: Academic Radiology

Author(s): Thaiss WM, Sannwald L, Kloth C, Ekert K, Hepp T, Bösmüller H, Klag T, Nikolaou K, Horger M, Kaufmann S

Rationale and Objectives

To noninvasively estimate the severity of liver fibrosis using perfusion-CT (PCT)-based quantification of dual liver blood supply prior to liver transplantation or liver resections and to correlate results with histological grading of fibrosis stages and AST-platelet ratio index.

Materials and methods

Institutional review board approved this retrospective study. We analysed 41 consecutive patients (19 classified as Child-Pugh A, 17 as Child-Pugh B, and 5 as Child-Pugh C; MELD score ranged from 7 to 28) who underwent PCT prior to liver transplantation/liver resections between 2013 and 2016. The examination protocol included a scan time of 40 s, 80 kV, 100/120 mAs. Arterial liver perfusion, portal-venous perfusion and hepatic perfusion index (HPI) were registered in liver parenchyma by three readers. Fibrosis was histological graded according to Ishak scoring system as liver fibrosis (F3, n = 10), incomplete liver cirrhosis (F5, n = 5), and complete liver cirrhosis (F6, n = 26).

Results

Portal-venous perfusion was significantly higher in liver fibrosis (F3 69.5±23.7 ml/100 ml/min) compared to incomplete liver cirrhosis (F5, 52.9±25.7 ml/100 ml/min) and complete liver cirrhosis (F6, 46.4±24.8 ml/100 ml/min (range 6.3–112.0 ml/100 ml/min; F = 15, p < 0.0001). HPI showed the same group differences (F = 20, p < 0.0001; HPI F3: 19.1±10.7%, HPI F5: 38.5±24.3%, HPI F6: 43.4±25.8%). Group comparisons were not significant for arterial liver perfusion (F = 3, p = 0.15). PCT parameters as well as histological fibrosis grading did neither correlate with laboratory findings including AST-platelet ratio index and MELD-Score, nor with Child-Pugh-Score.

Conclusion

Quantitative data from perfusion-CT can be used to differentiate between liver fibrosis (F3) and liver cirrhosis (F5/F6).

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Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk

Publication date: January 2019

Source: Academic Radiology, Volume 26, Issue 1

Author(s): Lars J. Grimm, Ashirbani Saha, Sujata V. Ghate, Connie Kim, Mary Scott Soo, Sora C. Yoon, Maciej A. Mazurowski

Rationale and Objectives

To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer.

Materials and Methods

All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts.

Results

Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3–4.8, P = .005). There was fair interreader agreement (κ = 0.39).

Conclusions

High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer.

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