Long-term follow-up of olfactory and gustatory dysfunction in COVID-19: 6 months case-control study of health workers

xlomafota13 shared this article with you from Inoreader Long-term follow-up of olfactory and gustatory dysfunction in COVID-19: 6 months case-control study of health workers 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. 2021 Mar 28. doi: 10.1007/s00405-021-06764-y. Online ahead of print. ABSTRACT PURPOSE: The study aimed to determine the incidence and long-term evolution of COVID-related olfactory (OD) and gustatory (GD) dysfunction, the recovery timeline, and the association with other symptoms. The secondary objective was to identify the predictive clinical factors for the evolution of these symptoms. METHODS: A prospective case-control study was conducted from March 15 to October 15, 2020, in health workers with COVID-19 related symptoms in a tertiary care hospital. 320 patients were included after 6 months of follow-up: 195 in the case group and 125 in the control group. Olfactory dysfunction (OD), dysosmia, and gustatory dysfunction (GD) onset and recovery rate after 6 months follow-up are analyzed in both groups. RESULTS: There were 125 (64.1%) in case group patients with OD and 118 (60.5%) with GD. Total o r partial recovery OD and GD was found in 89%, mainly in the first 2 months. In the control group, there were 14 (11.2%) patients with OD and 33 (26.4%) patients with GD, with 100% of total/partial recovery. CONCLUSION: In both groups, OD and GD showed high-resolution rates during the first two months after the onset of symptoms. Nevertheless, 11% of the case group patients did not show any recovery, and the partial resolution was present in 30% of our patients, at the 6 months follow-up. We found a high correlation between OD and GD, both in the appearance of symptoms and in their recovery. Nasal obstruction and dyspnea have been identified as risk factors for the persistence of symptoms. PMID:33774737 | DOI:10.1007/s00405-021-06764-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lumboperitoneal shunts for the treatment of idiopathic normal pressure hydrocephalus

xlomafota13 shared this article with you from Inoreader Lumboperitoneal shunts for the treatment of idiopathic normal pressure hydrocephalus Via leak of cerebrospinal fluid J Clin Neurosci. 2021 Apr;86:1-5. doi: 10.1016/j.jocn.2020.12.031. Epub 2021 Jan 25. ABSTRACT The standard of care for idiopathic normal pressure hydrocephalus (iNPH) is placement of a ventriculoperitoneal (VP) shunt. However, VP shunts require intracranial intervention and are associated with notable postoperative complications, with some groups reporting complication rates for VP shunts ranging from 17 to 33%, along with failure rates up to 17.7%. Lumboperitoneal (LP) shunts are an alternative for cerebrospinal fluid diversion that do not require intracranial surgery, thus providing utility in patients where intracranial surgery is not possible or preferred. Here we retrospectively reviewed our 25 patients with LP horizontal-vertical (LP-HV) shunts placement for initial treatment for iNPH from 2014 to 2019. All patients had preoperative gait dysfunction, 16 (64%) had urinary incontinence, and 21 (84%) exhibited cognitive insufficiency. Two weeks post-shunt placement, 23/25 (92%) patients demonstrated improvement in gait, 11/16 (68%) had improvement in incontinence, and 14/21 (66%) had improvement cognitive insufficiency. At six months or greater follow up 13/20 (65%) had improvement in gait, 7/15 (47%) showed improvement in incontinence, and 11/15 (73%) demonstrated improvement in cognitive function. Six patients (24%) required at least one revision of the LP shunt. Shunt malfunctions resulted from CSF leak in one patient, shunt catheter migration in two patients, peritoneal catheter pain in one patient, and clinical symptoms for overdrainage in two patients. Thus, we demonstrate that LP-HV shunt placement is safe and efficacious alternative to VP shunting for iNPH, resulting in notable symptomatic improvement and low risk of overdrainage, and may be considered for patients where cranial approaches should be avoided. PMID:33775310 | DOI:10.1016/j.jocn.2020.12.031 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pain management in cancer patients in a Tunisian hospital

