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Tetyana Leinberger, Claudia Heilmann, Stefan Sorg, Matthias Mueller, Sami Kueri, Claudia Schmoor, Matthias Siepe, Friedhelm Beyersdorf
BACKGROUND:  Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. METHODS:  A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebrüder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 ± 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 ± 5 days; incidence of pneumonia during hospitalization within the first 30 (±5) days and chest pain intensity...
February 2, 2018: Thoracic and Cardiovascular Surgeon
Saad Mohammed AlShareef, Richard Mark Smith, Ahmed Salem BaHammam
Kleine-Levin syndrome (KLS) is the commonest recurrent sleep disorder, with a prevalence of 1-2 per million population. Clear diagnostic criteria are now defined, but effective treatment remains elusive. The significant body of published literature allows consideration of possible aetiological mechanisms, an understanding of which could guide the development of therapeutic strategies. Functional imaging studies have been inconclusive; although diencephalic abnormalities are a common finding, no consistent pattern has emerged, and these studies have not revealed the mechanism(s) underlying the development of the abnormalities detected...
March 12, 2018: Sleep & Breathing, Schlaf & Atmung
Marino Marčić, Ljiljana Marčić, Marina Titlić
Kleine-Levin syndrome (KLS) is a rare sleep disorder mainly affecting teenage boys in which the main features are intermittent hypersomnolence, behavioral and cognitive disturbances, hyperphagia, and in some cases hyper sexuality. Etiology is unknown, and there is no specific clinical or imaging test for this syndrome even though the illness has well-defined clinical features. Also, there is no effective treatment for KLS. KLS is self-limited, so the prognosis for these patients is not so bad. This study presents our case report and comprehensive workout that led to diagnosis which is primarily clinical...
January 2018: Acta Medica Iranica
Saad M Al Shareef, Aljohara S Almeneessier, Richard M Smith, Ahmed S BaHammam
PURPOSE: Kleine-Levin syndrome (KLS) is a rare, relapsing-remitting, debilitating sleep disorder. Examining KLS characteristics in different ethnic populations may help elucidate the genetic basis of the disorder. No studies have examined Kleine-Levin syndrome in Arabs. Therefore, we compared the clinical characteristics of Saudi Arabian KLS patients to those in other published cohorts to determine whether Arab patients have a distinct phenotype. METHODS: This study included all patients who were diagnosed with KLS at our center between June 2003 and July 2016 (P=12;6 familial cases)...
February 3, 2018: International Journal of Neuroscience
Hani M Rayess, Peter Svider, Curtis Hanba, Vivek Sagar Patel, Michael Carron, Giancarlo Zuliani
Importance: Facial implants represent an important strategy for providing instant and long-lasting volume enhancement to address both aging and posttraumatic defects. Objective: To better understand risks of facial implants by examining national resources encompassing adverse events and considerations facilitating associated litigation. Design, Setting, and Participants: A cross-sectional study reviewed complications following facial implants...
January 18, 2018: JAMA Facial Plastic Surgery
Saad M Al Shareef, Aljohara S Almeneessier, Omeima Hammad, Richard M Smith, Ahmed S BaHammam
To establish baseline sleep architecture during an acute attack of Kleine-Levin syndrome (KLS) in a cohort of Saudi Arabian KLS patients and compare these characteristics with other published cohorts. Methods: This was a retrospective cohort study of the polysomnographic characteristics of 10 typical symptomatic Saudi Arabian KLS patients attending the University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia between 2002 and 2015. Data were captured by nocturnal polysomnography during an acute attack of hypersomnia and compared with other published cohorts identified via a systematic literature search...
January 2018: Saudi Medical Journal
Jlenia Guarnerio, Lourdes Maria Mendez, Noboru Asada, Archita Venugopal Menon, Jacqueline Fung, Kelsey Berry, Paul S Frenette, Keisuke Ito, Pier Paolo Pandolfi
Disease recurrence after therapy, due to the persistence of resistant leukemic cells, represents a fundamental problem in the treatment of leukemia. Elucidating the mechanisms responsible for the maintenance of leukemic cells, before and after treatment, is therefore critical to identify curative modalities. It has become increasingly clear that cell-autonomous mechanisms are not solely responsible for leukemia maintenance. Here, we report a role for Pml in mesenchymal stem cells (MSCs) in supporting leukemic cells of both CML and AML...
