Conservative Management of Post-Operative Cerebrospinal Fluid Leak following Skull Base Surgery: A Pilot Study

xlomafota13 shared this article with you from Inoreader Conservative Management of Post-Operative Cerebrospinal Fluid Leak following Skull Base Surgery: A Pilot Study Via leak of cerebrospinal fluid Brain Sci. 2022 Jan 24;12(2):152. doi: 10.3390/brainsci12020152. ABSTRACT BACKGROUND/AIMS: Iatrogenic CSF leaks after endoscopic endonasal transsphenoidal surgery remain a challenging entity to manage, typically treated with CSF diversion via lumbar drainage. OBJECTIVE: To assess the safety and efficacy of high-volume lumbar puncture (LP) and acetazolamide therapy to manage iatrogenic CSF leaks. METHODS: We performed a prospective pilot study of four patients who developed iatrogenic postoperative CSF leaks after transsphenoidal surgery and analyzed their response to treatment with concomitant high-volume lumbar puncture followed by acetazolamide therapy for 10 days. Data collected included demographics, intra-operative findings, including methodology of skull base repair and type of CSF leak, time to presentation with CSF leak, complications associated with high-volume LP and acetazolamide treatment, and length of follow-up. < p>RESULTS: Mean patient age was 44.28 years, with an average BMI of 27.4. Mean time from surgery to onset of CSF leak was 7.71 days. All four patients had resolution of their CSF leak at two- and four-week follow-up. Mean overall follow-up time was 179 days, with a 100% CSF leak cure rate at the last clinic visit. No patient suffered perioperative complications or complications secondary to treatment. CONCLUSION: Although our pilot case series is small, we demonstrate that a high-volume LP, followed by acetazolamide therapy for 10 days, can be considered in the management of post-operative CSF leaks. PMID:35203915 | DOI:10.3390/brainsci12020152 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between Thyroid Cancer and Breast Cancer: Two Longitudinal Follow-Up Studies Using a National Health Screening Cohort

xlomafota13 shared this article with you from Inoreader Association between Thyroid Cancer and Breast Cancer: Two Longitudinal Follow-Up Studies Using a National Health Screening Cohort Via radioactive iodine J Pers Med. 2022 Jan 20;12(2):133. doi: 10.3390/jpm12020133. ABSTRACT Background: The purpose of this study was to evaluate the association between thyroid cancer and breast cancer. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort were collected from 2002 to 2013. In study I, 3949 thyroid cancer participants were 1:4 matched with 15,796 control I participants, and hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer were evaluated using a stratified Cox proportional hazard model. In study II, 3308 breast cancer participants were 1:4 matched with 13,232 control II participants, and HRs with 95% CIs for thyroid cancer were assessed in the same way as in study I. In the subgroup analyses, associations were analyzed according to radioactive iodine (RAI) treatment and age (<60 years old and ≥60 years old). Results: The adjusted HR for breast cancer in the thyroid cancer group was 1.64 (95% CI = 1.13-2.39, p = 0.010). The adjusted HR for thyroid cancer in the breast cancer group was 1.91 (95% CI = 1.47-2.49, p < 0.001). In the subgroup analyses, the groups that were older and not treated with RAI treatment showed consistent results in study I, and the younger and older groups showed consistent results in study II. Conclusions: Based on this cohort study, breast and thyroid cancer have a reciprocal positive association. PMID:35207622 | DOI:10.3390/jpm12020133 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular aetiology of ski-slope hearing loss and audiological course of cochlear implantees

