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Macromastia often leads to physical complaints involving pain in the shoulder/neck area. In Germany, there are virtually no reliable data on the effects of breast reduction surgery with regard to neck and spine complaints. Therefore, the authors carried out a retrospective study to investigate the effect of breast-reducing surgery on neck pain and quality of life.Between January 1, 2014 and December 31, 2019, 107 breast reductions were performed for macromastia. Medical records and OP reports were evaluated, and the indication for breast reduction documented. Pain was recorded preoperatively on a visual analog scale (VAS). Pretreatments and perioperative complications were also documented and evaluated. All patients were sent a questionnaire, which determined whether the objective of the operation had been achieved, how satisfied the patients were with the result of the operation, and how severe the current pain (VAS) was. The EQ-5D 3L health questionnaire was used to assess quality of life, and the Neck-Disability Index was used to assess neck complaints. Statistical analysis was carried out using the Wilcoxon test.After an average of 56.5 months (min: 18, max: 90), 76/107 (71%) patients could be re-examined. There were 15 complications. Pain improved from an average of 7.2 preoperatively (min: 0, max: 10) to an average of 1.6 postoperatively (min: 0, max: 4; p 0.001). The Neck-Disability Index improved from an average of 43.8% (Min: 0, Max: 82) to an average of 10.8% (Min: 0, Max: 52) postoperatively (p 0.001). In all, 71/76 (93%) of the examined patients were very satisfied or satisfied with the result of the operation.With this study, the authors were able to show that there are often several reasons why breast reduction surgery is performed in patients with macromastia. A high patient satisfaction rate can be achieved and orthopedic clinical complaints associated with macromastia can be treated with a very high success rate.EINLEITUNG UND FRAGESTELLUNG: Die Mammahypertrophie führt häufig zu körperlichen Beschwerden mit Schmerzen im Schultergürtel/Nackenbereich. In Deutschland gibt es kaum belastbare Daten über die Auswirkungen der Mammareduktionsplastik in Hinblick auf Nacken- bzw. Wirbelsäulenbeschwerden. Wir führten daher eine retrospektive Studie durch, um den Einfluss brustverkleinernder Operationen auf Nackenschmerzen und die Lebensqualität zu untersuchen.Im Zeitraum vom 01.01.2014 bis 31.12.2019 wurden 107 Brustverkleinerungen wegen Makromastie durchgeführt. Es wurden Krankenakten und OP-Berichte ausgewertet sowie die Indikation der Brustverkleinerung dokumentiert. Die Schmerzen wurden präoperativ (VAS) (Visuelle Analog Skala) festgehalten. Vorbehandlungen und perioperative Komplikationen wurden ebenfalls dokumentiert und ausgewertet. Allen Patientinnen wurde ein Fragebogen zugesendet. Zur Beurteilung der Lebensqualität wurde der EQ-5D-3L-Gesundheitsfragebogen, zur Beurteilung der Nackenbeschwerden der Neck Disability Index verwendet. Die statistische Analyse erfolgte mit dem Wilcoxon-Test.Nach durchschnittlich 56,5 Monaten (Min: 18, Max: 90) konnten 76/107 (71 %) Patientinnen nachuntersucht werden. Es traten 15 Komplikationen auf. Die Schmerzen verbesserten sich von präoperativ Ø 7,2 (Min: 0, Max: 10) auf postoperativ Ø 1,6 (Min: 0, Max: 4; p 0,001). Der Neck Disability Index verbesserte sich von Ø 43,8 % (Min: 0, Max: 82) auf postoperativ Ø 10,8 % (Min: 0, Max: 52; p 0,001). 71/76 (93 %) der untersuchten Patientinnen waren mit dem Operationsergebnis sehr zufrieden bzw. zufrieden.Es kann eine hohe Patientenzufriedenheitsrate erzielt werden. Orthopädische Krankheitsbilder, die mit der Makromastie assoziiert sind, können mit sehr gutem Erfolg behandelt werden.

Intraoperative auditory brainstem response (ioABR) testing following tympanostomy tube (TT) placement may be biased due to temporary threshold shifts (TTS). The purpose of the study was to assess the evidence for TTS in children who have undergone ioABR using prolonged latencies of wave I (males > 1.95 ms, females > 1.88 ms) as a marker of a persisting air–bone gap. Eighty-three children underwent ioABR following surgical procedures at University Hospital Bonn, Germany. The primary outcome measure was the latency of wave I at 80-dB SPL. The total sample consisted of 66 males (79.5%) and 17 females (20.5%) with a mean (SD) age of 46.4 (26.6) months. Of 163 operated ears (83 children), 72 (44.2%) had no middle ear fluid, 19 (11.6%) serous fluid, and 72 (44.2%) mucoid fluid. The risk of having a prolonged latency of wave I at 80-dB SPL was OR 4.61 (95% CI 2.01–10.59; p < 0.001) in those with mucoid fluid as compared to those without mucoid fluid. Intraoperative ABR results should account for sex differences and be interpreted with caution and be verified. Ultimately, parents should be engaged in a preoperative discussion to decide if an ioABR should be postponed if mucoid fluid was found.

