Αρχειοθήκη ιστολογίου

Τετάρτη 2 Νοεμβρίου 2022

Identification Accuracy of Safety‐Relevant Environmental Sounds in Adult Cochlear Implant Users

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Identification Accuracy of Safety-Relevant Environmental Sounds in Adult Cochlear Implant Users

Twenty-one experienced cochlear implant users completed an Environmental Sound Identification (ESI) test consisting of 42 common environmental sounds, 28 of which were relevant to personal safety. Overall ESI accuracy was 57% correct for the safety-relevant sounds and 55% correct for control sounds, suggesting mediocre ESI accuracy in postlingual adult CI users. Deficits in identification of these sounds may put CI listeners at increased risk of accidents or injuries and may require a specific rehabilitation program to improve CI outcomes.


Objective

Examine cochlear implant (CI) users' ability to identify safety-relevant environmental sounds, imperative for safety, independence, and personal well-being.

Methods

Twenty-one experienced adult CI users completed an Environmental Sound Identification (ESI) test consisting of 42 common environmental sounds, 28 of which were relevant to personal safety, along with 14 control sounds. Prior to sound identification, participants were shown sound names and asked to rate the familiarity and, separately, relevance to safety of each corresponding sound on a 1–5 scale.

Results

Overall ESI accuracy was 57% correct for the safety-relevant sounds and 55% correct for control sounds. Participants rated safety-relevant sounds as more important to safety and more familiar than the non-safety sounds. ESI accuracy significantly correlated with familiarity ratings.

Conclusion

The present findings suggest mediocre ESI accuracy in postlingual adult CI users for safety-relevant and other environmental sounds. Deficits in the identification of these sounds may put CI listeners at increased risk of accidents or injuries and may require a specific rehabilitation program to improve CI outcomes.

Level of Evidence

4 Laryngoscope, 2022

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Irradiation accelerates SARS‐CoV‐2 infection by enhancing sphingolipid metabolism

alexandrossfakianakis shared this article with you from Inoreader

ABSTRACT

Cancer patients who receive radiotherapy have a high risk of SARS-CoV-2 infection, but the concrete reason remains unclear. Herein, we investigated the influence of irradiation on the vulnerability of cancer cells to SARS-CoV-2 using S pseudovirions and probed the underlying mechanism via RNA-seq and other molecular biology techniques. Owing to the enhancement of sphingolipid metabolism, irradiation accelerated pseudovirion infection. Mechanistically, irradiation induced the expression of acid sphingomyelinase (ASM), which catalyses the hydrolysis of sphingomyelin to ceramide, contributing to lipid raft formation and promoting SARS-CoV-2 invasion. Inhibition of lipid raft formation with methyl-β-cyclodextrin (MβCD) or the tyrosine kinase inhibitor genistein and ASM suppression through small interfering RNA or amitriptyline (AMT) treatment abolished the enhancing effect of irradiation on viral infection. Animal experiments supported the finding that irradiation promoted SARS-CoV-2 S pseudovirion infection in A549 cell tumour-bearing BALB/c nude mice, whereas AMT treatment dramatically decreased viral infection. This study discloses the role of sphingolipid metabolism in irradiation-induced SARS-CoV-2 infection, thus providing a potential target for clinical intervention to protect patients receiving radiotherapy from COVID-19.

This article is protected by copyright. All rights reserved.

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Monkeypox: Early Estimation of Basic Reproduction Number R0 in Europe

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Abstract

This world outbreak of Monkeypox-MPX infections outside Africa emerged on May 2022 in Europe and spread worldwide with unique characteristics: inter-human contagion and infection in men without specific previous immunization, prevalently men-having-sex-with-men MSM. Phylogenetic analysis confirmed a unique clade, the West African clade, subclade IIb. On August 30, WHO stated 48,895 laboratory confirmed cases from 101 different countries, of which 28,050 were in Europe. It has therefore become important to define new epidemiological indices. Starting from our new surveillance system EpiMPX open data, we defined an early R0 measure, using European ECDC confirmed cases from the epidemic start to the end of August 2022; our early R0 pooled median is 2.44, with high variability between countries. We observed the higher R0 in Portugal and Germany, followed by Italy, Spain and France. Anyway, these high estimates refer to the MSM gr oup rather than to the general population. Early estimation of R0 can be used to support the epidemiological understanding of transmission dynamics and contain MPX from spreading in naive populations and core groups with risk factors. MPX is in an evolving situation with much to learn and to do to combat the current epidemic outbreak.

