Wraparound nylon foil implant for isolated orbital floor fractures

xlomafota13 shared this article with you from Inoreader Wraparound nylon foil implant for isolated orbital floor fractures Via American Journal of Otolaryngology Publication date: Available online 15 September 2021 Source: American Journal of Otolaryngology Author(s): Benjamin C. Campbell, Taha Z. Shipchandler, Jonathan Y.M. Ting, Dominic Vernon, Rana S. Torabi, Manisha Miller, H.B. Harold Lee View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-Term Opioid Use in Post-Surgical Management of Patients With Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Long-Term Opioid Use in Post-Surgical Management of Patients With Head and Neck Cancer Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 14:34894211045771. doi: 10.1177/00034894211045771. Online ahead of print. ABSTRACT OBJECTIVE: This study aims to identify clinical and socioeconomic factors associated with long-term, post-surgical opioid use in the head and neck cancer population. METHODS: A single center retrospective study was conducted including patients diagnosed with head and neck cancer between January 1, 2014 and July 1, 2019 who underwent primary surgical man agement. The primary outcome measure was continued opioid use 6 months after treatment completion. Both demographic and cancer-related variables were recorded to determine what factors were associated with prolonged opioid use. Univariate analysis was performed using chi-squared test for categorical variables and 2-sample t-test for continuous variables. Multivariate analysis was performed using logistic regression. RESULTS: A total of 359 patients received primary surgical management. Forty-five patients (12.53%) continued to take opioids 6 months after treatment completion. Using univariate analysis, patients less than 65 years of age (P = .0126), adjuvant chemoradiation (n = 25, P < .001), and overall length of hospital stay (8.60 ± 8.58 days, P = .0274) were significantly associated with long term opioid use. Multivariate logistic regression showed that adjuvant chemoradiation (OR = 3.446, 95% CI [1.742, 6.820], P = .0004) and overall length of hospital stay (OR = 0.949, 95% CI [0.903, 0.997], P = .0373) to be significantly associated with opioid use 6 months after head and neck cancer treatment. CONCLUSION: Long-term postoperative opioid use in head and neck cancer patients is significantly associated with adjuvant chemoradiation, and patients with longer length of hospital stay. Therefore, future research should focus on interventions to better manage opioid use during the acute treatment period to decrease long-term use. PMID:34521247 | DOI:10.1177/00034894211045771 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oncogene-specific inhibition in the treatment of advanced pediatric thyroid cancer

xlomafota13 shared this article with you from Inoreader Oncogene-specific inhibition in the treatment of advanced pediatric thyroid cancer Via radioactive iodine J Clin Invest. 2021 Sep 15;131(18):152696. doi: 10.1172/JCI152696. ABSTRACT Papillary thyroid cancer (PTC) is the most common form of differentiated thyroid cancer in the pediatric population and represents the second most common malignancy in adolescent females. Historically, PTC has been classified on the basis of histology, however, accumulating data indicate that molecular subtyping based on somatic oncogenic alterations along with gene expression profiling can better predict c linical behavior and may provide opportunities to incorporate oncogene-specific inhibitory therapy to improve the response to radioactive iodine (RAI). In this issue of the JCI, Y.A. Lee, H. Lee, and colleagues showed that oncogenic fusions were more commonly associated with invasive disease, increased expression of MAPK signaling pathway genes (ERK score), and decreased expression of the sodium-iodine symporter, which was restored by RET- and NTRK-inhibitory therapy. These findings lend credence to the idea of reclassifying pediatric thyroid cancers using a three-tiered system, rather than the two-tiered adult system, and open avenues for the treatment of progressive, RAI-refractory PTC in patients. PMID:34523607 | DOI:10.1172/JCI152696 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Polygenetic Risk Scores Related to Immunity and Inflammation with Hyperthyroidism Risk and Interactions between the Polygenetic Scores and Dietary Factors in a Large Cohort