Summary Objective The objective of this observational study was to assess the relationship between established aging biobehavioral measures and voice decline in normally aging adults. Study design Cross-sectional study. Methods Participants 60–85 years of age were divided into two age and sex-matched groups, based on the presence or absence of presbylaryngeus. Both groups underwent a battery of tests measuring anthropometric variables, inflammatory markers, general health measures, and vocal function parameters. Differences from the norm were calculated for all variables. Parametric and nonparametric tests were performed to assess group differences. In addition, variable selection analysis was performed to determine variables that were most influential in predicting the occurrence of presbylaryngeus in our current sample. Results Fifty-three participants were divided into age and sex-matched groups of “presbylaryngeus” (n = 26) and “non-presbylaryngeus” (n = 27). The two groups were statistically different in select measures of inflammatory markers, general health measures, and vocal function parameters. Anthropometric measures were not statistically different. Based on variable selection, the variables most predictive of the presence of presbylaryngeus were measures of the Physical Activity Scale of the Elderly, C-reactive protein, laryngeal airway resistance, and vocal roughness. Conclusions In addition to group differences in vocal function measures, results for the presbylaryngeus group consistently trended sub-optimally on anthropometric measures, two inflammatory markers, and general health measures. These results suggest that this sample of individuals with presbylaryngeus demonstrated greater biobehavioral deficits associated with aging as compared to age and sex-matched non-presbylaryngeus individuals.

Knowledge on brain networks subserving vocalization in vocally healthy individuals under various task conditions is scarce but paramount to understand voice disorders. The aims of our study were to determine (1) the effect of social-evaluative stress on the central neural control of phonation underlying speech production; and (2) the neural signature, personality profile, and aerodynamic vocal function in relation to salivary cortisol responses. Thirteen vocally healthy females underwent an event-related sparse-sampling fMRI protocol consisting of voiced and whispered sentence productions with and without exposure to the social-evaluative stressor public speaking anticipation. Participants completed a personality questionnaire, rating scales of negative emotional state, and provided salivary cortisol samples. In the total sample, the task contrast of voiced productions revealed that stressor exposure resulted in a peak activation in the right caudate with concomitant deactivations in the bilateral pgACC and aMCC, and right IFG, BA 9, BA 10, insula, putamen, and thalamus. There were individual differences in stressor-induced brain activations as a function of stress reactivity with greater cortisol reactivity linked with lower laryngeal motor cortex activity and lower scores on aspects of extraversion. Our data confirm that stress alters the phonatory control for speech production through limbic-motor interactions. The findings support the Trait Theory of Voice Disorders (Roy and Bless 2000) and help provide critical insights to the study of voice disorders such as primary muscle tension dysphonia.

Communication problems (eg, dysphonia, dysfluency and language and articulation disorders), swallowing disorders (dysphagia and globus), cough and upper airway symptoms, resulting from functional neurological disorder (FND), are commonly encountered by speech and language professionals. However, there are few descriptions in the literature of the most effective practical management approaches. This consensus document aims to provide recommendations for assessment and intervention that are relevant to both adults and young people. An international panel of speech and language professionals with expertise in FND were approached to take part. Participants responded individually by email to a set of key questions regarding best practice for assessment and interventions. Next, a video conference was held in which participants discussed and debated the answers to these key questions, aiming to achieve consensus on each issue. Drafts of the collated consensus recommendations were circulated until consensus was achieved. FND should be diagnosed on the basis of positive clinical features. Speech and language therapy for FND should address illness beliefs, self-directed attention and abnormal movement patterns through a process of education, symptomatic treatment and cognitive behavioural therapy within a supportive therapeutic environment. We provide specific examples of these strategies for different symptoms. Speech and language professionals have a key role in the management of people with communication and related symptoms of FND. It is intended that these expert recommendations serve as both a practical toolkit and a starting point for further research into evidence-based treatments.