January 4, 2018: Nature Communications
Florian Baumann, Johannes Weber, Daniel Mahr, Martin Bäumlein, Maximilian Kerschbaum, Karolina Müller, Paavo Rillmann, Michael Nerlich, Markus Loibl
BACKGROUND: Evaluating patient-reported outcomes (PRO) in early osteoarthritis (OA) of the knee is difficult. Established measurement tools are focused on one of the two major patient groups in knee surgery: young, highly active patients, or older patients with advanced degenerative OA of the knee. Joint awareness in everyday life is a crucial criterion in measuring PRO. The purpose of this study was to validate a German version of the "Forgotten Joint Score" (FJS) in patients after surgical treatment of tibial plateau fractures...
December 2, 2017: Health and Quality of Life Outcomes
Swarndeep Singh, Saurabh Kumar, Rohit Verma, Nand Kumar
Kleine-Levin syndrome (KLS) is a rare disorder (around 1.5 cases per million population), often presenting with triad of recurrent episodes of hypersomnia, hyperphagia, and hypersexuality. However, cases of atypical KLS with features opposite to that being commonly reported are often misdiagnosed as psychosis and present as a diagnostic challenge for the physicians, psychiatrists, and neurologists. We describe a case of atypical KLS which was misdiagnosed as unspecified nonorganic psychosis previously, highlighting the various points which would be helpful in identifying and diagnosing cases of atypical KLS in future...
January 2017: Journal of Family Medicine and Primary Care
Arpit Parmar, Priyanka Yadav, Bichitra Nanda Patra, Rajesh Sagar
Kleine-Levin syndrome (KLS) is a rare disorder characterized by episodic hypersomnia along with cognitive and behavioral disturbances (i.e., hyperphagia and hypersexuality). It is commonly seen in a young male. Not much is known about its long-term management; however, many reports suggest the usefulness of anticonvulsants and lithium for the same. We hereby report a case of childhood KLS from India who was successfully treated with low-dose lithium and discuss the relevant literature.
July 2017: Indian Journal of Psychological Medicine
Ravi Sharma, R Manikandhan, P Sneha, Anantanarayanan Parameswaran, J Naveen Kumar, Hermann F Sailer
INTRODUCTION AND OBJECTIVES: Management of temporomandibular joint (TMJ) ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis...
May 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Laura Brandolini, Michele d'Angelo, Andrea Antonosante, Sara Villa, Loredana Cristiano, Vanessa Castelli, Elisabetta Benedetti, Mariano Catanesi, Andrea Aramini, Alberto Luini, Seetharaman Parashuraman, Emilia Mayo, Antonio Giordano, Annamaria Cimini, Marcello Allegretti
Ketoprofen L-lysine salt (KLS), is widely used due to its analgesic efficacy and tolerability, and L-lysine was reported to increase the solubility and the gastric tolerance of ketoprofen. In a recent report, L-lysine salification has been shown to exert a gastroprotective effect due to its specific ability to counteract the NSAIDs-induced oxidative stress and up-regulate gastroprotective proteins. In order to derive further insights into the safety and efficacy profile of KLS, in this study we additionally compared the effect of lysine and arginine, another amino acid counterion commonly used for NSAIDs salification, in control and in ethanol challenged human gastric mucosa model...
March 2018: Journal of Cellular Physiology
Naresh Nebhinani, Navratan Suthar
Kleine-Levin syndrome (KLS), also called "Sleeping beauty syndrome" is a rare, disorder predominantly reported in adolescent males, characterized by recurrent episodes of hypersomnia and to various degrees, hyperphagia, cognitive disturbances, and hypersexuality. Here, we are reporting a case of a middle-aged female, with 16 years delay in diagnosing KLS, poor response to most of the psychotropics, except good response to a combination of lithium, sertraline, and modafinil for last 12 months and also reviewing other female cases with KLS reported from India...
