Serous otitis media: Clinical and therapeutic considerations, including dexamethasone (C22H29FO5) intratympanic injection

xlomafota13 shared this article with you from Inoreader Serous otitis media: Clinical and therapeutic considerations, including dexamethasone (C<sub>22</sub>H<sub>29</sub>FO<sub>5</sub>) intratympanic injection Via Experimental and therapeutic medicine Exp Ther Med. 2022 Feb;23(2):125. doi: 10.3892/etm.2021.11048. Epub 2021 Dec 7. ABSTRACT Serous otitis media (SOM) occurs in children and constitutes one of the most significant causes of hearing loss in young age, posing as an important risk factor for long-term hearing loss. SOM is underdiagnosed, most frequently in infants, or the appointment to the ENT doctor is delayed due to non-acute symptomatology. The aim of the present study was to assess 285 patients with SOM diagnosed within a two-year span. The etiology and pathology of hearing loss in patients with different age groups were examined. The importance of a clinical examination and tympanometry was emphasized as absolutely necessary for a correct diagnosis. Treatment targeted Eustachian Tube permeabilization for satisfactory long-term middle ear aeration. Nasal drops with vasoconstrictor drugs (phenylephrine) and disinfectant (colloidal silver 1%) were commonly used, but some patients also benefitted from dexamethasone intratympanic injection. Patients were evaluated at the end of the treatment and follow-up occurred at one month, one year and three years later. PMID:34970348 | PMC:PMC8713185 | DOI:10.3892/etm.2021.11048 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased Incidence of Tapia's Syndrome Cases Since the COVID-19 Pandemic

xlomafota13 shared this article with you from Inoreader Increased Incidence of Tapia's Syndrome Cases Since the COVID-19 Pandemic Via ear nose throat Ear Nose Throat J. 2021 Dec 30:1455613211068570. doi: 10.1177/01455613211068570. Online ahead of print. NO ABSTRACT PMID:34969313 | DOI:10.1177/01455613211068570 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Administrative delays of temporary recommendation for use: Impact on access to innovation in melanoma

xlomafota13 shared this article with you from Inoreader Administrative delays of temporary recommendation for use: Impact on access to innovation in melanoma Via Association française pour l'étude du cancer Bull Cancer. 2021 Dec 28:S0007-4551(21)00514-2. doi: 10.1016/j.bulcan.2021.11.007. Online ahead of print. ABSTRACT INTRODUCTION: Melanoma has benefited in recent years from therapeutic innovations, which have improved overall survival of patients. France has developed a regulatory arsenal allowing faster access to innovative drugs before marketing authorization: temporary authorization for use (ATU) and temporary recommendation for use (RTU). METHOD: We describe here the decision-making processes that led to the non-publication of the decree on the funding of three RTU in adjuvant melanoma therapy: nivolumab, pembrolizumab and the combination of dabrafenib and trametinib, and we analyse the fate of these drugs in order to quantify the potential loss of chance. RESULTS: On 03AUG2018, the French National Agency for Medicines and Health Product Safety (ANSM) published 3 RTU in order to give rapid access to major innovations in adjuvant melanoma therapy: nivolumab, pembrolizumab and the combination of dabrafenib and trametinib. These drugs have respectively demonstrated reductions in the risk of recurrence by 35 %, 43% and 55% for target populations of 2200, 1900 and 650 patients per year. Despite a favourable opinion on reimbursement from the French National Authority for Health (HAS), the decrees on reimbursement will never be published, prohibiting the use of these products before the marketing authorisation, and depriving many patients of a potential cure. CONCLUSION: Despite a favourable opinion from scientists and health agencies for the rapid availability of a drug, the French public health code does not systematically imply access to a therapeutic innovation. The reform of access to innovation implemented on 01JUL2021 may help tackle this issue. PMID:34972538 | DOI:10.1016/j.bulcan.2021.11.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Restoration of Homeostasis in the Tracheal Mucosa After Thyroid Surgery in a Rat Model