Background and objectives: Bisphosphonates represent selective inhibitors of excess osteoblastic bone resorption that characterizes all osteopathies, targeting osteoclasts and their precursors. Their long-term administration in postmenopausal women suffering from osteoporosis has resulted in neural adverse effects. The current study focuses on the research of possible alterations in the femoral nerve, caused by bisphosphonates. We hypothesized that bisphosphonates, taken orally (per os), may produce degenerative changes to the femoral nerve, affecting lower-limb posture and walking neuronal commands. Materials and Methods: In order to support our hypothesis, femoral nerve specimens were extracted from ten female 12-month-old Wistar rats given 0.05 milligrams (mg) per kilogram (kg) of body weight (b.w.) per week alendronate per os for 13 weeks and from ten female 12-month-old Wistar rats given normal saline that were used as a control group. Specimens were studied using immunohistochemistry for selected antibodies NeuN (Neuronal Nuclear Protein), a protein located within mature, postmitotic neural nucleus, and cytosol and Sox10 (Sex-determining Region Y (SRY) - High-Motility Group (HMG) - box 10). The latter marker is fundamental for myelination of peripheral nerves. Obtained slides were examined under a light microscope. Results: Samples extracted from rats given alendronate were more Sox10 positive compared to samples of the control group, where the marker&rsquo, s expression was not so intense. Both groups were equally NeuN positive. Our results are in agreement with previous studies conducted under a transmission electron microscope. Conclusions: The suggested pathophysiological mechanism linked to histological alterations described above is possibly related to toxic drug effects on Schwann and neuronal cells. Our hypothesis enhances the existing scientific evidence of degenerative changes present on femoral nerve following bisphosphonates administration, indicating a possible relationship between alendronate use and neuronal function.

Composting and anaerobic digestion are the most common ways to treat organic residues. Sometimes the organic rest after anaerobic digestion is also composted. In this study we investigated greenhouse gas emissions from composting raw food waste compared to composting solid digestate of food waste. Cumulative methane emissions over 3 weeks were found to be almost 12 times higher from composting digested food waste than from raw food waste suggesting that the microbial community transferred from the anaerobic digestion to the compost process enhanced these emissions. Cumulative nitrous oxide emissions were also higher when composting solid digestate was compared to composting raw food waste, but the global warming potential was mostly driven by the impact of methane emissions. In conclusion, methane production during digestate composting can be high, therefore eliminating methane producing microbes in digestate before composting could be a promising way to reduce greenhouse gas emissions.

Within Oxfam, we continue to question how we could have better integrated gender equality in the Ebola response, and how to improve our gender mainstreaming in future emergencies. Why did gender mainstreaming in the Ebola response prove particularly challenging? How did the Ebola response differ from previous emergencies? What did we need to know to improve our response to the outbreak? Are there new ways in which we should approach gender mainstreaming? What lessons have we learned that we can carry forward in our work? Most importantly, what recommendations can we offer beyond those already provided in existing guidelines? In this article, we reflect on our experience as non-medical specialist practitioners involved in the response, to help us answer these questions.

Purpose The aims of the current study were to determine age-related changes to the phonatory and articulatory subsystems and to investigate an exploratory model of intelligibility for healthy aging based on phonatory and articulatory measures. Method Fifteen healthy, older adults (55-81 years) and 15 younger adults (20-35 years) participated in instrumental assessments of the phonatory (aerodynamic, acoustic) and articulatory (kinematic) subsystems. Speech intelligibility was determined by five listeners during multi-talker babble. Results Older adults displayed shorter maximum phonation time, greater airflow during sentence reading, and lower cepstral peak prominence (CPP) and CPP SD. Additionally, older adults had slower tongue movement speed than younger adults. Speech intelligibility was also significantly reduced in the older group. A generalized estimating equations model combining phonatory and articulatory measures showed that CPP SD, low/high (L/H) spectral ratio mean and SD, Cepstral Spectral Index of Dysphonia (CSID), and maximum tongue movement speed were significant contributors to intelligibility changes in older individuals. While L/H mean and SD and CSID displayed an inverse relationship with intelligibility, CPP SD and maximum tongue speed displayed a direct relationship with intelligibility. Discussion Aging affects the phonatory and articulatory subsystems with implications for speech intelligibility. Phonatory cepstral/spectral measures except for mean CPP were associated with speech intelligibility changes, suggesting that changes in voice quality may contribute to reduced intelligibility in older adults. Pertaining to articulation, slower tongue movement speed likely contributed to reduced intelligibility in older individuals.