xlomafota13 shared this article with you from Inoreader Molecular aetiology of ski-slope hearing loss and audiological course of cochlear implantees Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Feb 25. doi: 10.1007/s00405-022-07317-7. Online ahead of print. ABSTRACT PURPOSE: A challenge for patients with ski-slope hearing loss is that hearing aids do not adequately amplify the mid-to-high frequencies necessary for speech perception and conversely, cochlear implant (CI) may damage low-frequency hearing. We aimed to describe the clinical profile of patients with ski-slope hearing loss, with a special focus on aetiology of such hearing loss and audiological course of low-frequency hearing after CI. METHODS: We recruited hearing-impaired patients who visited a tertiary referral centre and met the criteria for ski-slope hearing loss patients from 2015 to 2021. Genetic testing was performed in all ski-slope hearing loss patients unless refused. Baseline audiograms of patients who continued to use hearing aids or who finally underwent CIs were reviewed. As for CI patients, outcome and hearing pr eservation rate were rigorously analysed. RESULTS: Of 46 recruited patients with ski-slope hearing loss, 45 agreed to undergo genetic testing and causative variants were identified in 17 (37.8%) patients. The TMC1, MYO7A, and TMPRSS3 variants were the most common, while LRTOMT was newly identified as a causative gene. Twenty-five patients eventually received CI, while 13 continued to wear the hearing aid and 8 patients did not ever try hearing aids. CI in ski-slope hearing loss led to immediate and sufficient improvement of sentence recognition by as early as 3 months, however, the duration of hearing loss was inversely correlated with the sentence recognition score. The average hearing preservation rate (using the HEARRING classification) after CI was 53.0% (SD 30.0) and 45.6% (SD 31.1) at 1 year. Seventy-nine percent of implantees maintained functional low-frequency hearing (better than 85 dB at 250 and 500 Hz) eligible for electric-acoustic stimulation (EAS). A trend was fo und that patients with hair cell stereocilia-associated genetic variants may have a slightly better preservation, albeit with no statistical significance. CONCLUSION: Detection rate of a molecular genetic aetiology of ski-slope hearing loss appears to be lower than other type of hearing loss reported in the literature. Especially with short hearing loss duration, CI in ski-slope hearing loss leads to immediate and sufficient speech improvement, while preserving functional low-frequency hearing eligible for EAS as many as in 79%. A certain genetic aetiology might be associated with a trend towards better low-frequency hearing preservation. PMID:35212774 | DOI:10.1007/s00405-022-07317-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma Via Head & Neck Abstract Background To evaluate the clinical significance of tumor response to induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients and further to develop a nomogram for predicting survival prognosis. Methods A total of 498 patients with stage III-IVA NPC applying IC and concurrent chemotherapy were reviewed (training cohort, n = 376; validation cohort, n = 122). Results Tumor response was an independent predictor for clinical outcomes. The nomogram included age, N stage, pretreatment Epstein–Barr virus DNA, lymphocyte-to-monocyte ratio, and tumor response achieved an ideal C-index of 0.703 (95% CI 0.655–0.751) in the validation cohort for predicting overall survival (OS), which outperformed than that of the TNM system alone (C-index, 0.670, 95% CI: 0.622–0.718). In addition, the nomogram could successfully classified patients into different risk groups. Conclusions We established and validated a precise and convenient nomogram based on tumor response for predicting the OS of LANPC patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for residual dizziness in patients with benign paroxysmal positional vertigo after successful repositioning: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Risk factors for residual dizziness in patients with benign paroxysmal positional vertigo after successful repositioning: a systematic review and meta-analysis Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Feb 26. doi: 10.1007/s00405-022-07288-9. Online ahead of print. ABSTRACT PURPOSE: To investigate the risk factors for residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) after successful repositioning. METHODS: Searches were performed in PubMed, Embase, Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, and Sino Med up to March 7, 2021 and references of relevant articles were screened. Data from eligible studies were meta-analyzed using Stata version 16.0 and Review Manager 5.4. RESULTS: In this systematic review and meta-analysis of 4487 patients from 31 studies, the prevalence of RD was 43.0% (95% CI 39.0-48.0%). Age (MD 4.17; 95% CI 2.13-6.21, P = 0.000), female gender (OR = 1.28, 95% CI 1.11-1.47, P = 0.001), secondary BPPV (OR 1.88; 95% CI 1.27-2.77, P = 0.001), a longer duration of BPPV before treatment (MD 3.45; 95% CI 1.87-5.0 2, P = 0.000), abnormal ocular vestibular evoked myogenic potential (OVEMP, OR 4.34; 95% CI 2.78-6.78, P = 0.000), abnormal cervical vestibular evoked myogenic potential (CVEMP, OR 2.48; 95% CI 1.54-3.99, P = 0.000), higher Dizziness Handicap Index (DHI) score before treatment (MD 10.88; 95% CI 5.96-15.80, P = 0.000), anxiety (OR 9.58; 95% CI 6.32-14.52, P = 0.000), osteopenia (OR = 4.40, 95% CI 2.17-8.96, P = 0.000), onset in winter (OR 7.27; 95% CI 2.38-22.24, P = 0.001) and with a history of BPPV (OR 1.79; 95% CI 1.06-3.04, P = 0.03) are the risk factors for RD in patients with BPPV after successful repositioning. The affected side, location or type of semicircular involvement, hyperlipidemia, diabetes, hypertension, heart disease, migraine, sleep disorders, canalolithiasis/cupulolithiasis, the number of times the canalith repositioning procedures (CRPs) were performed and number of vertigo attacks did not correlate with the occurrence of RD. CONCLUSIONS: Despite successful treatment, nearly half of the BPPV patients developed RD. RD seems to be a syndrome caused by multiple factors. The pathogenesis of most factors can be explained by psychological and/or physical disorders. Early recognition of these risk factors contributes to the prevention and treatment of RD. PMID:35218384 | DOI:10.1007/s00405-022-07288-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical features of the iliocapsularis muscle: a dissection study