xlomafota13 shared this article with you from Inoreader Association of Polygenetic Risk Scores Related to Immunity and Inflammation with Hyperthyroidism Risk and Interactions between the Polygenetic Scores and Dietary Factors in a Large Cohort Via Journal of Thyroid Research Graves's disease and thyroiditis induce hyperthyroidism, the causes of which remain unclear, although they are involved with genetic and environmental factors. We aimed to evaluate polygenetic variants for hyperthyroidism risk and their interaction with metabolic parameters and nutritional intakes in an urban hospital-based cohort. A genome-wide association study (GWAS) of participants with (cases; n = 842) and without (controls, n = 38,799) hyperthyroidism was used to identify and select genetic variants. In clinical and lifestyle interaction with PRS, 312 participants cured of hyperthyroidism were excluded. Single nucleotide polymorphisms (SNPs) associated with gene-gene interactions were selected by hyperthyroidism generalized multifactor dimensionality reduction. Polygenic risk scor es (PRSs) were generated by summing the numbers of selected SNP risk alleles. The best gene-gene interaction model included tumor-necrosis factor (TNF)_rs1800610, mucin 22 (MUC22)_rs1304322089, tribbles pseudokinase 2 (TRIB2)_rs1881145, cytotoxic T-lymphocyte-associated antigen 4 (CTLA4)_rs231775, lipoma-preferred partner (LPP)_rs6780858, and human leukocyte antigen (HLA)-J_ rs767861647. The PRS of the best model was positively associated with hyperthyroidism risk by 1.939-fold (1.317–2.854) after adjusting for covariates. PRSs interacted with age, metabolic syndrome, and dietary inflammatory index (DII), while hyperthyroidism risk interacted with energy, calcium, seaweed, milk, and coffee intake (). The PRS impact on hyperthyroidism risk was observed in younger ( View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of Large Dural Defect with CSF Leak in Hypertelorism Correction

xlomafota13 shared this article with you from Inoreader Management of Large Dural Defect with CSF Leak in Hypertelorism Correction Via leak of cerebrospinal fluid Ann Maxillofac Surg. 2021 Jan-Jun;11(1):136-139. doi: 10.4103/ams.ams_43_21. Epub 2021 Jul 24. ABSTRACT THE RATIONALE: Dural tear is a serious complication during hypertelorism corrective surgeries. Identifying the tear and managing requires considerable expertise. Managing large dural tears correctly is necessary to prevent cerebrospinal fluid (CSF)-related complications in craniofacial surgery. PATIENT CONCERNS: The patient presented with hypertelorism as a part of the Tessier Cleft 0 and sought to correct the widely placed eyes. DIAGNOSIS: Large critical-sized dural tear during modified box osteotomy surgery. TREATMENT: Besides successful modified box osteotomy surgery, the critical-sized dural tear was managed with fascia lata and fibrin glue. OUTCOMES: There was no CSF leak or related complication postsurgically indicating successful sealing and healing of the dural tear. TAKE-AWAY LESSONS: The synergistic m echanism by which fascia lata graft and fibrin glue help to hermetically seal the critical-sized defect, especially when there are variable amounts of hydrostatic-hydrodynamic forces of CSF exerting pressure on the patched area, is discussed. PMID:34522669 | PMC:PMC8407622 | DOI:10.4103/ams.ams_43_21 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of Diabetes Insipidus following Surgery for Pituitary and Suprasellar Tumours

xlomafota13 shared this article with you from Inoreader Management of Diabetes Insipidus following Surgery for Pituitary and Suprasellar Tumours Via leak of cerebrospinal fluid Sultan Qaboos Univ Med J. 2021 Aug;21(3):354-364. doi: 10.18295/squmj.4.2021.010. Epub 2021 Aug 29. ABSTRACT Central diabetes insipidus (CDI) is a common complication after pituitary surgery. However, it is most frequently transient. It is defined by the excretion of an abnormally large volume of dilute urine with increasing serum osmolality. The reported incidence of CDI after pituitary surgery ranges from 0-90%. Large tumour size, gross total resection and intraoperative cerebrospinal fluid leak usually pose an increased risk of CDI as observed with craniopharyngioma and Rathke's cleft cysts. CDI can be associated with high morbidity and mortality if not promptly recognised and treated on time. It is also essential to rule out other causes of postoperative polyuria to avoid unnecessary pharmacotherapy and iatrogenic hyponatremia. Once the diagnosis of CDI is established, close monitoring is required to evaluate the response to treatment and to determine whether the CDI is transient or permanent. This review outlines the evaluation and management of patients with CDI following pituitary and suprasellar tumour surgery to help recognise the diagnosis, consider the differential diagnosis, initiate therapeutic interventions and guide monitoring and long-term management. PMID:34522399 | PMC:PMC8407907 | DOI:10.18295/squmj.4.2021.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early Identification and Management of Congenital Cytomegalovirus

