Changes in Serum Thyroid Function Predict Cognitive Decline in the Very Old: Longitudinal Findings from the Newcastle 85+ Study

xlomafota13 shared this article with you from Inoreader Message: Abstract Background: Low serum thyrotropin (TSH) has been associated with an increased risk of cognitive impairment in observational studies of older individuals, but the mechanism underlying this is unclear. We investigated the association between changes in thyroid status and cognitive impairment in very old adults, using prospective data from the Newcastle 85+ study. Method: A cohort of 85-year-old individuals was assessed for health status and thyroid function. Complete data from a comprehensive multidimensional measure of health and repeat thyroid function were available for 642 participants with normal free thyroid hormones and TSH levels ranging between 0.1 and 10 mU/L. Cognitive performance, assessed using Mini-Mental State Examination (MMSE) and Cognitive Drug Research battery was examined by using linear mixed, logistic regression, and Cox proportional hazard models in relation to baseline and 3-year changes in serum TSH, free thyroxine (fT4), and free triiodothyronine (fT3). Results: Over 3 years, declining serum TSH was associated with reductions in fT4 and fT3, and an increased risk of incident cognitive impairment by 5 years (odds ratio1.77 [95% confidence interval: 1.19–2.61]; p = 0.004). A greater reduction in MMSE score was associated with larger TSH decline, at 3 (p = 0.001) and 5 years (p < 0.001), respectively. Steady fT4 concentrations were found in participants with rising TSH. Conclusions: In contrast to physiological expectation, in this group of 85-year-olds, a declining serum TSH was associated with reductions in free thyroid hormones over time. A decreasing serum TSH trajectory over time anticipated cognitive decline in later life. Declining TSH concentrations are a biomarker for cognitive impairment in later life. Changes in Serum Thyroid Function Predict Cognitive Decline in the Very Old: Longitudinal Findings from the Newcastle 85+ Study Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Measurement of Reverse Triiodothyronine Level and the Triiodothyronine to Reverse Triiodothyronine Ratio in Dried Blood Spot Samples at Birth May Facilitate Early Detection of Monocarboxylate Transporter 8 Deficiency

xlomafota13 shared this article with you from Inoreader Message: Abstract Background: Monocarboxylate transporter 8 (MCT8) deficiency is an X-chromosome-linked neurodevelopmental disorder resulting from impaired thyroid hormone transport across the cell membrane. The diagnosis of MCT8 deficiency is typically delayed owing to the late appearance of signs and symptoms as well as the inability of standard biomarkers of neonatal screening to provide early detection. In this study, we report, for the first time, the ability to detect MCT8 deficiency at birth using dried blood spot (DBS) samples. Methods: We retrospectively measured triiodothyronine (T3), thyroxine (T4), and reverse T3 (rT3) levels in DBS samples obtained at 4–5 days of life from 6 infants with genetically confirmed MCT8 deficiency and from 110 controls. The latter consisted of 58 healthy term neonates obtained at the same time, 16 were stored for more than 1 year before measurement to match samples from the MCT8-deficient infants. Ten DBS samples were collected at day 1 of life and 42 samples were from prematurely born neonates. Measurements were carried out in extract from eight millimeters diameter DBS using liquid chromatography-tandem mass spectrometry. Results: Contrary to characteristic iodothyronine abnormalities of MCT8 deficiency during later life, T3 and T4 values were not discriminatory from those of other study groups. In contrast, rT3 was significantly lower. The T3/rT3 ratio was higher in the DBS samples from the MCT8-deficient infants compared with all other groups with no overlap (p < 0.0001). Conclusions: rT3 and T3/rT3 ratio in DBS samples obtained from neonates can serve as biomarkers to detect MCT8 deficiency at birth. Introduction Monocarboxylate transporter 8 (MCT8) deficiency (OMIM 300095) is an inherited disorder that causes severe psychoneuromotor defects with characteristic abnormalities in serum thyroid hormone (TH) function