xlomafota13 shared this article with you from Inoreader Pain management in cancer patients in a Tunisian hospital Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 25:S0007-4551(21)00079-5. doi: 10.1016/j.bulcan.2020.12.013. Online ahead of print. ABSTRACT Pain is a common symptom in cancer patients. It is subjective and difficult to communicate. It continues to be outsourced and often overlooked despite the existence of multiple recommendations. The objective of this study is to describe pain management in cancer patients in a Tunisian hospital. This is a prospective study, conducted over one month at the maternity centre of Monastir by an intern in pharmacy using a questionnaire. Of 128 patients assessed, 50 were algic. Twenty-six percent of algic patients were not treated. The neuropathic component of pain was present in 30 % of cases but under treatment. Relief opioids were prescribed in 43 % of cases to relieve pain. Paracetamol was prescribed in 26 % of cases. Ten percent of patients use paracetamol self-medication. Sixteen percent of patients have tried non-pharmacolo gical means, of which 62 % consume plants. To optimise the management of pain at our centre, the available analgesic sheets have been developed, validated by the medical staff and disseminated in the departments of carcinology and oncohematology. Therapeutic education sessions were also scheduled to warn patients about the risks of self-medication and misuse of medicinal plants. Pain management is complex. It requires respect for international recommendations, but especially for the efforts made by all stakeholders. PMID:33775385 | DOI:10.1016/j.bulcan.2020.12.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pioneering Iodine-125-Labeled Nanoscale Covalent Organic Frameworks for Brachytherapy

xlomafota13 shared this article with you from Inoreader Pioneering Iodine-125-Labeled Nanoscale Covalent Organic Frameworks for Brachytherapy Via radioactive iodine Bioconjug Chem. 2021 Mar 28. doi: 10.1021/acs.bioconjchem.1c00040. Online ahead of print. ABSTRACT Brachytherapy has been clinically used for the treatment of malignant solid tumors. However, the classic therapeutic radioactive 125I seed must be surgically implanted directly into tumors. To avoid the surgery and prevent irrational radioactive distribution, radioiodine-loaded nanomaterials are ever-developing for brachytherapy. Hence, it is still a notable challenge to ob tain an advanced material that simultaneously incorporates features of high radiolabeling rate, short labeling time, good radiolabeling stability, and long tumor retention time. Covalent organic frameworks (COFs), which are crystalline polymers with ordered pores, are widely applied in guest delivery of drugs based on their high porosity and modifiable skeleton. Herein, we developed a functionalized nanoscale PEG-COF-Ag material, which could rapidly capture radioiodine reaching a 94% radiolabeling yield in 30 s. In addition, more than 95% 125I was maintained after 24 h in PBS (phosphate-buffered saline) as well as in serum and over 90% for nearly 1 week. PEG-COF-Ag-125I (125I-COF) demonstrated excellent cancer cell killing performance in vitro, and further experiments in vivo revealed a long tumor retention time and effective tumor treatment during the radiotherapy. The results indicate that radioiodine-labeled PEG-COF-Ag could be potentially applied in brachytherapy with a promising therapeutic effect. PMID:33775095 | DOI:10.1021/acs.bioconjchem.1c00040 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emerging and distinct video head impulse test responses in elderly with vestibular symptoms