xlomafota13 shared this article with you from Inoreader Restoration of Homeostasis in the Tracheal Mucosa After Thyroid Surgery in a Rat Model Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):161-169. doi: 10.21873/invivo.12687. ABSTRACT BACKGROUND/AIM: This study aimed to investigate the process of homeostatic restoration in the tracheal mucosa (TM) after thyroid surgery. MATERIALS AND METHODS: Fifty-four rats were divided into normal controls (NC) and three experimental groups: (i) flap elevation (FE), (ii) thyroid exposure (TE), and (iii) thyroid isthmusectomy (TI). Expression of mRNA and proteins of key factors regulating homeostasis were evaluated in the TM obtained 3, 7, and 21 days after thyroid surgery. RESULTS: Increased mRNA expression of transforming growth factor-β1 (TGF-β1), hypoxia-inducible factor-1α (HIF-1α), and matrix metalloproteinase-9 (MMP-9) were observed 21 days after thyroid surgery in all experimental groups compared to that of NC group. CONCLUSION: Thyroid surgery leads to an actual increase of TGF-β1, HIF-1α, and MMP-9 expression in the TM. This increased expression of key regulators of homeostatic restoration in the TM lasts for a considerable period of time after surgery, especially if the extent of surgery increased. PMID:34972711 | DOI:10.21873/invivo.12687 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Pectoral Muscle Values on Clinical Outcomes in Patients With Severe Covid-19 Disease

xlomafota13 shared this article with you from Inoreader Impact of Pectoral Muscle Values on Clinical Outcomes in Patients With Severe Covid-19 Disease Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):375-380. doi: 10.21873/invivo.12713. ABSTRACT BACKGROUND/AIM: The effect of sarcopenia on patients with severe Covid-19 disease is unknown. We aimed to assess the influence of baseline computed tomography (CT)-based body composition parameters (pectoralis muscle area, pectoralis muscle index, skeletal muscle gauge) on clinical variables in patients with severe Covid-19 disease. PATIENTS AND METHODS: Chest CT scans of adult patients with confirmed Covid-19 who were hospitalized from March 2020 to May 2021 at a level-one medical center in Germany were retrospectively analyzed. Pectoralis muscle area, pectoralis muscle index and skeletal muscle gauge were measured on the first CT scan after admission. Body composition parameters were assessed for association with clinical variables and 30-day mortality. RESULTS: A total of 46 patients were included. None of the body composition parameters was a pred ictor for 30-day mortality, duration of hospital stay, duration of intensive care unit treatment, or duration of invasive mechanical ventilation. CONCLUSION: Pectoralis muscle composition parameters in CT chest scans did not predict outcomes in adult patients with severe Covid-19 infection. PMID:34972737 | DOI:10.21873/invivo.12713 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer

xlomafota13 shared this article with you from Inoreader Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):409-415. doi: 10.21873/invivo.12718. ABSTRACT BACKGROUND/AIM: To investigate changes in post-progression chemotherapy (PPC) before and after nivolumab approval and determine their prognostic impact. PATIENTS AND METHODS: A total of 146 patients with unresectable gastric cancer who had at least progressive disease after first- and/or second-line chemotherapy were retrospectively enrolled. RESULTS: Among the 146 patients, 46 and 23 received ramucirumab and nivolumab, respectively. Moreover, 95 and 62 patients received PPC after first- and second-line chemotherapy, respectively. Group B (i.e., at least chemotherapy after nivolumab approval) had significantly higher proportions of patients receiving ramucirumab therapy, nivolumab therapy, and PPC after first- or second-line chemotherapy compared to group A (i.e., termination of chemotherapy before nivolumab approval). Group A had significantly poorer prognosis than group B. Multivariate analysis showed that age, number of distant metastatic sites, and ramucirumab therapy were independent prognostic factors. CONCLUSION: Changes in chemotherapeutic strategies, including PPC, might contribute to improved prognosis in patients with advanced gastric cancer. PMID:34972742 | DOI:10.21873/invivo.12718 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Techniques of Y-Sleeve Lobectomy in Patients With Primary Lung Cancer

