Genetic characterization of early renal changes in a novel mouse model of diabetic kidney disease.

Genetic factors influence susceptibility to diabetic kidney disease. Here we mapped genes mediating renal hypertrophic changes in response to diabetes. A survey of 15 mouse strains identified variation in diabetic kidney hypertrophy. Strains with greater (FVB/N(FVB)) and lesser (C57BL/6 (B6)) responses were crossed and diabetic F2 progeny were characterized. Kidney weights of diabetic F2 mice were broadly distributed. Quantitative trait locus analyses revealed diabetic mice with kidney weights in the upper quartile shared alleles on chromosomes (chr) 6 and 12; these loci were designated as Diabetic kidney hypertrophy (Dkh)-1 and -2. To confirm these loci, reciprocal congenic mice were generated with defined FVB chromosome segments on the B6 strain background (B6.Dkh1/2f) or vice versa (FVB.Dkh1/2b). Diabetic mice of the B6.Dkh1/2f congenic strain developed diabetic kidney hypertrophy, while the reciprocal FVB.Dkh1/2b congenic strain was protected. The chr6 locus contained the candidate gene; Ark1b3, coding aldose reductase; the FVB allele has a missense mutation in this gene. Microarray analysis identified differentially expressed genes between diabetic B6 and FVB mice. Thus, since the two loci identified by quantitative trait locus mapping are syntenic with regions identified for human diabetic kidney disease, the congenic strains we describe provide a valuable new resource to study diabetic kidney disease and test agents that may prevent it.

Analysis of social media use among Australian and New Zealand otolaryngologists.

BACKGROUND: Social media's rapid worldwide growth has permeated surgical practice. To date, no study has evaluated social media use amongst Australian and New Zealand otolaryngologists. METHODS: Cross-sectional study of all members of the Australian and New Zealand Societies of Otolaryngology Head and Neck Surgery with comprehensive searches of websites and social media platforms (Facebook, Twitter, LinkedIn, ResearchGate and Instagram) was performed. RESULTS: A total of 498 otolaryngologists were identified with 81.7% working in Australia; 79.1% had some form of online presence - either professional website or activity on ≥1 social media platform and 53.0% of otolaryngologists had a professional website and mean number of social media profiles averaged 1.35 per surgeon. LinkedIn was the most widely used social media platform (51.6%). 38.8% of otolaryngologists had Facebook accounts with 11.9% of those 'public' accounts used for business purposes. Otolaryngologists with a research and authorship interest had the highest mean number of social media accounts (1.78) and were more likely to be associated with ResearchGate, LinkedIn and website ownership. Facial plastic surgeons averaged the second highest mean number of social media accounts per surgeon (1.71) and were most active on Facebook, Instagram and YouTube. There was a linear decline in the mean number of social media accounts per surgeon and rate of professional website ownership with increasing years in practice. CONCLUSION: Social media uptake amongst otolaryngologists appears consistent with colleagues in other surgical specialties. Otolaryngologists with fewer years in practice and specialty interests in facial plastic surgery and authorship and research are significantly more active on social media.

Prognostic value of albumin in patients with head and neck cancer.

OBJECTIVES/HYPOTHESIS: Albumin is an indicator of nutritional status and has been investigated as a predictor of cancer survival and perioperative outcomes. This study investigated the prognostic value of preoperative serum albumin in surgical patients with head and neck cancer (HNC). STUDY DESIGN: Retrospective cohort study. METHODS: A chart review was performed of patients who underwent HNC resection over a 6-year period at a single institution. Statistical analyses including Cox proportional hazards models, Pearson's correlation, and logistic regression were used to identify relationships between preoperative serum albumin and postoperative outcomes. Albumin was analyzed as a continuous variable. RESULTS: A total of 604 patients were studied representing all cancer types. There was no association between albumin and pneumonia, flap complications, or length of stay. Albumin was found to have statistically significant inverse associations with overall survival (OS) (hazard ratio [HR] = 0.685, P < .001) and postoperative wound infection (HR = 0.455, P = .001). In multivariate analysis of OS, albumin did not achieve significance as an independent predictor (HR = 0.78, P = .064), whereas hemoglobin, age, and cancer stage remained significant. In a subgroup of 280 patients with upper aerodigestive squamous cell carcinoma (SCCA), albumin maintained significance in multivariate analysis of OS (HR = 0.74, P = .046). When controlling for preoperative radiotherapy, salvage surgery, and cancer stage in multivariate analysis, albumin was a significant predictor of wound infection (OR = 0.55, P = .018). CONCLUSIONS: In patients with HNC, lower preoperative serum albumin is associated with an increased rate of wound infection and poorer OS. The effect on OS is most pronounced in patients with upper aerodigestive SCCA. LEVEL OF EVIDENCE: 2b Laryngoscope, 126:1567-1571, 2016.

Preliminary outcomes of cholesteatoma screening in children using non-echo-planar diffusion-weighted magnetic resonance imaging.

OBJECTIVE: Diffusion-weighted (DW) MRI imaging is evolving into an alternative to second look surgery in detection of cholesteatoma recurrence. Insights into the DW MRI appearances of postoperative or inflammatory mucosal changes have recently described using non-echo-planar, turbo spin-echo (TSE) DW MRI which reliably distinguishes between postoperative changes and cholesteatoma. We investigated the use of TSE DW MRI in our pediatric population in order to validate a rapid and cost-effective MRI sequence that can be used to screen for cholesteatoma. METHODS: Prospective comparative study with adult and pediatric patients at a tertiary referral centre. Patients in the study underwent TSE DW MRI prior to second look or revision surgery for cholesteatoma. A Siemens 1.5 T scanner was employed, using the HASTE sequence (EPI DW MRI) as well as standard echo-planar DWI, T1 and T2 sequences. The MRI findings were then correlated with the intraoperative findings at surgery 9-15 months after primary surgery, or of revision surgery in the cases that were referred from other centres. Detection and localisation of cholesteatoma on TSE DW MRI were compared with the findings at second surgery, long considered the gold standard for detection of residual or recurrent disease. Scanning time between the TSE sequence and the standard planar DW MR were also compared. RESULTS: In a cohort of 92 patients, 21 pediatric patients were identified. 15 patients have had their 15 second look or revision procedures and DW MRI prior to their surgery. TSE DW MRI detected cholesteatoma and reliably identified the location of the cholesteatoma in 2 patients whom all had disease confirmed at surgery. The 13 cases with negative preoperative DW MRI for cholesteatoma were all confirmed to be disease free at surgery. Scanning time of the TSE sequence takes 100 s as opposed to 20 min using standard echo-planar DW MRI techniques without the requirement of a contrast agent and without the need for a general anaesthetic for any of the children. CONCLUSION: TSE (HASTE) DW MRI is emerging as a cost effective, noninvasive alternative to second look surgery for detection and screening for cholesteatoma in pediatric patients.