tests (1). It is caused by mutations in the MCT8 (SLC16A2) gene, on Xq13.2, which impair the transport of TH into the brain, producing the psychoneuromotor abnormalities. However, excess TH available to peripheral tissues, through alternative TH transporters, produces hypermetabolism. The former abnormalities consist of early poor head control and truncal hypotonia, followed by inability to stand or walk, absent speech, abnormal involuntary movements, and spastic quadriplegia. These signs are not evident until later in life, and given the X-chromosome linked inheritance, carrier mothers are asymptomatic. In children aged four months or more, TH abnormalities consist of high serum triiodothyronine (T3), low normal thyroxine (T4), and low reverse T3 (rT3) with normal or slightly elevated thyrotropin (TSH). Although this combination of thyroid hormone abnormalities is characteristic of MCT8 deficiency, current neonatal detection programs will not detect affected newborns. Current screening programs only measure TSH and/or T4 and will miss the high T3 and low rT3. As carrier females are asymptomatic and do not have the characteristic TH test abnormalities, prenatal diagnosis is practicable only in those women who have previously given birth to an affected child. Newborns of women not known to be carriers of an MCT8 gene mutation may harbor embryos with a de novo mutation, which will not be identified until neurodevelopmental abnormalities are identified later in infancy or even childhood. This is unfortunate as a recent trial with the thyroid analogue Triac suggested that early treatment is more likely to be effective in improving or preventing the evolution of the neuromotor deficit (2). While the thyroid tests abnormalities in MCT8 deficiency are virtually pathognomonic in both humans (1) and in mice (3,4), this may not be the case at birth. Indeed, at birth, Mct8-deficient mice have higher rather than lower serum T4 concentration and undetectably low T3 (5). Thus, we performed a retrospective pilot study to determine the nature of iodothyronine abnormalities in the first five days of life and to assess whether they could be used in the early detection of MCT8 deficiency. In this retrospective study, we measured T3, T4, and rT3 levels in dried blood spot (DBS) samples obtained from newborns later confirmed genetically to have MCT8 deficiency. Results were compared with those from DBS samples obtained from normal controls at 1–6 days of life, in prematurely born, and in samples stored up to 2 years. To the best of our knowledge, this is the first study that measured T3 and rT3 levels in DBS specimens obtained in the first week of life. Our findings provide promising biomarkers for the early detection of MCT8 deficiency and a possible means to determine the prevalence of this devastating condition. Materials and Methods Subjects In Japan, DBS samples are obtained from all neonates at 4–5 days of life as part of mass screening program for inborn errors of metabolism. All DBS samples in this study had TSH values within the reference range and were not recalled by the respective screening programs. The deidentified residual DBS samples, stored at room temperature, were used for our studies. There were six samples from infants with genetically confirmed MCT8 deficiency [c.733C>T (p.R245X); c.1556C>A (S519L); c.883G>A (p.G295S); c.985_986insG (p.Asp329Glyfs*1); c.661G>A (p.G221R); and c.1188dup (p.Ile397Hisfs*57); amino acids numbered according to the long form of the MCT8 protein]. As controls, 110 DBS samples were obtained consisting of healthy neonates, 16 of which were measured after storage for more than a year. In addition, 10 DBS samples were obtained from healthy infants born at term but collected at the end of the 1st day of life, as this is sometimes the practice in the United States for neonates and mothers discharged 1 day postpartum. Of the total of 106 DBS samples, 88 were collected in Japan and 18 in the United States. The same filter paper was used. Details on demographics including gestational age, sex, birth weight, and duration of sample storage before analysis are provided in Supplementary Table S1. The study was approved by the ethical committees and institutional review boards of the three involved institutions (Aichi Medical University, 2015-H359; Universities of Miami and Chicago, 20200996). A written informed consent was obtained from the parents of all study subjects. All study evaluations and procedures were performed in accordance with the Declaration of Helsinki. Methods T3, T4, and rT3 were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) as described previously (6). It was based on the LC-MS/MS method used in mouse serum and tissues, and results were in agreement with those obtained by radioimmunoassay (5). The LC-MS/MS method was modified for use in DBS samples (for details see Supplemental Data). Statistical analysis T3, T4, and rT3 levels are expressed as mean ± standard deviation (SD). Statistical analysis using analysis of variance with Dunnett's test for comparison of differences between all five groups was performed at Aichi Medical University and results were confirmed at the University of Chicago. Results The demographics of the two groups are given in Supplementary Table S1. These were not significantly different with respect to gestational age or birth weight except for the group of prematurely born. The same table provides information regarding age at blood sampling and the time elapsed from sampling to analysis. As storage is expected to produce iodothyronine degradation (7) by deiodination, a group of DBS samples obtained from normal infants but stored for 1.1–2.2 years were included to match the stored DBS samples to the MCT8-deficient group. Results of the study are presented in Figures 1 and 2, and mean values ± SD are provided in Table 1. The concentrations of T3, rT3, and T4 are shown in Figure 1A–C. The T3 concentrations of the MCT8-deficient infants were not significantly different than those of the other groups, except for the group of prematurely born, whose T3 was lower (57 ± 30 vs. 94 ± 18; p < 0.01; Fig. 1A). The concentrations of rT3 in the MCT8-deficient newborns were significantly lower than that of all other groups (Fig. 1B; mean values ± SD in Table 1). The concentration of T4 was also not significantly different than the other group, except for those of the normal infants (Fig. 1C; Table 1). Of note, taking into account the effect of storage, the T4 concentrations in DBS samples of MCT8-deficient infants were not significantly different compared with the normal infants. FIG. 1. FIG. 1. Concentrations of T3 (A), rT3 (B), and T4 (C) in individual DBS samples in groups identified on the bottom of each panel. p-Values obtained by comparisons using ANOVA between samples from MCT8-deficient and each other group are given on top of each panel. The p-values of differences between the samples from normal neonates one of which was stored for more than 1 year (1.1–2.3 years) are also shown. Open circles identify samples collected in Japan and closed circles identify samples collected in the United States. ANOVA, analysis of variance; DBS, dried blood spot; MCT8, monocarboxylate transporter 8; rT3, reverse T3; SD, standard deviation; T3, triiodothyronine; T4, thyroxine. FIG. 2. FIG. 2. Calculated T3/rT3 (A), T3/T4 (B), and T3/(rT3 · T4) (C) ratios in individual DBS samples in groups identified on the bottom of each panel. p-Values obtained by comparisons using ANOVA between samples from MCT8-deficient and each other group are given on top of each panel. The p-values of differences between the samples from normal neonates one of which was stored for more than 1 year (1.1–2.3 years) are also shown. Open circles identify samples collected in Japan and closed circles identify samples collected in the United States. Table 1. Number of Infants Analyzed, Thyroid Hormone Concentrations, and Ratios Mean ± SD T3 rT3 T4 T3/rT3 T3/T4 Group N ng/dL ng/dL μg/dL ng/ng ng/μg T3/(rT3 × T4) MCT8 deficient 6 94 ± 18 32 ± 7 9.3 ± 2.2 3.04 ± 0.67 10.1 ± 2.3 0.349 ± 0.146 Normal infants 42 76 ± 21 78 ± 20 15.7 ± 3.6 1.02 ± 0.34 20.5 ± 4.7 0.067 ± 0.027 Normal infants (DBS stored >1 year) 16 119 ± 42 130 ± 47 8.7 ± 2.1 0.96 ± 0.31 7.8 ± 2.2 0.117 ± 0.049 Prematurely born 34 + [8] 57 ± 30 131 ± 56 7.9 ± 3.1 0.50 ± 0.35 21.1 ± 18.4 0.071 ± 0.063 Normal infants (DBS collected at day 1) [10] 80 ± 22 137 ± 55 9.2 ± 3.0 0.64 ± 0.20 11.8 ± 3.8 0.075 ± 0.031 Numbers in square brackets are samples from the United States. DBS, dried