Modeling Recurrence in Idiopathic Subglottic Stenosis With Mobile Peak Expiratory Flow

xlomafota13 shared this article with you from Inoreader Modeling Recurrence in Idiopathic Subglottic Stenosis With Mobile Peak Expiratory Flow Via The Laryngoscope Objectives/Hypothesis We sought to establish normative peak expiratory flow (PEF) data for patients with idiopathic subglottic stenosis (iSGS), evaluate whether immediate changes in PEF after a procedure predict long-term treatment response, and test if a decline in longitudinal PEF is associated with disease recurrence. Study Design International, prospective, 3-year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. Methods iSGS patients consented and enrolled in the North American Airway Collaborative (NoAAC) iSGS1000 cohort recorded PEF data on a mobile smartphone app. Cox regression tested the associations between the magnitude of postoperative PEF improvement and longitudinal 90-day PEF decline with the risk of disease recurrence. Results Within the NoAAC iSGS1000 cohort, 810 patients participated in a 3-year prospective study comparing surgical treatment efficacy and 385 had appropriate PEF measurements and follow-up data. Of those patients, 42% (161/385) required at least one operation during study follow-up. The mean PEF preceding operative intervention was 241 L/min (95% confidence interval [CI]: 120–380) corresponding to a predicted PEF of 52%. The mean increase in PEF following a procedure was 111 L/min (95% CI: 96–125 L/min). Interestingly, the magnitude of immediate PEF improvement was not predictive of disease recurrence (hazard ratio [HR] for 100 L/min increase = 0.90, 95% CI: 0.60–1.00). However, recurrence was associated with the magnitude of PEF decline over 90 days (30% vs. 10% decline, HR = 2.2, 95% CI: 1.5–3.0). Conclusions We provide normative PEF data on a large iSGS patient cohort. The degree of PEF improvement immediately after surgery was not associated with a longer procedure-free interval. However, a 30% decline in PEF over 90 days was associated with elevated risk of disease recurrence. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effectiveness of Mitomycin C in Otolaryngology procedures: A systematic review

xlomafota13 shared this article with you from Inoreader The effectiveness of Mitomycin C in Otolaryngology procedures: A systematic review Via Clinical Otolaryngology Abstract Objective Many studies have evaluated the effectiveness of topical intraoperative mitomycin (MCC) usage in a wide range of Otolaryngologic procedures with variable conclusions on effectiveness. This systematic review aims to provide a qualitative estimation of mitomycin C's treatment effectiveness in maintaining or preventing stenosis after surgical interventions. Design and Main outcome measures Following the PRISMA guideline, a comprehensive systematic search of MEDLINE, EMBASE, and CINAHL databases was performed including hand-searching and cross-reference checking. The search was limited to humans, sample size greater than two, and study designs including a comparative arm. Results 571 unique abstracts and 109 full articles were reviewed. 77 studies were included in the final analysis. The available evidence ranged from case series to randomized control studies. Meta-analysis was deemed inappropriate due to heterogeneity of study design. 38 studies assessed the effective of MCC in dacryocystorhinostomy, which is reported in a separate meta-analysis. All other studies were categorized into otolaryngologic site and pathology including: choanal atresia (n=5), endoscopic sinus surgery (n=12), airway procedures (n=9), esophageal procedures (n=8), and other (n=2). Conclusions The published literature on the effectiveness of MMC was mixed, but suggested topical MMC improved surgical outcomes in many Otolaryngologic procedures compared to controls. This was the first review to assemble literature on MMC usage for different surgical procedures. Comprehensive interpretation of the data was limited due to heterogeneity in primary outcome, procedure type, and study quality. High quality prospective and randomized controlled studies are required to further confirm the positive effect of MMC use on surgical outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Minimally invasive fully ROBOT‐assisted cochlear implantation in humans: preliminary results in five consecutive patients

xlomafota13 shared this article with you from Inoreader Minimally invasive fully ROBOT‐assisted cochlear implantation in humans: preliminary results in five consecutive patients Via Clinical Otolaryngology Abstract - Cochlear implants are medical devices indispensable for the treatment of severe-to-profound bilateral sensorineural hearing loss - The most commonly used surgical procedure for cochlear implantation involves temporal bone drilling associating mastoidectomy with a facial recess approach - Improvements in robot-assisted surgery since 2010 have raised questions about the possibility of "simplifying" cochlear implant surgery - This study showed that the use of robotic assistance coupled to CT guidance for cochlear implantation is possible and apparently safe for the entire procedure using a Robot that is already available worldwide. - Several improvements are required to optimize this procedure View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