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Spatial‐temporal dynamics and time series prediction of HFRS in mainland China: a long‐term retrospective study

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Abstract

Hemorrhagic fever with renal syndrome (HFRS) is highly endemic in mainland China. The current study aims to characterize the spatial-temporal dynamics of HFRS in mainland China during a long-term period (1950-2018). A total of 1,665,431 cases of HFRS were reported with an average annual incidence of 54.22 cases/100,000 individuals during 1950-2018. The joint regression model was used to define the global trend of the HFRS cases with an increasing-decreasing-slightly increasing-decreasing-slightly increasing trend during the 68 years. Then spatial correlation analysis and wavelet cluster analysis were used to identify four types of clusters of HFRS cases located in central and northeastern China. Lastly, the Prophet model predicts that 14,223 cases of HFRS will occur in mainland China during 2019-2038. Our findings will help reduce the knowledge gap on the transmission dynamics and distribution patterns of the HFRS in mainland China and facilitate to take rel evant preventive and control measures for the high-risk epidemic area.

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Wound healing in endoscopic sinus surgery ‐ Phase 1 clinical trial evaluating the role of Chitogel with adjuvants

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Abstract

Background & Objectives

Ostial stenosis and persistent inflammation are the main reasons for revision endoscopic sinus surgery (ESS). Post-operative (PO) dressings can improve PO wound healing and patient outcomes after ESS. This study aimed to determine the safety and efficacy of Chitogel, with and without Deferiprone (Def) and Gallium Protoporphyrin (GaPP), as a promoter of wound healing to improve surgical outcomes.

Design, Setting & Outcome

A double-blinded, randomized control human clinical trial was conducted in patients undergoing ESS as treatment for CRS. Participants underwent functional endoscopic sinus surgery (1) or FESS with drill out (DO) as required and were randomised to receive test product Chitogel, Chitogel in combination with Def or Def-GaPP versus no packing (control). Patients were followed up at 2, 6 and 12 weeks PO, outcome scores such as SNOT-22, VAS and LKS, pre and post-surgery (12 weeks) were compared.

Results

79 patients completed the study, there was a significant reduction in SNOT-22 score and improvement of VAS at 12-week in patients treated with Chitogel compared to control (p<0.05). In those patients, the mean ostium area for the Chitogel and the Chitogel + Def + GaPP groups were higher across all 3 sinuses compared to the no-treatment control group, without statistical significance. Sphenoid sinus ostium was significantly more patent in patients treated with Chitogel compared to control at the 12-week time point (p < 0.05).

Conclusion

Chitogel as a post-operative dressing after ESS results in the best patient reported symptom scores and objective measurements. The combination of Def and GaPP to Chitogel though proving safe, had no effect on the ostium patency or mucosal healing.

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Immunological mechanisms and treatable traits of chronic rhinosinusitis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objectives

To review the current literature on immunological mechanisms and treatable traits of chronic rhinosinusitis (CRS) in Asia.

Design

This is a narrative review of published data on the immunological mechanisms and treatable traits of CRS in Asia. Published English literature on CRS in Asian and Western countries was reviewed. Where available, the data extracted included epidemiology, immunology, bacterium, phenotype, endotype, and treatment.

Results and Conclusion

CRS is a heterogeneous disease characterized by persistent locoregional mucosal inflammation of the paranasal sinuses. The inflammatory signatures of CRS vary across patients with distinct racial and ethnic backgrounds and geographic areas. Compared to CRS patients in Western countries, Asian CRS patients display less eosinophilic and type 2 inflammation, which is associated with lower asthma and allergic rhinitis comorbidities. In contrast, Asian patients with CRS have more prominent non-eosinophilic inflammation than those in Western countries. In addition, Asian CRS patients may have different bacterial colonization than patients in Western countries. Our review suggests that the distinct immunological mechanisms between Asian and Western CRS patients may influence the clinical phenotype, responses to treatment, and outcomes. The treatable trait is a new strategy and therapeutic target identified by phenotype or endotype and has been proposed as a new paradigm for the managemen t of diseases. Improved understanding of CRS phenotypic and endotypic heterogeneity and incorporation of treatable traits into clinical care pathways may facilitate more effective selections of therapeutic interventions, including surgery and biologics.

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Comparison of clinical features and surgical outcomes between hypopnea‐ and apnea‐predominant obstructive sleep apnea

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Abstract

Objectives

This study is aimed to investigate the differences in the clinical features and surgical outcomes between hypopnea- and apnea-predominant obstructive sleep apnea (OSA).

Design

Cohort study

Setting

Single tertiary care center

Participants

This study included 190 patients with OSA who underwent multilevel upper airway surgery between September 2012 and September 2021. The patients were divided into two groups according to the proportion of each respiratory event: hypopnea-predominant (n = 102) and apnea-predominant (n = 88).

Main outcome measures

The primary outcome measure was the percentage improvement in the apnea-hypopnea index (AHI) from baseline AHI after surgery.