blood spot; MCT8, monocarboxylate transporter 8; N, number of DBS; rT3, reverse T3; SD, standard deviation; T3, triiodothyronine; T4, thyroxine. We calculated the ratios of T3/rT3, T3/T4, and T3/(rT3 × T4). The T3/rT3 and T3/(rT3 × T4) ratios between the MCT8-deficient and all other groups were significantly different (Figs. 1A and 2C; p < 0.0001). The values of the MCT8-deficient infants did not overlap with those of the other groups. Of note, the T3/T4 ratios between the MCT8-deficient group and the corresponding matched normal controls of newborns, whose DBS samples were stored for more one year, completely overlapped (Fig. 2B). Ratios of T3/(rT3 + T4) (not shown) did not give better discriminatory results. Discussion Currently, most neonatal screening programs are based on measurement of TSH only in DBS samples and, therefore, have not detected newborns with MCT8 deficiency. Programs that also measure T4, total or free, have picked up the low concentration in some newborns with MCT8 deficiency. This led in some instances to treatment with physiological doses of levothyroxine, with no beneficial effects (8,9). In fact 6 and 4 of 8 DBS samples from newborns with MCT8 deficiency had total T4 values that were 1 and 2 SDs, respectively, below the mean value (10). In another report of 8 MCT8-deficient newborn, the mean total T4 was 5.1 ± 1.6 μg/dL with a range of 3.1–8.4, compared with a reference range of 6–15 μg/dL (11). Serum TH tests abnormalities in older infants, children, and adults with MCT8 deficiency are typical if not fully pathognomonic. However, it could not be construed that this will also be the case in the first few days of life, given their immature livers, and the contribution of other tissues to the metabolism of TH affecting serum TH concentrations. Based on studies in adult mice with Mct8 deficiency, serum T4 is low due to the combination of reduced secretion from the thyroid gland, increased consumptive degradation by deiodinase 1, and increased excretion in urine (12,13). Serum T3 is increased owing to the increased conversion of T4 to T3 by deiodinases 1, its decreased degradation by low deiodinase 3 activity, and, to some extent, reduced transport into tissues (3,4). The high deiodinase 1 and low deiodinase 3 activity contribute to the markedly reduced rT3 (14). While Mct8-deficient mice manifest the same abnormalities as humans during adulthood, this is not the case in the ear ly postnatal life. Postpartum low rT3 is the first to manifest, followed by low T4, high TSH, and only then high T3 (3,5). However, in humans with MCT8 deficiency, the TH abnormalities during the first few days of life remained unknown until this study. Thus, the primary aim of this study was to determine the nature of iodothyronine abnormalities in the 1st week of life. Should MCT8-deficient newborns present characteristic TH abnormalities similar to those found in later life, they could be applied to possibly detect MCT8 deficiency. A future screening program using such tests would enable the determination of the prevalence of this defect. To the best of our knowledge, this is the first study that has measured T3 and rT3 levels in DBS samples obtained at birth. MCT8-deficient newborns showed significantly decreased rT3 and T4 compared to normal newborns. Measurement of T3 in the MCT8 deficient newborns was not significant from normal newborns as the elevated T3 is seen only in later life (Fig. 1). This is not surprising as T3 is maintained low in the fetus. However, the rT3, normally elevated at birth, was significantly reduced in MCT8-deficient newborns. More importantly the ratios of T3/rT3 and T3/(rT3 × T4) were lower and with no overlap with all other groups (Fig. 2). The values of the latter two in control, compared with MCT8-deficient newborns, did not overlap (Fig. 1). This suggests that these biomarkers could have 100% sensitivity and specificity for the detection of newborns with MCT8 deficiency. Newborns T4 and FT4 concentrations can be low in prematurity, critical illness, thyroglobulin deficiency, and in infants born to thyrotoxic mothers as well as in congenital central hypothyroidism (15,16). In contrast, in embryonic fluids and at birth, T3 is low and rT3 is high (17,18). In congenital central