xlomafota13 shared this article with you from Inoreader Emerging and distinct video head impulse test responses in elderly with vestibular symptoms Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 20:S1808-8694(21)00056-2. doi: 10.1016/j.bjorl.2021.02.011. Online ahead of print. ABSTRACT INTRODUCTION: Dizziness has been reported to be the most common symptom in elderly population. Video head impulse test, VHIT, allows clinicians to assess the vestibular function in elderly individuals, during their initial stages of vestibular symptoms. Inferences from VHIT responses were traditionally low vestibulo-ocular reflex gain or a normal vestibulo-ocular reflex gain. However, the possibility of a third and new variant of the vestibulo-ocular reflex gain has not been clinically explored yet. OBJECTIVES: To determine and report distinct patterns of vestibulo-ocular reflex gain using VHIT in elderly individuals with vestibular symptoms. METHODS: Retrospective cross-sectional study was done on a group of elderly patients who were above 70 years of age. These individuals were subjected to VHIT du ring their symptomatic phase. A vestibulo-ocular reflex gain value between 0.80-01.20 (Horizontal plane) was considered normal. The gain above and below this cutoff range was considered abnormal. RESULTS: 39 elderly patients (15 males and 24 females) whose mean age range was 74.71 years were evaluated for the VHIT response. Vestibulo-ocular reflex gain obtained was categorized into three distinct patterns: (i) normal vestibulo-ocular reflex gain, (ii) reduced vestibulo- ocular reflex gain and (iii) increased vestibulo-ocular reflex gain. The mean vestibulo- ocular reflex gain for both left and right horizontal canals varied significantly between the three groups (p < 0.05). No significant effect of age and vestibulo-ocular reflex gain was noted, though vestibulo-ocular reflex gain was higher in 80 years and above age (p > 0.05). CONCLUSION: Elderly individuals with dizziness may show varying responses with vestibulo-ocular reflex gain during the symptomatic period. The third type of hyperactive vestibule-ocular reflex responses that emerged from the current study were potential indicators of fluid dynamic changes in the inner ear. These responses need to be explored further as it relates to new clinical markers for both peripheral and central vestibular disorders. PMID:33775614 | DOI:10.1016/j.bjorl.2021.02.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary epidural lumbar Ewing sarcoma presenting as cauda equina syndrome in an adult patient who underwent surgical decompression: A case report

xlomafota13 shared this article with you from Inoreader Primary epidural lumbar Ewing sarcoma presenting as cauda equina syndrome in an adult patient who underwent surgical decompression: A case report Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Mar 25:S1130-1473(21)00029-4. doi: 10.1016/j.neucir.2021.01.005. Online ahead of print. ABSTRACT Ewing sarcoma (ES) is a rare primary neoplasm in the lumbar adult spine and may mimic a benign tumor. In this case, after a patient's three-month history of lower back pain and rapidly progressing leg numbness and weakness, magnetic resonance imaging (MRI) showed a mass in the third lumbar vertebra. At a two-month follow-up, imaging showed a fracture, compression and lesion enlargement. Decompression and fixation confirmed ES, and the patient began combined radiotherapy and chemotherapy. Two months postoperatively, residual ES was suspected on MRI. The patient underwent a second surgery, and histopathology confirmed necrosis. A six-month follow-up after the first surgery showed no tumor recurrence. This case supports the inclusion of ES in the differential diagnosis of pathologic spinal fracture. Early decompression and spinal fixation are critical for preserving neurologic and spinal functions in ES complicated by a compression fracture. Combined adjuvant radiotherapy and chemotherapy remain the standard therapeutic strategy. PMID:33775555 | DOI:10.1016/j.neucir.2021.01.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis

xlomafota13 shared this article with you from Inoreader The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis Via American Journal of Otolaryngology Publication date: Available online 29 March 2021 Source: American Journal of Otolaryngology Author(s): Hüseyin Sari, Semih Karaketir, Tolgar Lutfi Kumral, Muhammed Fatih Akgun, Berk Gurpınar, Deniz Hanci, Guler Berkiten, Yavuz Uyar View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Cartilage Umberlla Ossiculoplasty: As Total Ossicular Replacement Using Endoscope Holder

xlomafota13 shared this article with you from Inoreader Endoscopic Cartilage Umberlla Ossiculoplasty: As Total Ossicular Replacement Using Endoscope Holder Via Otolaryngology Indian Abstract We describe our innovative technique of endoscopic cartilage tympanoplasty using cartilage fashioned as umbrella in stapes absent condition using endoscope holder. Tragal cartilage disc of 3 × 3 mm dimensions with a circular slot of 0.8 mm to accommodate the vertical strut measuring 3 mm × 7 mm in cases with absent incus and stapes. Tympanic membrane reconstruction was done, with or without attic reconstruction, using sliced tragal cartilage of less than 0.5 mm thickness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient‐specific Virtual Temporal Bone Simulation Based on Clinical Cone‐beam Computed Tomography