“Topical pentoxifylline can be an effective and safe adjunctive therapy to NBUVB therapy in treating vitiligo: a split‐side clinical trial”

xlomafota13 shared this article with you from Inoreader "Topical pentoxifylline can be an effective and safe adjunctive therapy to NBUVB therapy in treating vitiligo: a split‐side clinical trial" Via Experimental Dermatology View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Antimicrobial peptides and proteins: Interaction with the skin microbiota

xlomafota13 shared this article with you from Inoreader Antimicrobial peptides and proteins: Interaction with the skin microbiota Via Experimental Dermatology Abstract The cutaneous microbiota comprises all living skin microorganisms. There is increasing evidence that the microbiota plays a crucial role in skin homeostasis. Accordingly, a dysbiosis of the microbiota may trigger cutaneous inflammation. The need for a balanced microbiota requires specific regulatory mechanisms that control and shape the microbiota. In this review we highlight the present knowledge suggesting that antimicrobial peptides (AMPs) may exert a substantial influence on the microbiota by controlling their growth. This is supported by own data showing the differential influence of principal skin-derived AMPs on commensal staphylococci. Vice versa we also illuminate how the cutaneous microbiota interacts with skin-derived AMPs by modulating AMP expression and how microbiota members protect themselves from the antimicrobial activity of AMPs. Taken together, the current picture suggests that a fine-tuned and well-balanced AMP-microbiota interplay on the skin surface may be cr ucial for skin health. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multimodality‐based knee joint modeling method with bone and cartilage structures for total knee arthroplasty

xlomafota13 shared this article with you from Inoreader Multimodality‐based knee joint modeling method with bone and cartilage structures for total knee arthroplasty Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Objective We propose a robust and accurate knee joint modeling method with bone and cartilage structures to enable accurate surgical guidance for knee surgery. Methods A multimodality registration strategy is proposed to fuse MR and CT images of the femur and tibia separately to remove spatial inconsistency caused by knee bending in CT/MR scans. Automatic segmentation of the femur, tibia, and cartilages is carried out with ROI clustering and intensity analysis based on the multimodal fusion of images. Results Experimental results show that the registration error is 1.13 ± 0.30 mm. The Dice similarity coefficient (DSC) values of the proposed segmentation method of the femur, tibia, femoral and tibial cartilages are 0.969, 0.966, 0.910, and 0.872, respectively. Conclusions This study demonstrates the feasibility and effectiveness of multimodality-based registration and segmentation methods for knee joint modeling. The proposed metho d can provide users with 3D anatomical models of the femur, tibia, and cartilages with few human inputs. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single assistant vs dual assistant robotic surgery for robot‐assisted laparoscopic hysterectomy using da Vinci Xi or X

xlomafota13 shared this article with you from Inoreader Single assistant vs dual assistant robotic surgery for robot‐assisted laparoscopic hysterectomy using da Vinci Xi or X Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background To verify the usefulness of single assistant robotic surgery (SA-RS) using da Vinci Xi or X performed for total hysterectomy. Methods The SA-RS group (S-group) includes surgeries in which the surgeon performed all surgical operations other than that of the uterine manipulator, while the dual assistant robotic surgery group (D-group) includes surgeries performed by the surgeon with two assistants. In S-group, the forceps and camera were replaced during surgery in cases of a large uterus with limited range of motion of the instrument. A comparative study of patient background, intraoperative and postoperative results and surgery-related cost was performed between the two groups. Results No significant differences were observed between the two groups. On the contrary, S-group showed a significant reduction in preparation time and wound closure time, and a savings of $768. Conclusion SA-RS for total hysterectomy was possible , which is excellent in terms of cost, esthetics, and manpower This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Observational Study on Association of Clinical Outcome of Diphtheria Cases with Immunization Status: A Tertiary Care Hospital, Jaipur

xlomafota13 shared this article with you from Inoreader An Observational Study on Association of Clinical Outcome of Diphtheria Cases with Immunization Status: A Tertiary Care Hospital, Jaipur Via Otolaryngology Indian Abstract Background. Diphtheria is an important vaccine preventable disease with varied outcome from mild to death. It was observed that the outcome also gets affected with status of immunization. The outcome is relatively milder in immunized children. Objective. To find out the clinical presentation and outcome of diphtheria cases and its association with the immunization status. Methods. A descriptive analysis of 64 diphtheria cases admitted from January 2019 to May 2020 at SMS hospital, a tertiary care referral hospital in Jaipur. Results. Half of (51.56%, 33/60) patients were in the age group of 6–10 years. The peak load (48.44%) of diphtheria cases was seen in the monsoon season. Around 60% of the patients were fully immunized and around 10% partially immunized, every third case was un-immunized. The most common complication was neurological in 13 cases (20.31%), followed by cardiac complications in 11 cases (17.19%), and respiratory (7.81%). The pro portion of complication was much lower (26.3%) in immunized cases as compare to partially immunized and un immunized. The proportion of myocarditis was significantly higher in un immunized cases (40%) than partially immunized (16.7%) and filly immunized group (5.3%). Similarly, Bronchopneumonia was also significantly higher (20%) in unimmunized. Conclusion. Our study depicted that there has been a shift of age above 5 years for diphtheria which suggests the need for the booster dose. Also high chances of complications are seen in unimmunized and partially immunized calling for public awareness regarding complete immunization. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Large Intraoral Lipoma: Case Report