hypothyroidism, both T3 and rT3 are low (18). Thus, measurement of all three iodothyronines may be necessary to identify newborns with MC8 deficiency. LC-MS/MS provides these results at the same time without additional effort or cost. The key prerequisites for an effective neonatal screening program include adequate knowledge of the natural history, availability of methods for early diagnosis, and effective treatment to improve prognosis (19). The natural history of MCT8 deficiency is well known (10). This study provides a basis for the development of neonatal screening test for MCT8 deficiency. The use of LC-MS/MS in routine clinical diagnosis is gaining popularity and has already become the preferred method in the measurements of serum testosterone and thyroglobulin. With reduction in cost of LC-MS/MS measurement and the increase in survival and cost for the care of individuals with MCT8 deficiency, the application of LC-MS/MS in neonatal screening is possible. Although current treatments of MCT8 deficiency are at best palliative, more effective early treatment using TH analogues (2) and gene-directed treatments are under development (11,20). In conclusion, measurement of rT3 and the T3/rT3 ratio in DBS samples at birth are useful for early detection of MCT8 deficiency and will help determine the prevalence of this condition. Acknowledgment We thank Masatsune Itoh from Kanazawa Medical University for the genetic analysis of MCT8. Authors' Contributions H.I. designed the research project, interpreted the results, and wrote the initial version of the article. H.K., S.A., K.T., M.K., Y.F., H.O., Y.Y., and K.H. contributed to the acquisition of samples. M.I. was a major contributor in the measurement of iodothyronines by LC-MS/MS. A.O. and R.E.W. reviewed the data and critically revised the article for its scientific content. S.R. advised in setting LC-MS/MS conditions and had a major role in preparation of the article. All authors read and approved the final article. Author Disclosure Statement No competing financial interests exist. Funding Information The research of H.I. was supported by JSPS KAKENHI, Grant Nos. 16K19676 and 18K15691, The Nitto Foundation, Aichi Medical University "Aikei-Kai" Foundation, The Japanese Society for Pediatric Endocrinology Future Development Grant, and Yoshiko and Seizo Foundation. S.R. was supported, in part, by Grant No. DK15070 from the National Institutes of Health, USA. and R.E.W. by funds from the Esformes Thyroid Research Fund. Supplementary Material Supplementary Data Supplementary Table S1 Figures References Related Details View details for Thyroid cover image Article has an altmetric score of 3 Information © Hideyuki Iwayama et al., 2021; Published by Mary Ann Liebert, Inc. To cite this article: Hideyuki Iwayama, Hiroki Kakita, Masumi Iwasa, Shinsuke Adachi, Kyoko Takano, Masahiro Kikuchi, Yasuko Fujisawa, Hitoshi Osaka, Yasumasa Yamada, Akihisa Okumura, Khemraj Hirani, Roy E. Weiss, and Samuel Refetoff.Thyroid.ahead of printhttp://doi.org/10.1089/thy.2020.0696 Online Ahead of Print:July 2, 2021 Online Ahead of Editing: May 28, 2021 Keywords dried blood spotLC-MS/MSMCT8 deficiencynewborn screeningreverse T3 Open access This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. BACK Call us toll free (800) M-LIEBERT Publications Publications A-Z Journal Collections Publications by Type Recommend a Title For Authors Fees and Options Publishing Open Access Submission Guidelines Policies Librarians Our Journals Account Support Archive Terms & Conditions Resources Liebert Link Newsletter Contact Open Access Open Option Open Access Journals Publishing Services FAQs Contact Corporate Capabilities Custom Publications Interactive Media Other Opportunities Reprints Advertising Company Customer Support Contact Us Privacy Policy © 2021 Mary Ann Liebert, Inc., publishers. All rights reserved, USA and worldwide. Call us toll free at (800) M-LIEBERT (800-654-3237).Counter CompliantCrossref logo Back to Top Measurement of Reverse Triiodothyronine Level and the Triiodothyronine to Reverse Triiodothyronine Ratio in Dried Blood Spot Samples at Birth May Facilitate Early Detection of Monocarboxylate Transporter 8 Deficiency Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk Factors for Recurrence of Follicular Thyroid Cancer: A Systematic Review