Background and objectives: Bisphosphonates (BPs) are selective inhibitors of osteoclasts, used for the treatment of bone disorders. The objective of this study is to investigate the possible effects of BPs on the tongue&rsquo, s mucosa. Materials and Methods: Specimens of the tongue of 20 female 12-month old Wistar rats were taken. Ten were used as control group, while in the remaining alendronate (Fosamax, Merck) was administered per os from 13 weeks. Observation of the harvested samples was made by Transmission Electron Microscopy (TEM). Results: In the experimental group, focal alterations were observed to various extent in all specimens. The basement membrane was intact. Furthermore, an increase at the intercellular space was observed, predominantly at the middle layer, and the desmosomes were disorganized. In the lamina propria focal edema was observed. Conclusions: Investigation on the effect of BPs on the tongue&rsquo, s mucosa through TEM hasn&rsquo, t been documented in the past. According to our results, BPs seem to cause mild mucosal lesions on the tongue.

Bisphosphonates are commonly used in clinical practice. Their effectiveness is indisputable, however their adverse effects, especially in the GI tract, are still controversial. In our report, we demonstrate pathological findings of the effect of systematic alendronate administration in esophagus, stomach and the liver of an in-vivo animal model of 15 Wistar rats. Light microscopy with immunohistochemistry and electron microscopy were used. Microscopic findings of inflammation of the stomach and mild hepatic dysfunction were observed. Conclusively, alendronate can potentially affect gastric mucosa and liver function on this animal experimental model.

Our previous studies demonstrated that it is possible to perform the classification of both simulated pressed and actual vocally fatigued voice productions versus vocally healthy productions through the pattern recognition of sEMG signals obtained from subjects’ anterior neck. In these studies, the commonly accepted Vocal Fatigue Index factor 1 (VFI-1) was used for the ground-truth labeling of normal versus vocally fatigued voice productions. Through recent experiments, other factors with potential effects on classification were also studied, such as sEMG signal normalization, and data imbalance—i.e., the large difference between the number of vocally healthy subjects and of those with vocal fatigue. Therefore, in this paper, we present a much improved classification method derived from an extensive study of the effects of such extrinsic factors on the classification of vocal fatigue. The study was performed on a large number of sEMG signals from 88 vocally healthy and fatigued subjects including student teachers and teachers and it led to important conclusions on how to optimize a machine learning approach for the early detection of vocal fatigue.

Symptoms of voice disorder may range from slight hoarseness to complete loss of voice; from modest vocal effort to uncomfortable neck pain. But even minor symptoms may still impact personal and especially professional lives. While early detection and diagnosis can ameliorate that effect, to date, we are still largely missing reliable and valid data to help us better screen for voice disorders. In our previous study, we started to address this gap in research by introducing an ambulatory voice monitoring system using surface electromyography (sEMG) and a robust algorithm (HiGUSSS) for pattern recognition of vocal gestures. Here, we expand on that work by further analyzing a larger set of simulated vocal dysfunctions. Our goal is to demonstrate that such a system has the potential to recognize and detect real vocal dysfunctions from multiple individuals with high accuracy under both intra and intersubject conditions. The proposed system relies on four sEMG channels to simultaneously process various patterns of sEMG activation in the search for maladaptive laryngeal activity that may lead to voice disorders. In the results presented here, our pattern recognition algorithm detected from two to ten different classes of sEMG patterns of muscle activation with an accuracy as high as 99%, depending on the subject and the testing conditions.

Introduction Impaired wound healing, chronic wounds and extended soft tissue defects present a crucial problem in reconstructive surgery of the head and neck region, even more after radiation therapy. In such cases the standard is a prolonged open wound treatment. The negative pressure instillation therapy might present an alternative therapy option. Material and methods In this study the effects of negative pressure instillation therapy on the healing of chronic wounds in 15 patients diagnosed with impaired wound healing were investigated. These based upon infected osteoradionecrosis and osteomyelitis of the jaw. The parameters investigated as markers of the therapeutic success were serum inflammatory parameters i.e. white blood cell counts, wound smear results and wound surface reduction. Results The use of negative pressure instillation therapy lead to a reduction of the bacterial load and formation of a stabile granulation tissue in all but one case. The mean inpatient time of the patients was 13.33 ± 4.62 days. Between 2 and 8 dressing changes were needed to reach clinical sufficient wound healing results. Secondary intention wound healing could be obtained in 14 out of 15 cases. The crucial part for the successful application was a watertight enoral suturing as oro-cutaneous fistulae were present in most cases. Conclusion The negative pressure instillation therapy poses a good treatment for wound healing problems and extended size soft tissue defects, even when oro-cutaneous fistulae were present. Especially in cases that contraindicate micro-vascular reconstruction, negative pressure instillation therapy could be a good alternative.