xlomafota13 shared this article with you from Inoreader Early Identification and Management of Congenital Cytomegalovirus Via Otolaryngologic Clinics of North America Congenital cytomegalovirus (cCMV) is the most common nongenetic cause of sensorineural hearing loss. Despite its prevalence, universal screening for cCMV is not currently performed. Hearing loss caused by cCMV is most often severe to profound, often bilateral, and may be fluctuating or progressive. Infants with hearing loss at birth and confirmed cCMV might benefit from antiviral therapy. Roughly half of hearing loss cases owing to cCMV are delayed in onset, and consequently, these children pass newborn hearing screening. Children with cCMV require close audiologic monitoring, require appropriate management with hearing aids, and should be monitored for cochlear implant candidacy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Covid 19 Pandemic-Training of Healthcare Workers in Obtaining a Nasopharyngeal Swab: Our Experience

xlomafota13 shared this article with you from Inoreader Covid 19 Pandemic-Training of Healthcare Workers in Obtaining a Nasopharyngeal Swab: Our Experience Via Otolaryngology Indian Abstract To describe the training of healthcare workers (HCW) in nasopharyngeal swabbing during the COVID 19 pandemic. Study design: Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: One hundred and seventy eight health care workers were trained from May 2020 to January 2021. Three modules were designed to train the health care workers in the technique of obtaining a nasopharyngeal swab specimen.Training consisted of an instructional video on how to perform nasopharyngeal swabs and live demonstration followed by hands-on supervised training. The trainees included 30 doctors, 101 nurses, 31 respiratory therapists, 3 physiotherapists, 9 interns and 4 lab technicians. There were 39 male and 139 female trainees. After attending all 3 modules of training, they were confident and efficient in taking a non-traumatic nasopharyngeal swab. Good knowledge and adequate training is key to a good nasopharyngeal sampling for SARS CoV-2 testing. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of different markers of ovarian reserve in women with papillary thyroid cancer treated with radioactive iodine

xlomafota13 shared this article with you from Inoreader Assessment of different markers of ovarian reserve in women with papillary thyroid cancer treated with radioactive iodine Via radioactive iodine Endocr Connect. 2021 Sep 1:EC-21-0187.R2. doi: 10.1530/EC-21-0187. Online ahead of print. ABSTRACT Treatment with radioactive iodine (RAI) in women with differentiated thyroid cancer is associated with decreased serum concentrations of anti-Müllerian hormone (AMH); however, other markers have not been investigated. Therefore, this study aimed to evaluate the effect of RAI on antral follicle count (AFC) and the serum concentration of inhibin B, follicle-stimulating hormone (FSH), a nd AMH in women with papillary thyroid cancer (PTC) treated with RAI. We examined 25 women at a median age of 33 years treated with a single dose of RAI. We divided the participants into women over (n = 11) and under 35 years of age (n = 14). Serum concentrations of inhibin B, FSH, AMH, and AFC were assessed at baseline and one year after RAI treatment. We found decreased AFC (p = 0.03), serum levels of AMH (p < 0.01), inhibin B (p = 0.03), but not FSH (p = 0.23), one year after RAI treatment in comparison to baseline in the whole group. When we compared serum levels of AMH in younger vs. older women separately, we observed a significant reduction of this hormone's serum level after RAI treatment in both groups (p < 0.01; p = 0.04, respectively). We concluded that RAI treatment significantly impacts the functional ovarian reserve in premenopausal women with PTC. PMID:34524978 | DOI:10.1530/EC-21-0187 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Normal anatomy, variants and factors associated with the cervical vagus nerve topography: a high-resolution ultrasound study