xlomafota13 shared this article with you from Inoreader Message: Abstract Background: In risk assessment of recurrence, papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC) are often grouped together as differentiated thyroid cancer (DTC). However, while risk factors affecting recurrence of PTC are well established, risk factors for recurrence of FTC are not. This systematic review examines risk factors for recurrence of FTC and evaluates their significance. Methods: A systematic search on PubMed and Embase was performed in September 2020, including studies evaluating risk factors for recurrence of FTC. A quality assessment of the enrolled studies was performed. Results: Nine studies (n = 1544 patients) from eight countries were included. The average recurrence rate was 13.6%, and distant metastasis (DM) constituted 64.8% of the recurrent cases. The risk factors examined were sex, age at diagnosis, primary tumor size, degree of invasiveness, focality, positive resection margin, lymph node (LN) metastasis, and DM at diagnosis. Risk factors correlated with recurrence of FTC were age older than 45 years, primary tumor size above 40 mm, widespread invasion, multifocality, positive resection margin, LN metastasis, and DM at diagnosis. Sex was not a statistically significant risk factor. Conclusions: We identified seven risk factors associated with recurrence of FTC. Age and multifocality were found to be of greater impact regarding recurrence risk of FTC compared with PTC. Future research needs to address the impact of different risk factors for recurrence of FTC particularly including age, primary tumor size, angioinvasion, and mutational status. Risk Factors for Recurrence of Follicular Thyroid Cancer: A Systematic Review Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A novel MYH9 mutation related to non-syndromic delayed post-lingual sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader A novel MYH9 mutation related to non-syndromic delayed post-lingual sensorineural hearing loss 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 Jul 6. doi: 10.1007/s00405-021-06976-2. Online ahead of print. ABSTRACT OBJECTIVE: Hearing loss (HL) is the most common sensory organ dysfunction disease. The cause is often complex, though genetics are the main factor. METHODS: In this study, we investigated a Chinese family with non-syndromic delayed post-lingual deafness. Comprehensive data collection was performed on this family's members, including basic information, audiological examinations, blood system examinations and imaging examinations. A pedigree diagram was drawn and the genetic patterns were analyzed. RESULTS: A new gene mutation, c.314A>T:p.Y105F in the MYH9 exon, was confirmed by next generation sequencing and Sanger sequencing. This mutation co-segregated with the phenotype in the pedigree. Patients in this family present bilateral symmetry and gradual and delayed high-frequency sensorineural hearing loss. The age of ons et was approximately 30 years old. Except for hearing loss, no lesions were seen in other organs, especially the blood system. CONCLUSION: The identification and detection of a novel MYH9 mutation may be of great significance to provide the basis for gene function research and genetic consultation. PMID:34228168 | DOI:10.1007/s00405-021-06976-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The ulnar interosseous tuberosity exists: a radiological and descriptive cadaveric study

xlomafota13 shared this article with you from Inoreader The ulnar interosseous tuberosity exists: a radiological and descriptive cadaveric study Via radiol anat Surg Radiol Anat. 2021 Jul 6. doi: 10.1007/s00276-021-02792-9. Online ahead of print. ABSTRACT PURPOSE: The anatomy of the ulna seems to have already been described exhaustively, particularly at its extremities, but very little in its middle third. We report the existence of an interosseous tuberosity on the interosseous border of the ulnar shaft that we have named the "tuberositas interossea ulnarii" (TIU). METHODS: First, we analyzed all side view X-rays of the forea rm in neutral rotation, as well as forearm CT scans carried out during a 1-year period in our hospital. On these radiographic examinations, we evaluated the