Este artigo visa analisar o uso de brincadeiras como instrumentos pedagógicos para o ensino de ciências às crianças. Para isto, foram consideradas as estratégias pedagógicas do Projeto de Extensão Batuclagem (PROEC-UFABC/2011-2016), que tem como base o ensino lúdico voltado à questão ambiental. Inicialmente, discute-se o aspecto lúdico no ensino de ciências com base em Vygotsky, Winnicott e Kishimoto. Adiante, apresenta-se os resultados da observação participante das oficinas do Projeto Batuclagem, analisando-os segundo a perspectiva sociointeracionista. Dentre os resultados obtidos, verifica-se a importância do brincar às crianças para o ensino de ciências, enquanto uma ação que potencializa o desenvolvimento dos processos superiores, propiciando memória, atenção, raciocínio lógico, expressão oral e corporal. Além disso, o brincar é um instrumento psicológico para imitação da realidade, o qual se apropria de signos e símbolos da cultura humana, permitindo que a criança empregue tais conhecimentos em situações socialmente construídas.

PM2.5 pollution has become a global health concern, however its size-resolved health impact remains to be poorly elucidated. Here, ambient particulate matter (PM) were collected into 13 different size ranges (10 nm to 18 μm) and the mass, metal, endotoxin distributions, and related oxidative potential were investigated in two regions (Zurich, Switzerland and Beijing, China). Results showed that the two regions had remarkably different PM distribution patterns. Swiss urban samples had a mode around 40 nm with 23.3% of total PM mass, while Chinese samples featured two modes around 0.75 and 4.23 μm with 13.8–18.6% and 13.7–20.4% of total PM mass, respectively. Two peaks for endotoxin at 40–100 nm and 1–4 μm were observed in different regions. For PM-borne metals, Chinese samples had 67.6–100% of total Cd, As, and Pb in the size range of 0.1–1 μm, and Swiss samples had similar distributions of Cd and Pb but much lower total metals than Chinese samples. The PM oxidative potential varied greatly with sizes for ...

Summary Primary muscle tension dysphonia (pMTD) is a voice disorder that occurs in the absence of laryngeal pathology. Dysregulated activity of the paralaryngeal muscles is considered the proximal cause; however, the central origin of this aberrant laryngeal muscle activation is unclear. The Trait Theory (Roy and Bless, 2000a,b) proposed that specific personality traits can predispose one to laryngeal motor inhibition and pMTD, and this inhibition is mediated by a hyperactive “behavioral inhibition system (BIS)” composed of limbic system structures (and associated prefrontal connections). This case study used functional magnetic resonance imaging to detect brain activation changes associated with successful management of pMTD, thereby evaluating possible neural correlates of this poorly understood disorder. Method A 61-year-old woman with moderate-to-severe pMTD underwent functional magnetic resonance imaging scans before and immediately after successful treatment using manual circumlaryngeal techniques. Experimental stimuli were blocks of repeated vowel production and overt sentence reading. Results Significantly greater activation was observed pre- versus posttreatment in all regions of interest during sentence production, that is, periaqueductal gray, amygdala, hypothalamus, anterior cingulate cortex, hippocampus, dorsolateral prefrontal cortex, Brodmann area 10, and premotor and inferior sensorimotor cortex. Conclusions Our findings are compatible with overactivation of neural regions associated with the BIS (cingulate cortex, amygdala, hypothalamus, periaqueductal gray) and motor inhibition networks (eg, [pre-]supplementary motor area) along with the dorsolateral prefrontal cortex and medial prefrontal cortex. Heightened input from limbic regions combined with dysfunctional prefrontal regulation may interfere with laryngeal motor preparation, initiation, and execution thereby contributing to disordered voice in pMTD.

This gender and conflict analysis of ISIS-affected communities of Iraq aims to improve understanding of gender dynamics in the context of conflict and displacement. The report sets out to identify the differential impact of ISIS occupation on women, girls, men and boys in order to explore shifts in prevailing gender norms held by study participants in Anbar, Salah Al Din and Nineveh governorates of Iraq. The objective is to enhance the understanding of the social pressures women and men experience when aiming to conform to context-specific gendered expectations of masculinity and femininity, in order to derive concrete recommendations for gender-responsive and conflict-sensitive humanitarian and recovery programming.

