Peripheral T cell activation, not thymic selection, expands the T follicular helper repertoire in a lupus-prone murine model.

Many autoimmune diseases are characterized by the activation of autoreactive T cells. The T cell repertoire is established in the thymus; it remains uncertain whether the presence of disease-associated autoreactive T cells reflects abnormal T cell selection in the thymus or aberrant T cell activation in the periphery. Here, we describe T cell selection, activation, and T cell repertoire diversity in female mice deficient for B lymphocyte-induced maturation protein (BLIMP)-1 in dendritic cells (DCs) (Prdm1 CKO).

Component Restoration in the Bilateral Intermediate Cleft Tip Rhinoplasty.

The intermediate cleft tip rhinoplasty is frequently performed during childhood to address nasal tip anomalies in cleft patients before the most critical period of psychosocial development. The authors previously described the component restoration intermediate cleft tip rhinoplasty technique for the unilateral cleft nose, which was developed to systematically address the lining deficiency, cleft lower lateral cartilage malpositioning, and cleft lateral cartilage weakness using a combination of lower lateral cartilage release, lateral cartilage repositioning, and placement of an auricular composite chondrocutaneous graft. In this work, the authors evaluate the utility of this technique to the bilateral cleft nose.

Syndrome of the Trephined: Quantitative Functional Improvement after Large Cranial Vault Reconstruction.

Background: Large decompressive craniectomies may be life-saving; however, they may also result in syndrome of the trephined. This postrecovery sequela is characterized by dizziness, fatigue, depression, weakness, speech slowing, gait disturbance, and impaired mentation. Because this entity is poorly understood, the authors attempted to quantify the functional improvement in patients with syndrome of the trephined after cranial vault reconstruction.

Effect of Parental English Proficiency on Psychosocial Functioning in Children with Craniofacial Anomalies.

Background: Psychosocial distress in children with craniofacial anomalies is multifactorial. A known cause of childhood psychosocial distress is parental limited English proficiency; however, its role as a psychosocial stressor in the craniofacial anomaly population remains unknown. The current study aimed to understand the potential influence of parental English proficiency in children with craniofacial anomalies.

Discrepancies in Parent Perceptions and Patient-Reported Psychosocial Function in Children with Craniofacial Anomalies.

Background: Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies.

Methods: Two hundred twenty-one children with craniofacial anomalies (aged 8 to 17 years) and their parents were prospectively evaluated at two institutions using the parent-proxy and pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships.

Intraoperative Three-dimensional Virtual Reality and Computed Tomographic Guidance in Temporomandibular Joint Arthroplasty of Syndromic Craniofacial Dysostoses.

Bony ankylosis of the temporomandibular joints (TMJ) occurs in up to 28% of patients with syndromic mandibular dysostoses. Release of complete osseous ankylosis is particularly challenging due to the lack of tissue planes separating the mandible from the skull base and the presence of congenital skeletal abnormalities. One recent advance in surgical imaging technology is three-dimensional virtual reality (3D VR), now in common use in neurosurgical resections.

History of NSAID Use in the Treatment of Headaches Pre and Post-industrial Revolution in the United States: the Rise and Fall of Antipyrine, Salicylic Acid, and Acetanilide.

Purpose Of Review: Non-steroid anti-inflammatory drugs (NSAIDs) constitute a vital class of medications in today's headache regimen. However, up until the nineteenth century, they were largely unknown to most of the medical community. The purpose of this review is to explore the evolution of NSAIDs in the treatment of headaches spurred on by the Industrial Revolution in the USA.

Powered irrigation with suction evacuation for chronic rhinosinusitis in the office setting: A pilot study.

Bacterial infections in the form of adherent biofilms are frequently implicated in the pathogenesis and recalcitrance of chronic rhinosinusitis. The Hydrodebrider, a disposable powered irrigation and suction device, has been developed specifically to remove biofilm from the paranasal sinuses. We conducted a prospective study to evaluate the tolerability and efficacy of the Hydrodebrider in the office setting with the use of local anesthesia.