presence or absence of the TIU, its length, the thickness of the interosseous cortex at its level, above and below compared with anterior, posterior, and lateral bone cortices. In the second part of the study, we dissected cadaveric forearms to determine which ligaments and muscles were attached to it. RESULTS: A total of 91 standard forearm radiographs and 13 CT scans were analyzed. In all cases, the ulnar interosseous tuberosity was present. The mean tuberosity length was 107.5 mm (± 18.2), without any significant gender influence. It corresponded to a thickening (6.9 mm then 4.6 mm above and 3.9 mm below; p < 0.0001) of the ulnar interosseous cortex. Then, ten anatomic subjects (six females, four males) were dissected. We observed that this tuberosity served as an attachment for the central band of the interosseous membrane, for the deep flexor and extensor muscles for the long fingers, and for the abductor pollicis longus muscle's inner attachment. CONCLUSION: Tuberositas interossea ulnarii exists besides the tuberositas interossea radii, corresponds to thickening of the cortex and may play a role in the stability of the forearm and the function of the long fingers. PMID:34228179 | DOI:10.1007/s00276-021-02792-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Post Viral Olfactory Dysfunction After SARS-CoV-2 Infection: Anticipated Post-pandemic Clinical Challenge

xlomafota13 shared this article with you from Inoreader Post Viral Olfactory Dysfunction After SARS-CoV-2 Infection: Anticipated Post-pandemic Clinical Challenge Via Otolaryngology Indian Abstract Persistent olfactory dysfunction (OD) is the second most common symptom of post coronavirus disease-19 (COVID-19) now being termed long-COVID. Its prevalence after recovery from COVID-19 is estimated to be 12% after nearly 6 months of follow-up. It thus becomes imperative for the treating clinicians to update themselves with the pathophysiology of this post COVID disability as well as the tools for diagnosis and the available treatment options. A systematic literature search was performed as per PRISMA guidelines in MEDLINE, Cochrane Library, LILACS, Google Scholar, ClinicalTrials.gov, and medRxiv databases. The keywords used were covid-19, Olfactory Disorders, Smell, Anosmia, PVOD, Post Viral Olfactory Disorders, post-covid and post haul. All articles were studied for definition, mechanism, diagnostic tests and treatment options for post COVID OD. 33 published articles and 8 ongoing tri als were found relevant and included after full-text review. SARS-CoV-2 can cause conductive, neural and central OD. Olfactory evaluation can be done both subjectively (visual analogue scale) and objectively (Sniffin' sticks, Sinonasal Outcome Test, University of Pennsylvania Smell Identification Test and modified Davidson's alcohol sniff test). They can be used to detect and follow-up patients. Despite several on-going clinical trials, the most reliable and advisable treatment option available till date is olfactory training. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The circadian timing of noise exposure influences noise-induced inflammatory responses in the mouse cochlea

xlomafota13 shared this article with you from Inoreader The circadian timing of noise exposure influences noise-induced inflammatory responses in the mouse cochlea Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Jun 12:S1808-8694(21)00106-3. doi: 10.1016/j.bjorl.2021.05.010. Online ahead of print. ABSTRACT INTRODUCTION: Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss. Nevertheless, the mechanisms of noise-induced hearing loss are still not fully understood. OBJECTIVE: To investigate the dynamics of inflammatory responses in the mammalian cochlea following noise trauma at two different times, once during the light cycle and once during the dark. METHODS: We challenged C57BL/6J mice with moderate, continuous noise trauma at either 9 a.m. or 9 p.m. Auditory function, histological changes in hair cells, and modifications in gene expression levels of inflammatory mediators were assessed at specific time points. Shifts in auditory brainstem response thresholds were measured at 1, 3, 7 and 14 days after noise exposure to measure potential noise-induced hearing loss. Co chlear basilar-membrane