xlomafota13 shared this article with you from Inoreader Anatomical features of the iliocapsularis muscle: a dissection study Via radiol anat Surg Radiol Anat. 2022 Feb 26. doi: 10.1007/s00276-022-02905-y. Online ahead of print. ABSTRACT PURPOSE: Iliocapsularis (IC) overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty. Previously believed to be part of iliacus, few publications describe the prevalence, attachments, fibre direction, blood supply, innervation, and size of IC. This study was aimed to determine these anatomical features using embalmed bodies and whether they vary between sides, sex, and age. METHODS: Thirty-eight formalin-fixed adult bodies were dissected and the prevalence, presence of a connective tissue raphe, attachments, fibre direction, blood supply, and innervation, were documented. Length and width were measured, and significant differences were investigated with t tests. RESULTS: Iliocapsularis was present in all bodies examined, originating from the inferior border of the anterior inferior iliac spine, and inserting 20 mm distal to the lesser trochanter in 54 muscles (71%). Iliocapsularis was supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins. Muscle fibre direction was from superolateral to inferomedial. Mean length was 116.8 ± 11.2 mm and width was 12.8 ± 3.1 mm, with no significant differences between sides, sex, and age. CONCLUSION: This was the first study to document the venous drainage and compare the di mensions with sides, sex, and age, using adult bodies. However, the true function of IC is still unknown. Iliocapsularis is a constant muscle, distinct from iliacus, which is relevant to orthopaedic surgeons and physical rehabilitation specialists, particularly for postoperative patient care. PMID:35218407 | DOI:10.1007/s00276-022-02905-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader Prognostic significance of wait time for radical radiotherapy in locoregionally advanced nasopharyngeal carcinoma Via Head & Neck Abstract Background The prognostic significance of wait time between definite diagnosis and initial radical radiotherapy is not well established in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) receiving both induction chemotherapy (IC) and concurrent chemoradiotherapy (CCRT). Methods From 2010 to 2018, 648 patients with LA-NPC treated with IC followed by CCRT were included. Results A total of 172 pairs of patients with LA-NPC were selected by propensity score matching (PSM). Compared to patients with an acceptable wait time (≤75 days), patients with a prolonged wait time (>75 days) had a significant lower 5-year DMFS rate (86.6% vs. 74.1%, p = 0.006). Subgroup analyses indicated that the unfavorable effects of longer waiting times were mainly seen among stage IVa patients. Conclusions A prolonged wait time (>75 days) between definite diagnosis and initial radical radiotherapy has negative prognostic effects on patients with LA-NPC receiving IC plus CCRT, particularly those with IVa stage. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of a local single dose administration of growth hormone on the osseointegration of titanium implants

xlomafota13 shared this article with you from Inoreader Effects of a local single dose administration of growth hormone on the osseointegration of titanium implants Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e174-e180. doi: 10.4317/medoral.25164. ABSTRACT BACKGROUND: The aim of the present study was to evaluate the effect of different concentrations of growth hormone (GH) on endosteal implant's surface at the early stages of osseointegration. MATERIAL AND METHODS: Sixty tapered acid-etched titanium implants were divided into four groups: i) Collagen, used as a control group; and three experimental groups, where after collagen coating, GH was administered directly to the surface in varying concentrations: ii) 0.265 mg, iii) 0.53 mg, and iv) 1 mg. Implants were placed in an interpolated fashion in the anterior flange of C3, C4 or C5 of 15 sheep with minimum distance of 6 mm between implants. After 3-, 6- and 12-weeks of healing samples were harvested, histologically processed, qualitatively and quantitatively assessed for bone-to-implant contact (BIC) and bone area fraction occupancy (BAF O). RESULTS: Statistical analysis as a function of time in vivo and coating resulted in no significant differences for BIC and BAFO at any evaluation time point. Histological evaluation demonstrated similar osseointegration features for all groups with woven bone formation at 3 weeks and progressive replacement of woven for lamellar bone in close contact with the implant surface and within the implant's threads. CONCLUSIONS: A single local application of growth hormone to the surface of titanium implants did not yield improved implant osseointegration independent of healing time. PMID:35218646 | DOI:10.4317/me doral.25164 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoral onlay block bone grafts versus cortical tenting technique on alveolar ridge augmentations: a systematic review