xlomafota13 shared this article with you from Inoreader Normal anatomy, variants and factors associated with the cervical vagus nerve topography: a high-resolution ultrasound study Via radiol anat Surg Radiol Anat. 2021 Sep 15. doi: 10.1007/s00276-021-02832-4. Online ahead of print. ABSTRACT PURPOSE: To describe the cervical vagus nerve (CVN) topography at the thyroid lobe (TL) level using high-resolution ultrasound and to investigate the possible association with anthropometric data, TL size, and thyroid disease. METHODS: We prospectively examined 550 CVNs in 275 (205 female, 70 male) individuals with normal thyroid (53/275, 19.3%), multinodular disease (167/27 5, 60.7%), and Hashimoto thyroiditis (55/275, 20%). The CVN location relative to the common carotid artery was recorded as typical (lateral position) and atypical (anterior, medial, and posterior position). The shortest distance between CVN and TL margin, the TL dimensions, and volume were measured. RESULTS: Normal thyroid subjects had lateral-positioned right CVNs in 100% and lateral/anterior/medial left CVNs in 81.1%, 15.1%, and 3.8%, respectively. CVN types did not differ significantly bilaterally between study groups. Asymmetry in CVN topography in all subjects was found in 22.2%, of which anterior CVN was the most common atypical position (64%), especially on the left side (82%). Significant gender, age, body mass, and BMI differences among CVN types were observed on the left side only. Among CVN types, no difference in TL dimensions, volume, and CVN-TL distance was found in all study groups. A weak negative correlation was recorded between CVN-thyroid distance and TL vol ume only on the left side (r = - 0.147, p = 0.01). CONCLUSION: Asymmetry in CVN topography is mainly due to the increased incidence of the anterior location of CVN on the left side. Age and anthropometric parameters are different on the left side possibly due to the increased prevalence of left CVN variants. PMID:34524485 | DOI:10.1007/s00276-021-02832-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical manifestation and treatment of temporal bone tympanic plate fracture

xlomafota13 shared this article with you from Inoreader Clinical manifestation and treatment of temporal bone tympanic plate fracture Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):801-805. doi: 10.3760/cma.j.cn115330-20210512-00266. ABSTRACT Objective: To elucidate the clinical manifestations of temporal bone tympanic plate fracture and the correlation between treatment time after injury and its prognosis, and to discuss the importance of early treatment of tympanic fracture. Methods: Retrospective analysis was carried out on the clinical data of 15 patients(17 ears)with temporal bone tympanic plate fracture from March 2006 to July 2019. The course of disease was less than 1 month (initial stage) in 7 cases (7 ears), 1 month to 6 months (middle stage) in 2 cases (3 ears), and 6 months or more (late stage) in 6 cases (7 ears). The symptoms, signs, CT findings, pure tone audiometry results, surgical methods and clinical efficacy of each group were summarized. Results: Most patients with temporal bone tympanic plate fracture were r eferred to otology department by maxillofacial surgery. Fracture occured indirectly with the chin or zygomatic region as the direct stress point. Thirteen of the 15 patients had mental region wounds or scars, and 14 patients had external acoustic canal bleeding immediately after injury. In the initial-stage group, hearing was mostly unchanged, while in the middle and late-stage groups, hearing loss was mainly caused by conduction factors. In the initial stage group, 6 cases/7 cases were cured by external acoustic canal packing; External acoustic canal stenosis or atresia occurred in 2 cases in the middle-stage group and were cured by external acoustic canal plasty. All the 6 patients in the late-stage group had external acoustic canal stenosis or atresia, among whom 5 patients with external acoustic canal cholesteatoma were cured by external acoustic canal plasty, and the other one patient with middle ear cholesteatoma was cured by modified radical mastoidectomy and tympanoplasty af ter external acoustic canal plasty for three times. Conclusions: Temporal bone tympanic plate fracture is a special type of temporal bone fracture. In the early stage of temporal bone tympanic fracture, bleeding of the external acoustic canal is the main symptom, and hearing is normal mostly. Advanced conductive deafness may result from external acoustic canal stenosis and/or cholesteatoma formation later. Bleeding of the external acoustic canal and irregular bulge of the anterior wall of the external acoustic canal with mental region wound are important signs for early diagnosis of temporal bone fracture. Temporal bone tympanic fracture should be paid attention to, early detection and timely treatment can avoid external acoustic canal stenosis and atresia. PMID:34521162 | DOI:10.3760/cma.j.cn115330-20210512-00266 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.