May 2017: Indian Journal of Psychological Medicine
B Gareb, N B van Bakelen, G J Buijs, J Jansma, J G A M de Visscher, Th J M Hoppenreijs, J E Bergsma, B van Minnen, B Stegenga, R R M Bos
BACKGROUND: Biodegradable fixation systems could reduce or eliminate problems associated with titanium removal of implants in a second operation. AIM: The aim of this study was to compare the long-term (i.e. >5 years postoperatively) clinical performance of a titanium and a biodegradable system in oral and maxillofacial surgery. MATERIALS AND METHODS: The present multicenter Randomized Controlled Trial (RCT) was performed in four hospitals in the Netherlands...
2017: PloS One
Y Hu, J Y Wang, X S Dong, J Li, H Yan, P P Wang, L Zhao, X Z Zhang, F Han
Objective: To analyze the clinical features of Kleine-Levin syndrome (KLS) patients. Methods: Clinical data of 44 patients with KLS of the Sleep Center of Peking University People's Hospital from January 2002 to July 2013 were systematically reviewed. The predisposing factors and clinical presentations were summarized, and compared with the data from a Western KLS study with a large subjects number. Nocturnal polysomnography (PSG) and multiple sleep latency test (MSLT) were conducted during relapse and remission period, respectively...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Natan Gadoth, Arie Oksenberg
Since 1962, when Critchley and Hoffman coined the term Kleine-Levin Syndrome (KLS) for the triad of hypersomnia, excessive eating and "often abnormal behavior" which they have observed in 11 adolescent boys, the number of patients recognized with this rare syndrome expanded, the spectrum of the clinical presentation, disease course, prognosis, gender specificity and the presence of familial cases were established. However, in spite of the progress made in neuroscience, the search for the cause, neuroanatomy, pathophysiology and drug treatment of KLS is still ongoing...
September 2017: Brain & Development
Zhengqi Wang, Kevin D Bunting
Aging is associated with significant changes in hematopoiesis, including clonal dominance, anemia, myeloid malignancies, and reduced activation of signal transducer and activator of transcription 5 (Stat5). In previous studies, Stat5 deletion surprisingly amplified FLT3/ITD+ myeloid expansion or Myc-driven lymphoid expansion. Here we show that Stat5 deficiency has a strong impact upon transcriptional heterogeneity in single sorted c-Kit+Lin-Sca-1+ (KLS) cells or CD150+CD48- KLS long-term repopulating hematopoietic stem cells (LT-HSC)...
April 4, 2017: Oncotarget
Brandon Kikuo Richland, Christopher Ellstrom, Asim Ahmad, Daniel Jaffurs
BACKGROUND: Mandibular distraction osteogenesis is an important technique to correct the pediatric hypoplastic mandible. Regression of the mandible after distraction continues to be a challenge, with some studies reporting up to 22% to 56% decrease toward predistraction length in the first year. We hypothesize that a resorbable plate placed after removal of the distractor will provide additional stability to newly formed bone, allowing further time for consolidation and minimizing regression...
May 2017: Annals of Plastic Surgery
Olufunke Afolabi-Brown, Thornton B A Mason
Kleine-Levin syndrome (KLS) is a rare disorder characterized by discrete episodes of hypersomnia associated with cognitive and behavioural abnormalities, as well as normal alertness and function between episodes. The prevalence of KLS may be underestimated as it is often misdiagnosed and managed as another sleep disorder, neurological disorder or psychiatric condition. KLS is more typically seen in adolescence than at other ages, and is more common in males than in females. There are currently neither standard biomarkers nor specific imaging study findings, making the diagnosis of KLS a challenge...
December 23, 2016: Paediatric Respiratory Reviews
Florian G Draenert, Florian Gebhart, Gergo Mitov, Andreas Neff
OBJECTIVES: Alveolar ridge and vertical augmentations are challenging procedures in dental implantology. Even material blocks with an interconnecting porous system are never completely resorbed. Shell techniques combined with autologous bone chips are therefore the gold standard. Using biopolymers for these techniques is well documented. We applied three-dimensional (3-D) techniques to create an individualized bending model for the adjustment of a plane biopolymer membrane made of polylactide...
June 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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