xlomafota13 shared this article with you from Inoreader Surgical Techniques of Y-Sleeve Lobectomy in Patients With Primary Lung Cancer Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):350-354. doi: 10.21873/invivo.12709. ABSTRACT BACKGROUND/AIM: The directions of distal and proximal airway stumps were different in Y-sleeve lobectomy. This difference might make Y-sleeve lobectomy a difficult procedure. In this article, we present our surgical techniques and analyse short-term outcomes of Y-sleeve lobectomy. PATIENTS AND METHODS: Right middle and lower, left lower, and left lower and lingular segment sleeve lobectomies are categorized in Y-sleeve lobectomy. We retrospectively investigated the clinical courses of 17 patients who underwent Y-sleeve lobectomy from January 2017 to December 2020. RESULTS: No treatment-related deaths occurred. One patient developed a bronchopleural fistula. Four patients developed pneumonia and were cured by repeated bronchoscopies and antibiotic therapy. Three patients had retention of pleural effusion, and two had prolonged air leakage. One patient had empyema after prolonged air leakage and was cured by thoracic drainage and antibiotic therapy. CONCLUSION: A major complication was observed only in one patient. Y-sleeve lobectomy is a reliable surgical method to avoid pneumonectomy. PMID:34972733 | DOI:10.21873/invivo.12709 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intervention Strategies to Reduce Surgical Site Infection Rates in Patients Undergoing Rectal Cancer Surgery

xlomafota13 shared this article with you from Inoreader Intervention Strategies to Reduce Surgical Site Infection Rates in Patients Undergoing Rectal Cancer Surgery Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):439-445. doi: 10.21873/invivo.12722. ABSTRACT BACKGROUND/AIM: This study aimed to determine the effectiveness of surgical site infection (SSI) prevention approaches in rectal cancer surgery. PATIENTS AND METHODS: A total of 1,408 patients who underwent elective rectal cancer surgery between 1995 and 2017 were reviewed. Patients were divided into three groups: control group (group A, n=245), SSI prevention intervention group (group B, n=516), and laparoscopic or robotic surgery group (group C, n=647). The groups were compared in terms of SSI and anastomotic leakage (AL) incidences, and risk factors for SSI were investigated. RESULTS: The overall SSI and AL rates were 19.4% and 3.6%, respectively. These rates were significantly lower in Group C (9.3%, 1.7%), compared to Groups A (40.0%, 6.1%) and B (22.5%, 3.5%). Abdominoperineal resection, open surgery, operation time, intraoperative bleeding, lac k of absorbable sutures, lack of mechanical bowel preparation, and lack of oral antibiotics were independently associated with SSI. CONCLUSION: SSI reduction after rectal cancer surgery was achieved through various intervention strategies. PMID:34972746 | DOI:10.21873/invivo.12722 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Synchronous Basal Cell Carcinoma and Squamous Cell Carcinoma of Nasal Vestibule With Novel Unique Variants Identified by Whole-exome Sequencing