xlomafota13 shared this article with you from Inoreader A Large Intraoral Lipoma: Case Report Via Otolaryngology Indian Abstract Lipomas of the oral cavity are uncommon. Here we report a case of 85 year old female presenting with a progressively increasing large growth in the oropharynx which was diagnosed as lipoma on histopathology. The clinicoradiological and histopathological findings are discussed. To the best of our knowledge; this is one of the largest intraoral lipoma reported in India till date. The present case highlights the need to be aware of intraoral lipomas which can present as large growths at this unusual site so as to avoid any unwarranted aggressive surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasopharyngeal Tuberculosis mimicking Nasopharyngeal Carcinoma: A Case Series

xlomafota13 shared this article with you from Inoreader Nasopharyngeal Tuberculosis mimicking Nasopharyngeal Carcinoma: A Case Series Via Otolaryngology Indian Abstract Tuberculosis is a highly contagious granulomatous disease which is endemic in South East Asia. Most common presentation is pulmonary tuberculosis which is spread by droplets inhalation of mycobacterium tuberculosis bacterium. Nasopharyngeal tuberculosis is a rare entity which poses a diagnostic difficulty as its presentation is greatly similar to that of nasopharyngeal carcinoma. Herein, we describe two cases of nasopharyngeal tuberculosis which mimics nasopharyngeal malignancy leading to diagnostic difficulties. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Negative pressure wound therapy in cases of spinal surgery and exposed dura: a case-based review

xlomafota13 shared this article with you from Inoreader Negative pressure wound therapy in cases of spinal surgery and exposed dura: a case-based review Via leak of cerebrospinal fluid Childs Nerv Syst. 2021 Jul 26. doi: 10.1007/s00381-021-05302-9. Online ahead of print. ABSTRACT PURPOSE: Study of negative pressure wound therapy (NPWT) safety for patients with intraoperative exposure of the dura. METHODS: We analyzed the literature on the NPWT usage after spinal surgery in patients with exposure of the dura. We also described our experience of NPWT in 3 pediatric patients with spinal dysraphism. Due to the peculiarities of the anatomy (spina bifida), all of these patients had dural sac exposure during spinal surgery. RESULTS: The reasons for NPWT in all three cases were different. In the first patient with segmental spinal dysgenesis, surgery was complicated by extensive postoperative wound necrosis and the formation of soft tissue deficiency. The second patient with post-myelomeningocele kyphosis had a deficiency of soft tissues during spinal surgery due to a large bedsore at the apex of the deformity. And in t he third patient also with post-myelomeningocele kyphosis, NPWT was applied with surgical site infection. In all three cases, NPWT was used when the dura was exposed, without complications and with satisfactory results. The observation period for the patients was 3 years, 2.5 years, and 2 years, respectively. CONCLUSIONS: The usage of NPWT in cases of wound complications in the spinal surgery may be a useful option, which allows saving implants. NPWT is not contraindicated in cases of intraoperative dural exposure if there are no signs of cerebrospinal fluid (CSF) leak. PMID:34312707 | DOI:10.1007/s00381-021-053 02-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunohistochemical study of inflammatory responses in septa arising from type I intestinal atresia

xlomafota13 shared this article with you from Inoreader Immunohistochemical study of inflammatory responses in septa arising from type I intestinal atresia Via Cellular and Molecular Biology Histol Histopathol. 2021 Jul 27:18364. doi: 10.14670/HH-18-364. Online ahead of print. ABSTRACT The purpose of this study was to evaluate defensive functional cells in intestinal septa during recanalization in the embryonic period, and to access immune responses in septa arising from type I intestinal atresia and normal intestinal walls. Tissue samples were of septa located in the intestinal wall at a distance <15cm from the ligament of Treitz, and normal intestine walls obtained from seven neonates who underwent surgery. Following serial tissue sectioning, the samples were subjected to hematoxylin and eosin (HE), periodic acid-Schiff (PAS) and immunohistochemical staining to determine the morphological features and markers of functional cells and immune responses in the septa and normal intestinal walls. Quantitative analysis was conducted to compare differences between them. Compared with normal intestinal wall, the mucosal layer of septa arising from type I intestinal atresia had fewer misaligned villi and no classic epithelial crypts. Immunohistochemical staining showed that the mucosal layer of septa arising from type I intestinal atresia had fewer Paneth cells and goblet cells and lower amounts of lysozyme and MUC2, than normal intestinal walls. The concentration of pro-inflammatory cytokines, including interlukin (IL)-6 and tumor necrosis factor (TNF) -α, as well as macrophage inflammatory protein 3α (MIP-3α) and its receptor, CCR6, were higher in the mucosal layer of septa arising from type I intestinal atresia than in normal intestinal walls. Moreover, the numbers of mature dendritic cells and CD4+ T lymphocytes were higher in the mucosal layer of septa than in normal intestinal walls. The defensive activity of septa arising from type I intestinal atresia is weaker than that of normal intestinal walls. This weaker activity may correlate with increases in mature dendritic cells and CD4+ T lymphocyte s, as well overexpression of proinflammatory cytokines. PMID:34312829 | DOI:10.14670/HH-18-364 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.