Results

The apnea-predominant group included more male patients and had higher AHI, respiratory disturbance index (RDI), and oxygen desaturation index (ODI) than the hypopnea-predominant group. Both groups showed significant improvements in AHI, apnea index, RDI, supine AHI, REM AHI, non-REM AHI, ODI, lowest O2 saturation, and Epworth Sleepiness Scale scores following the surgery. Notably, hypopnea index increased after surgery in the apnea-predominant OSA group. Although the improvement in the absolute value of AHI by surgery was significantly greater in the apnea-predominant group than in the hypopnea-predominant group, the two groups showed no significant difference in the percentage improvement in AHI from baseline AHI.

Conclusion

Patients with apnea-predominant OSA had more severe disease than those with hypopnea-predominant OSA; however, surgical outcomes, as evaluated by percentage AHI improvement, were comparable between the two groups. In addition, multilevel upper airway surgery may induce the transition from apnea to hypopnea in patients with apnea-predominant OSA.

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¿Qué es la Hashitoxicosis?

alexandrossfakianakis shared this article with you from Inoreader

La tiroiditis de Hashimoto es la patología tiroidea más frecuente. Se presenta mucho más frecuentemente en mujeres y puede aparecer a cualquier edad. Es una inflamación crónica autoinmune, generalmente indolora, caracterizada por una infiltración linfocitaria de la glándula tiroidea, parcial o total. La función tiroidea puede no verse alterada o puede producirse una disminución de la misma (hipofunción tiroidea), y se caracteriza por la presencia de anticuerpos antiperoxidasa (anti-TPO) y/o anti-tiroglobulina (anti-Tg). En este tipo de tiroiditis se puede desarrollar un hipotiroidismo de forma lenta y generalmente progresiva.

Excepcionalmente algunos pacientes desarrollan una presentación clínica y bioquímica de hiperfunción tiroidea, desarrollando hipertiroidismo, cuadro conocido como "Hashitoxicosis". Se puede definir como una enfermedad mixta, caracterizada por tirotoxicosis, gran aumento sérico de anticuerpos antitiroideos y presencia de hiperplasia-hipertrofia (aumento de volumen) folicular e infiltración linfocítica.

¿Por qué algunas personas con tiroiditis de Hashimoto tienen Hashitoxicosis?

En pacientes con diagnóstico de tiroiditis de Hashimoto, la incidencia es escasa (5-10%), si bien es cierto que la alteración bioquímica no viene acompañada claramente de una clínica de hiperfunción tiroidea y la clínica puede pasar desapercibida.

La Hashitoxicosis es un cuadro de hipertiroidismo que se presenta generalmente en pacientes con o sin diagnóstico previo de tiroiditis de Hashimoto, que confunde muchas veces el diagnóstico por su similitud con un brote de Enfermedad de Graves – Basedow. De hecho, las características clínicas de hiperfunción tiroidea no varían. El tamaño del bocio suele ser evidente y con más dureza a la palpación, y a nivel bioquímico no difiere en cuanto al nivel de anticuerpos antitiroideos, pero se diferencia de la enfermedad de Graves en que las personas no tendrán niveles elevados de anticuerpos antirreceptor de TSH (TSI).

¿Cuál es la causa del hipertiroidismo derivado de la Hashitoxicosis en la tiroiditis de Hashimoto?

En este caso el hipertiroidismo no es causado por el estímulo de TSH sobre la liberación de hormonas tiroideas como ocurre con la enfermedad de Graves, sino que es producido por la liberación de las hormonas tiroideas contenidas en los folículos que se han destruido. De ahí que el cuadro generalmente sea de corta duración y muchas veces autolimitado.

Muchas veces el diagnóstico de la Hashitoxicosis es tardío y sobre todo debido a una hiperrespuesta al tratamiento con medicamentos antitiroideos en un paciente inicialmente diagnosticado de enfermedad de Graves, por eso es importante hacer una buena valoración clínica inicial que incluya determinación de anticuerpos antirreceptor de TSH (TSI).

¿Hay que tratar la Hashitoxicosis?

El tratamiento con fármacos antitiroideos es pocas veces necesario, porque el cuadro suele ser transitorio y se indica porque la clínica lo aconseja. Debe valorarse al paciente a corto plazo por el riesgo de hipotiroidismo yatrógeno (hipotiroidismo inducido por medicación). Lo más aconsejable es mantener al paciente con un betabloqueante. Durante la fase aguda de la tirotoxicosis, los betabloqueantes pueden ser útiles.

La Hashitoxicosis generalmente precede a un cuadro de hipofunción tiroidea que requerirá tratamiento sustitutivo permanente con hormonas tiroideas.


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La entrada ¿Qué es la Hashitoxicosis? se publicó primero en Cuida tu tiroides.

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