xlomafota13 shared this article with you from Inoreader Intraoral onlay block bone grafts versus cortical tenting technique on alveolar ridge augmentations: a systematic review Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e181-e190. doi: 10.4317/medoral.25169. ABSTRACT BACKGROUND: To review systematically the bone gain and superficial resorption rate of the onlay block bone grafts versus the cortical tenting technique, as well as secondarily study the postoperative complications, implant survival and success rates, and peri-implant marginal bone loss. MATERIAL AND METHODS: Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was performed in the PubMed (MEDLINE), EMBASE and the Cochrane Library of the Cochrane Collaboration (CENTRAL) databases to identify all relevant articles published up to March 2021 on onlay block bone grafts and cortical tenting technique. RESULTS: Eighteen papers complied with the inclusion criteria. In onlay grafts, the vertical bone gain mean was 4.24 mm, and resorption 20.91%; and 4.29 mm in the horizontal augmentati on with a resorption of 10.28%. The complication rate was 14.8%. The implant survival and success rates were 100% and 92%; and the mean peri-implant bone loss ranged from 0.6 to 1.26 mm. In cortical tenting technique, the vertical bone gain mean was 6.17 mm and the resorption of 9.99%; and 5.55 mm in the horizontal augmentation with a 6.12% of resorption. The complication rate was 24.6%. The implant survival and success rates were 96.63% and 100%; and the mean peri-implant bone loss ranged from 0.27 to 0.77mm. CONCLUSIONS: Despite the limitations, both techniques offer a predictable way to reconstruct atrophic alveolar ridges, though the cortical tenting technique seems to achieve a greater bone gain and a lower surface resorption. Current evidence is still limited due to the inadequate follow-up, lack of information referred to methodological quality and sample attrition. PMID:35218647 | DOI:10.4317/medoral.25169 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MutSα expression predicts a lower disease-free survival in malignant salivary gland tumors: an immunohistochemical study

xlomafota13 shared this article with you from Inoreader MutSα expression predicts a lower disease-free survival in malignant salivary gland tumors: an immunohistochemical study Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e164-e173. doi: 10.4317/medoral.25138. ABSTRACT BACKGROUND: Appropriate DNA replication is vital to maintain cell integrity at the genomic level. Malfunction on DNA repair mechanisms can have implications related to tumor behavior. Our aim was to evaluate the expression of key complexes of the DNA mismatch-repair system MutSα (hMSH2-hMSH6) and MutSβ (hMSH2-hMSH3) in a panel comprising the most common benign and malignant salivary gland tumors (SGT), and to determine their association with disease-free survival. MATERIAL AND METHODS: Ten cases of normal salivary gland (NSG) and 92 of SGT (54 benign and 38 malignant) were retrieved. Immunohistochemistry was performed for hMSH2, hMSH3, hMSH6. Scanned slides were digitally analyzed based on the percentage of positive cells with nuclear staining. Cases were further classified in MutSαhigh and MutSβhigh based on hMSH2-hMSH6 and hMSH3- hMSH6 expression, respectively. RESULTS: hMSH3 expression was lower in malignant SGT compared to NSG and benign cases. Adenoid cystic carcinoma (ACC) cases with perineural invasion presented a lower percentage of hMSH3 positive cells. hMSH6 was downregulated in both benign and malignant SGT compared to NSG. Malignant SGT cases with MutSαhigh expression had lower disease-free survival compared to MutSαlow cases. A 10.26-fold increased risk of presenting local recurrence was observed. CONCLUSIONS: Our findings suggest that a lack of hMSH3 protein function is associated with a more aggressive phenotype (malignancy and perineural invasion) and that MutSα overexpression predicts a poor clinical outcome in malignant SGT. PMID:35218645 | DOI:10.4317/medoral.25138 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.