Purpose The purpose of the study was to determine whether persons who responded with high stressor-induced extralaryngeal muscle activity in a stress reactivity protocol differed from those with low muscle activity on measures of emotional and autonomic cardiovascular reactivity and personality. Method Thirty-six vocally healthy women (18–35 years) were assigned to high and low extralaryngeal groups based on submental (SM) and infrahyoid (IH) surface electromyography (sEMG) recordings obtained during a stress reactivity protocol (high vs. low sEMG SM and sEMG IH , n = 18 per subgroup; Dietrich & Verdolini Abbott, 2012). Measures included assessments of basic fear and fear of public speaking, rumination, systolic blood pressure (SBP), and personality. Results The high sEMG IH group reported significantly greater basic fear across experimental phases than did the low sEMG IH group ( p = .036). However, the high sEMG SM and sEMG IH versus low sEMG SM and sEMG IH groups did not differ on fear of public speaking, rumination, or SBP across phases. Both high sEMG SM and sEMG IH groups were characterized by significantly lower scores on Extraversion ( p < .001). Conclusion In combination with the authors' previous findings (Dietrich & Verdolini Abbott, 2012), the present findings provided robust evidence that low Extraversion was linked to stressor-induced changes in extralaryngeal functioning and that perceived fear played a contributing role.

Objectives This systematic review examined the evidence linking vocal nodule development in children to personality traits, psychological factors, and associated behavioral tendencies. Methods Four electronic databases—PubMed, Scopus, ScienceDirect, EBSCO Host—as well as the reference lists from articles (including online sources) were searched. After screening for relevance, eight comparative, case-control studies were identified that met inclusion criteria. The quality of each study was evaluated by two raters using a modified, standardized checklist. Results Four studies were rated as “good quality” and four were “fair”. The questionnaires used to measure personality or psychological factors varied widely among the studies, and the results linking personality dispositions (and associated behavioral inclinations) to vocal nodule development in children were mixed. Conclusions Fair to good quality evidence exists to suggest that psychological factors or personality traits related to extraversion and impulsivity (and their related behavioral inclinations) might predispose children to vocal nodules and deserve further attention. Clinical implications, limitations of the current systematic review, and recommendations for future research are also discussed.

Angiogenesis and the acquisition of an angiogenic phenotype is important for cancer cell proliferation. Copper in an essential trace element that participates in many enzymatic complexes like the cytochrome c, superoxide dismutase and lysyl oxidase and it is involved in processes, like embryogenesis, growth, angiogenesis and carcinogenesis. In particular, its involvement in carcinogenesis was described for the first time in oral submucous fibrosis, where fibroblasts produce large amounts of collagen in the presence of copper. Copper's action in carcinogenesis is two-fold: (1) it participates in reactions with an increased redox potential that result in the production of oxidative products and oxidative stress. Through this mechanism, copper may cause DNA mutations in the nucleus and mitochondria or alterations to membrane phospholipids, (2) it participates in angiogenesis even in the absence of angiogenic molecules, as it was reported for the first time in rabbit cornea models with copolymer pellets charged with PGE1. Copper chelation regimens like penicillamine and tetrathiomolybdate are being described in the literature as having anti-angiogenic, anti-fibrotic and anti-inflammatory actions. Animal models of brain cancer that evaluated the anti-angiogenic properties of copper, have proven evidence of the reduction of tumor's microvascular supply, tumor volume and vascular permeability after plasma copper levels reduction. Interestingly, plasma copper levels reduction was shown to suppress micrometastases generation in mice models of breast cancer. We hypothesize that copper chelation therapy: increases oxidative stress in cancer cells to a level that does not allow survival because of the reduction of anti-oxidative enzymes production. It may also result in inhibition of angiogenesis and of the initiation of the angiogenic switch, because copper normally enhances endothelial cell migration and proliferation, improves binding of growth factors to endothelial cells and enhances the expression of angiogenic molecules. Copper chelation may also reduce extracellular matrix degradation and cancer spread, through reduction of MMP-9 production and probably of other collagenases and may inhibit propagation of micrometastases. However, copper chelation therapy may enhance angiogenesis through reduction of thrombospondin-1, that results into an increase in VEGF-VEGFR2 complexes and a high level of active MMP-9. These hypotheses help in understanding of the anti-angiogenic action of copper chelation therapies and of the complex network of interactions between copper and other molecules involved in angiogenesis. It may also stimulate further research regarding differences in copper metabolism, the effects of anti-copper regimens on organs, the development of resistance, and their possible angiogenic action through thrombospondin expression reduction.