xlomafota13 shared this article with you from Inoreader Patient‐specific Virtual Temporal Bone Simulation Based on Clinical Cone‐beam Computed Tomography Via The Laryngoscope Objectives Patient‐specific surgical simulation allows presurgical planning through three‐dimensional (3D) visualization and virtual rehearsal. Virtual reality simulation for otologic surgery can be based on high‐resolution cone‐beam computed tomography (CBCT). This study aimed to evaluate clinicians' experience with patient‐specific simulation of mastoid surgery. Methods Prospective, multi‐institutional study. Preoperative temporal bone CBCT scans of patients undergoing cochlear implantation (CI) were retrospectively obtained. Automated processing and segmentation routines were used. Otologic surgeons performed a complete mastoidectomy with facial recess approach on the patient‐specific virtual cases in the institution's temporal bone simulator. Participants completed surveys regarding the perceived accuracy and utility of the simulation. Results Twenty‐two clinical CBCTs were obtained. Four attending otologic surgeons and 5 otolaryngology trainees enrolled in the study. The mean number of simulations completed by each participant was 16.5 (range 3–22). "Overall experience" and "usefulness for presurgical planning" were rated as "good," "very good," or "excellent" in 84.6% and 71.6% of the simulations, respectively. In 10.7% of simulations, the surgeon reported to have gained a significantly greater understanding of the patient's anatomy compared to standard imaging. Participants were able to better appreciate subtle anatomic findings after using the simulator for 60.4% of cases. Variable CBCT acquisition quality was the most reported limitation. Conclusion Patient‐specific simulation using preoperative CBCT is feasible and may provide valuable insights prior to otologic surgery. Establishing a CBCT acquisition protocol that allows for consistent segmentation will be essential for reliable surgical simulation. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do Perioperative Systemic Corticosteroids Improve Cochlear Implant Hearing Preservation Outcomes?

xlomafota13 shared this article with you from Inoreader Do Perioperative Systemic Corticosteroids Improve Cochlear Implant Hearing Preservation Outcomes? Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improved Patient Dosimetry at Radioiodine Therapy by Combining the ICRP Compartment Model and the EANM Pre-Therapeutic Standard Procedure for Benign Thyroid Diseases

xlomafota13 shared this article with you from Inoreader Improved Patient Dosimetry at Radioiodine Therapy by Combining the ICRP Compartment Model and the EANM Pre-Therapeutic Standard Procedure for Benign Thyroid Diseases Via radioactive iodine Front Endocrinol (Lausanne). 2021 Mar 12;12:634955. doi: 10.3389/fendo.2021.634955. eCollection 2021. ABSTRACT Radioactive iodine is commonly used for the treatment of different thyroid conditions since the 1940s. The EANM has developed a standard pre-therapeutic procedure to estimate patient specific thyroid uptake at treatment of benign thyroid diseases. The procedure which models the time dependent fractional thyroid uptake is based on a two-compartment fitting system, one repre senting the thyroid and the other the blood. The absorbed dose is however only estimated for the thyroid and not for any other organ in the body. A more detailed biokinetic model for iodine is given by the ICRP and includes an iodide transport in the whole body. The ICRP model has 30 different compartments and 48 transfer coefficients to model the biokinetics of iodide and to model different transfer for inorganic iodide and organic iodine. The ICRP model is a recirculation iodine model, and the optimization is performed on the whole model and not exclusively on the thyroid as in the EANM procedure. Combining the EANM method and the ICRP model gives both patient specific estimations of thyroid uptake and retention and include most organs in the body. The new software gives both an improved patient specific dosimetry for the thyroid and an estimation of the absorbed dose to non-target organs and tissues like kidneys, urinary bladder, stomach wall, and uterus. Using the method describ ed in this paper, the repercussions on the daily routines will be minimal. PMID:33776929 | PMC:PMC7995899 | DOI:10.3389/fendo.2021.634955 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.