xlomafota13 shared this article with you from Inoreader Synchronous Basal Cell Carcinoma and Squamous Cell Carcinoma of Nasal Vestibule With Novel Unique Variants Identified by Whole-exome Sequencing Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):251-257. doi: 10.21873/invivo.12698. ABSTRACT BACKGROUND/AIM: It is estimated that nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), affects more than 3 million Americans each year. Translation of next-generation sequencing (NGS) data into identification of new potential targets for therapeutic applications may be helpful. Whole-exome sequencing (WES) is a widely used NGS method that involves sequencing the protein-coding regions of the genome. CASE REPORT: We report a case of a 65-year-old female smoker who was found to have two 6 mm lesions in her left nasal vestibule. Biopsies demonstrated synchronous BCC and SCC. The patient underwent surgical excision of both cancers with safe margins followed by plastic reconstruction. WES was performed on both cancers and 16 alterations including BRCA2 (p.P389S), FAM5C (S420L), KMT2A (P855L), and SMO (L412F), as unique for BCC, and 4 alterations including TP53 (p.H179Q) and CDKN2A (p.P114L), as unique for SCC, were identified. CONCLUSION: We report the first documented case with unique genetic alterations in two distinct and synchronous skin BCC and SCC arising from the same nasal vestibule of a patient. This adds to the growing field of data regarding genetic variants in characterizing malignancies and potentially for targeted therapies. PMID:34972722 | DOI:10.21873/invivo.12698 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vesico-uterine Fistula Following C-section - A Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Vesico-uterine Fistula Following C-section - A Case Report and Literature Review Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):528-532. doi: 10.21873/invivo.12734. ABSTRACT BACKGROUND/AIM: Vesico-uterine fistulas represent a rare type of genito-urinary fistulas; however, due to the increasing incidence of Caesarean section (C-section) in the last decade, this abnormal communication between the urinary and genital tracts has been reported more often after such surgical procedures. The aim of the current article was to report the case of a 28-year-old patient who was submitted to surgery for a vesico-uterine fistula seven years after a C-section. CASE REPORT: The 28-year-old patient with a previous history of four vaginal deliveries and one C-section was self-presented to the Gynecology Department for cyclic hematuria and diagnosed with a vesico-uterine fistula after injecting methylene blue in the uterine cavity during hysteroscopy. The patient was further submitted to surgery, and a parcelar myometrectomy en bloc with parcelar cystectomy, cystography, and prophylactic salpingectomy was performed. The postoperative outcome was uneventful. CONCLUSION: Although vesico-uterine fistulas represent rare events, they should be considered, especially in young patients with a previous history of C-section. PMID:34972758 | DOI:10.21873/invivo.12734 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sternocleidomastoid Muscle Transfer for Treatment of Longstanding Facial Paralysis: Long-term Outcomes and Complications

xlomafota13 shared this article with you from Inoreader Sternocleidomastoid Muscle Transfer for Treatment of Longstanding Facial Paralysis: Long-term Outcomes and Complications Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):501-509. doi: 10.21873/invivo.12731. ABSTRACT BACKGROUND/AIM: The use of sternocleidomastoid muscle (SCM) flap for facial reanimation was established in the 1980s by the senior author of this paper. We aimed to analyze long-term outcome and complications of this procedure. PATIENTS AND METHODS: We conducted a retrospective chart review of all patients undergoing SCM reanimation for longstanding facial palsy between January 2009 and December 2015. Patients with follow-up longer than 12 months (range=12-96) were included in the study. Facial muscle function was evaluated before and at each follow-up after the surgery with the House-Brackmann (HB) scale-facial nerve grading system and Facegram analysis. Donor site morbidity and overall complication rates were documented and analyzed. RESULTS: Forty-two patients aged 18-66 years (mean age=37) with a mean duration of facial palsy of 5 years (range=2-4 8) met the inclusion criteria. The HB score 2 years after surgery improved significantly (p<0.05) in comparison to the pre-operative condition (3.6 vs. 4.7). Twelve months after surgery, oral commissure excursion improved by mean 8.95 mm. No flap necrosis occurred, nor compromise of neck and shoulder function despite an obvious contour defect in the SCM donor site. None of the patients presented head posture or movement issues. CONCLUSION: The SCM flap transfer is a reliable and effective procedure to achieve moderate improvement of the oral commissure excursion using a local method with moderate donor site morbidity. It can be regarded as a valuable option for dynamic facial reanimation in case of longstanding facial palsy. PMID:34972755 | DOI:10.21873/invivo.12731 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.