Primary surgical approaches offer the best survival outcomes in smokers with p16-positive cancers and in patients with p16-negative cancers. © 2015 Wiley Periodicals, Inc. Head Neck 38: E-E, 2016.

Acute gastroenteritis remains a major cause of morbidity and mortality among young children worldwide. It accounts for approximately 1.34 million deaths annually in children younger than five years. Infection can be caused by viral, bacterial and/or parasitic microorganisms. Dysbiosis due to such infections could dramatically affect disease prognosis as well as development of chronic illness. The aim of this study was to analyze gut microbiome and clinical outcomes in young children suffering from viral or mixed viral-bacterial infection. We evaluated gut microbiota composition in children suffering from viral or mixed viral-bacterial infection with two major viruses rotavirus (RV) and norovirus (NoV) and two pathogenic bacteria [Enteroaggregative E. coli (EAEC), and Enteropathogenic E. coli (EPEC)]. We sequenced 16S ribosomal RNA (V4 region) genes using Illumina MiSeq in 70 hospitalized children suffering from gastroenteric infections plus nine healthy controls. The study summarized Operational Taxonomic Unit (OTU) abundances with the Bray-Curtis index and performed a non-metric multidimensional scaling analysis to visualize microbiome similarities. We used a permutational multivariate analyses of variance to test the significance of group differences. We also analyzed the correlation between microbiome changes and clinical outcomes. Our data demonstrated a significant increase in the severity score in children with viral-bacterial mixed infections compared to those with virus infections alone. Statistical analysis by overall relative abundance denoted lesser proportions of Bacteroides in the infected children, whereas Bifidobacteriaceae richness was more prominent in the bacterial-viral mixed infections. Pairwise differences of gut microbiota were significantly higher in RV + EAEC (P = 0.009) and NoV + EAEC (P = 0.009) co-infections, compared to EPEC mixed infection with both, RV (P = 0.045) and NoV (P = 0.188). Shannon diversity index showed considerable more variation in microbiome diversity in children infected with RV cohort compared to NoV cohort. Our results highlight that richness of Bifidobacteriaceae, which acts as probiotics, increased with the severity of the viral-bacterial mixed infections. As expected, significant reduction of relative numbers of Bacteroides was characterized in both RV and NoV infections, with more reduction observed in co-infection pathogenic E. coli. Although mixed infection with EAEC resulted in significant microbiota differences compared to viral infection only or mixed infection with EPEC, the clinical condition of the children were worsened with both pathogenic E.coli co-infections. Further, in comparison with RV cohort, augmented number of differential abundant pathogenic OTUs were peculiarly noticed only with NoV mixed infection.

We have developed a comprehensive reconstructive protocol that provides patients with separation of the oropharynx and nasopharynx, while maintaining nasal patency. Restoration of function is timely, with reestablishment of normal intelligibility and resonance of speech as well as safe and efficient swallowing function.

Summary Twenty‐six cases of “benign epilepsy of childhood” with Rolandic spikes, thoroughly studied clinically and electroencephalographically, were compared with 26 patients with petit mal or petit mal and grand mal seizures. Absences could be detected in a fair number of children with “benign epilepsy.” Rolandic spikes and MU rhythms were found almost exclusively in patients having convulsions, whether focal or generalized. Rolandic spikes associated with MU rhythms and bilaterally synchronous or asynchronous discharges of spikes or of spike‐and‐slow‐waves seem, therefore, to be the features of an epilepsy whose clinical manifestations (absences or convulsions) may depend on the psycho‐biophysiological background. RÉsumé 26 cas d' “Epilepsie bénigne de L'enfance avec pointes Rolandiques” ont étéétudiés du point de vue clinique et électroencéphalographique, ils sont compareés à 26 observations de patients présentant des crises petit mal, ou petit mal et grand mal associées. Les absences petit mal électrocliniques sont fréquentes chez les sujets porteurs d'une épilepsie bénigne de L'enfance. Les pointes Rolandiques et les rythmes MÛ sont exclusivement enregistrés chez les patients présentant des crises convulsives focales ou et généralisées. L'association pointes Rolandiques, rythme MÛ, décharges bilatérales de pointes ou de pointes ondes, synchrones ou asynchrones, semble caractéristique des épilepsies bénignes dont la forme convulsive ou nonconvulsive dépend des conditions psycho‐biophysiologiques actuelles. ZUSAMMEnfassung 26 vollständig klinisch und elektroencephalographisch untersuchte Fälle von kindlicher benigner Epilepsie mit Rolandischen spikes, wurden mit 26 Kindern mit Petit‐Mai oder Petit‐Mal und Grand‐Mal verglichen. In einer beträchtlichen Anzahl von Kindern mit benigner Epilepsie konnten Absencen beobachtet werden. Rolandische spikes und MU‐Rhythmen wurden fast ausschliesslich bei Patienten mit fokalen oder generalisierten Anfällen gefunden. Das gemeinsame Auftreten von Rolandischen spikes, MU‐Rhythmen und bilateral synchronen oder asynchronen Entladungen von spikes oder spike‐slow‐waves scheinen somit Zeichen einer Epilepsie zu sein, deren klinische Manifestation (Absencen oder Krampfanfälle) vom psycho‐biophysiologischem Hintergrund abhängen. RESUMEN Se han comparado 26 casos de “epilepsyía benigna del niño con puntas Rolándicas,” concienzudamente estudiados clínica y electroencefalográficamente con 26 enfermos que padecían episodios de petit‐mal o ataques de gran mal asociados a petit‐mal. Se recogieron ausencias en un considerable número de niños con “epilepsyía benigna.” Puntas Rolándicas y ritmos MU se encontraron exclusivamente con convulsiones, ya fueran focales o generalizadas. La asociación de puntas Rolándicas, ritmos MU y descargas bilaterales síncronas o asíncronas, de puntas o punta‐onda lenta parece ser un hallazgo de las epilepsyías cuyas manifestaciones clínicas (ausencias o convulsiones) pueden depender de un fondo psico‐biofisiológico.

Respiratory syncytial virus continues to pose a serious threat to the pediatric populations worldwide. With a genomic makeup of 15,200 nucleotides, the virus encodes for 11 proteins serving as envelope spikes, inner envelope proteins, and non-structural and ribonucleocapsid complexes. The fusion (F) and attachment (G) surface glycoproteins are the key targets for neutralizing antibodies. The highly variable G with altered glycosylations and the conformational alternations of F create challenges for vaccine development. The metastable F protein is responsible for RSV-host cell fusion and thus infectivity. Novel antigenic sites were identified on this form following its stabilization and solving its crystal structure. Importantly, site ø displays neutralizing activity exceeding those of post-F-specific and shared antigenic sites, such as site II which is the target for Palivizumab therapeutic antibody. Induction of high neutralizing antibody responses by pre-F immunization in animal models promoted it as a major vaccine candidate. Since RSV infection is more serious at age extremities and in individuals with undermining health conditions, vaccines are being developed to target these populations. Infants below three months of age have a suppressive immune system, making vaccines' immunogenicity weak. Therefore, a suggested strategy to protect newborns from RSV infection would be through passive immunity of maternal antibodies. Hence, pregnant women at their third trimester have been selected as an ideal target for vaccination with RSV pre-F vaccine. This review summarizes the different modes of RSV pathogenesis and host's immune response to the infection, and illustrates on the latest updates of vaccine development and vaccination approaches.