immunofluorescent staining was performed at 3 and 14 days after noise exposure. The mRNA levels of several inflammatory mediators were measured via quantitative real-time polymerase chain reaction before (pre) and after (0, 3, 12, 24 and 72 h) noise exposure. RESULTS: We found that all noise-exposed mice developed a temporary threshold shift and that there were no significant differences between daytime and nighttime noise exposures in terms of inducing hearing-threshold shifts. Similarly, we did not detect significant histological changes in hair cells between these two groups. However, we discovered an interesting phenomenon in that the peak mRNA levels of IL-1β, IL-6, CCL2 and TNF-α were higher in day noise-exposed mice compared to those in night noise-exposed mice, and these mRNA levels subsided more slowly in day noise-exposed mice. CONCLUSION: Overall, these observations suggest that the circadian timing of noise exposure has a significant effect on noise-induced inflammatory responses in the mouse cochlea and that a greater inflammatory response might occur after daytime exposure. PMID:34217678 | DOI:10.1016/j.bjorl.2021.05.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

National certification for gynecological cancer surgery

xlomafota13 shared this article with you from Inoreader National certification for gynecological cancer surgery Via Association française pour l'étude du cancer Bull Cancer. 2021 Jun 30:S0007-4551(21)00202-2. doi: 10.1016/j.bulcan.2021.03.019. Online ahead of print. ABSTRACT OBJECTIVE: In France, we are lacking an identified pathway for training in gynaecological cancer surgery. The four competent French learned societies: the SFOG, the CNGOF, the SFCO and the SCGP supported by the CNU of Obstetrics & Gynaecology, and UNICANCER agreed to materialize this course and attest it by a certification awarded by a national jury. MATERIAL AND METHODS: The national committee of certification in gynaecological oncology made up of ten members, representing the 6 concerned organizations, set itself five objectives: the definition of the eligibility criteria for training centres; the determination of a check-list to be filled by the candidate; the determination of a targeted curriculum for the training in gynecological oncological surgery; the determination of the assets necessary for the certific ation of a candidate already in practice; and the practical organization of the certification. RESULTS: Criteria for approval of centres for training included 150 gynaecological cancer cases per year, among which 100 excisional surgeries, including twenty advanced-stage ovarian cancers. For certification of candidate who followed the curriculum established by the committee or by validation of prior experience for an actual practitioner, a candidate must validate a logbook and fill out a checklist including four parts: theoretical and practical training; research and publications; teaching and subscription to a continuing education program. The accomplished elements of the logbook and the checklist will be evaluated by a score. The first certification session is planned for the end of 2021. PMID:34217437 | DOI:10.1016/j.bulcan.2021.03.019 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Role of Infrahyoid Flap in Tongue Defect Reconstruction Following Tumour Excision

xlomafota13 shared this article with you from Inoreader The Role of Infrahyoid Flap in Tongue Defect Reconstruction Following Tumour Excision Via Otolaryngology Indian Abstract Carcinoma tongue is one of the commonest cancer of head and neck in India. Various pedicled and free flaps have been used to reconstruct the tongue defect following glossectomies. In this era of free flaps various loco- regional pedicled flaps have been overlooked and infrahyoid flap is one of them. This flap meets the functional and cosmetic acceptance of the tongue defect reconstruction with minimal morbidity to the donor site. This paper presents author's experience of using infrahyoid flap in 10 patients of carcinoma tongue. In all the patient's tongue defect was closed with the infrahyoid flap, in 1 case flap necrosed fully and in 1 partially. Functional outcome and quality of life in all the patients were acceptable. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.