Purpose Postoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment. Materials and methods A total of 128 patients treated at our clinic in the period 2012–2015 who required analgesic treatment adaptation by our pain clinic were included. They were further divided into 10 groups: tumor, temporomandibular joint disorder, tooth extraction, osteomyelitis, bisphosphonate-related osteonecrosis of the jaw, submandibular abscess, orthognathic surgery, cyst, sinusitis, and fracture. Pain characteristics evaluated were intensity on a numerical rating scale (NRS) before and after intervention of the pain clinic, quality, genesis, and type. Results Post treatment pain intensity values at rest 1.8 (SD: 1.4) and on exercise (walking and physical therapy) 4 (SD: 2) were statistically significant better compared to pretreatment values (4.2, SD: 2.5, and 6.8 SD: 2, respectively). The highest pain intensities were reported after tooth extractions, orthognathic surgery, cystectomies, and fracture reposition. Pain was mainly continuous and related to a combination of a somatic and a neuropathic pathophysiological mechanism. Conclusions Intervention by a specialized pain clinic leads to reduction of postoperative pain.

This article moves beyond stereotypical portrayals of the connections between hyper-masculinity and violence in militarized contexts and identifies expressions of insurgent masculinities different from the imagery of ‘heroic guerrilla fighter’. Based on conversations with fifty female and male former insurgent militants in Peru, Colombia and El Salvador, this comparative analysis explores patterns within gender regimes created in insurgent movements. This contribution shows that ‘gender’ is not merely a ‘side contradiction’, but that guerrilla movements invest considerable efforts in creating and managing gender relations. The construction of insurgent masculinities is not based on the rejection or devaluation of women in general, but requires diluting gendered dichotomies, enabling not only alternative role models functional for armed struggle, but also female–male bonding, prioritizing comrade identity over gender-binary consciousness.

Vascular malformations are benign tumors that are characterized by the presence of blood vessels lined by cells with a normal cell turnover. They constitute less than 1 % of all osseous tumors. A central location within the jaws is rare, but the body of the mandible is most often affected. Reports of intraosseous vascular malformations of the mandibular condyle are extremely rare; only eight previous cases have been reported. The purpose of this study is to present a case of a vascular malformation of the condyle with diagnostic images and to discuss the differential diagnosis.

Purpose Therapies for certain voice disorders purport principles of skeletal muscle rehabilitation to increase muscle mass, strength, and endurance. However, applicability of limb muscle rehabilitation to the laryngeal muscles has not been tested. In this study, the authors examined the feasibility of the rat thyroarytenoid muscle to remodel as a consequence of increased activity instantiated through chronic electrical stimulation. Method Twenty adult Sprague-Dawley rats ( Rattus norvegicus), assigned to a 1-week or 2-week stimulation group, were implanted with a nerve cuff electrode placed around the right recurrent laryngeal nerve and were fitted with a head connector. All animals were placed under anesthesia twice a day for 1 hr each time. Following the training, rats were killed, and thyroarytenoid muscles were isolated for histology and immunohistochemistry. Results Mean muscle fiber area decreased, neuromuscular junction density increased, mitochondrial content increased qualitatively, and glycogen-positive fibers increased, demonstrating exercise-induced changes similar to those seen in limb muscles after endurance training. Conclusion Rat thyroarytenoid muscles are capable of remodeling in response to chronic electrical stimulation.

(2011). For Your Vocal Health: Keeping the Mature Voice Healthy. Voice and Speech Review: Vol. 7, A World of Voice, pp. 280-286.

Objective: Laryngeal muscle dysfunction in the aged contributes to dysphagia and increases the risk of aspiration, factors that lead to higher rates of mortality and morbidity.These changes also co...

Starting from early stages of craniofacial development, the leading role of vasculature, in particular endothelial progenitor cells, becomes apparent. They are probably the cells that synthesize the appropriate bone morphogenetic protein (BMP), that precedes neural crest cell migration and determines their final destination and skeletal development. During postnatal osteosynthesis in the mandible, angiogenesis similarly goes before osteosynthesis, regulates this process with the production of BMP-2 and serves as a scaffold for osteoblasts. This growth factor is involved in bone metabolism and bone injury repair. The dependence of bone from vasculature, is better understood when looking to osseous changes that result from vasculopathies and arteritides, like in diabetes mellitus and polyarteritis nodosa respectively, that affect the mandible more frequently than previously suspected. These changes are not only the result of a dysregulation of osteoblasts and osteoclasts, but of a complex network of factors that affect the vasculature, like VEGF and hypoxia. Abnormal vasculature results in qualitatively degradated bone, with an atypical architecture or even in bone necrosis. The dynamic interplay between vasculature and bone of the mandible, with the vasculature endothelium playing an initiating and regulatory role in osteosynthesis, supports the hypothesis of an angiogenic origin of bone. This hypothesis, helps in understanding of bone pathology, like avascular necrosis and of the impact of interventions and medications that affect vasculature, on bone metabolism.

Bu makale militarist erkekliklerin direnişçi silahlı mücadele bağlamındaki oluşumunu ele almaktadır. Makale gerilla hareketlerinin çatışma ortamında faaliyet gösteren daimi ordulardan farklı bir toplumsal cinsiyet rejimi oluşturduğunu savunmaktadır. Toplumsal cinsiyet ilişkilerinin bu yeni konfigürasyonu, hiyerarşik cinsiyet ilişkilerini meşrulaştırmaktan kaçınan, alternatif ve hegemonik olmayan direnişçi erkekliklerin ve kadınlıkların oluşması anlamına gelir. Hegemonik erkeklikle ilgilenen araştırmacıların son dönemde yürüttükleri tartışmalara dayanan bu makalenin amacı, silahlı çatışma bağlamında görülen hegemonik olan ve olmayan pratikler arasında bir ayrım yapmaktır. Makale, Kolombiya’daki 19 Nisan Hareketi (M-19) (1974-1990) içindeki cinsiyet kurgularını ele alan ampirik bir araştırma vasıtasıyla, silahlı çatışma bağlamında ortaya çıkan hegemonik olmayan erkekliklerle ilgili cinsiyet perspektifli bilgi üretimine katkıda bulunmayı amaçlamaktadır. Üçü kadın, beşi erkek, sekiz eski M-19 militanıyla gerçekleştirilen adet yarı yapılandırılmış mülakatlara dayanan bu çalışma, hegemonik örüntülerin yanı sıra görülen hegemonik olmayan cinsiyet ilişkilerinin farkına dikkat çekecektir., This article engages with the constructions of militarised masculinities in the context of insurgent armed struggle. It argues that guerrilla movements organisations generate a different gender regime than standing armies operating in conflict contexts. This reconfiguration of gender relations amounts to alternative, non-hegemonic constructions of insurgent masculinities and femininities that refrain from legitimising hierarchical gender relations. Resorting to recent discussions among scholars engaging with hegemonic masculinity this article aims to disentangle hegemonic from non-hegemonic practices that circulate alongside in the context of insurgent armed struggle. It aims to further the gendered knowledge production on nonhegemonic masculinities in armed conflicts through an empirical exploration of gender constructions within the 19th of April Movement (M-19) in Colombia (1974-1990). Using eight semistructured interviews with former militants of the M-19 (three female and five male) conducted in the course of fieldwork in 2010 in Bogota this research will distinguish un-hegemonic patterns in gender relations that circulate alongside hegemonic patterns.

Over the past decades, the international community has increased efforts to enhance spaces of women’s meaningful participation in all spheres of conflict to post-conflict transition. The acknowledgement of women as essential actors for sustainable peace has prompted advocacy activities to include women in planning, implementing and monitoring of peace-building efforts. Despite significant advances in the field, the challenge remains to overcome stereotypical notions that associate women as passive bystanders or only as bearers of the violent consequences of armed conflicts, while ignoring the role women play as political actors. A step towards a more inclusive and holistic transition consists of exploring contributions the female actors in armed conflict can bring to peace-building. Female ex-combatants have played active political and military roles in insurgent organizations. Besides their first-hand experience in disarmament, demobilization and reintegration (DDR) programmes, some of them maintain connections with former insurgent groups and may influence processes from within. In that sense, organizations of female ex-combatants constitute an untapped resource for the promotion of gender-responsive transitions.

Ranulas are rare cystic lesions resulting from damage or rupture of one or more of the ducts of the sublingual gland, that lead to mucus extravasation or dilatation of the gland's duct. Extravasation cysts are more common than retention cysts. We present a case of a 45-year-old male with a squamous cell carcinoma of the ventral surface of the tongue that was treated with excision of the oral lesion and bilateral supraomohyoid neck dissection without supplementary radiotherapy. A left myocutaneous platysma flap was raised for defect closure. Ten months postoperatively he presented complaining of swelling of the right submandibular region. The diagnosis, based on his medical anamnesis and the CT imaging, was a sublingual-plunging ranula. It is postulated that the ranula resulted from damage to the ducts of the sublingual gland during selective neck dissection. One year postoperatively there are no signs of recurrence either of the ranula or of the cancer. We suggest that sublingual gland excision and intraoral cyst marsupialization is a logical treatment for sublingual-plunging ranulas.