Long-term follow-up of patients managed conservatively for acute traumatic CSF rhinorrhoea

xlomafota13 shared this article with you from Inoreader Long-term follow-up of patients managed conservatively for acute traumatic CSF rhinorrhoea Via leak of cerebrospinal fluid World Neurosurg. 2022 Feb 19:S1878-8750(22)00211-X. doi: 10.1016/j.wneu.2022.02.065. Online ahead of print. ABSTRACT OBJECTIVE: Conservative management of acute traumatic cerebrospinal fluid rhinorrhoea (TCR) results in cessation of the leak in most patients. The objective of this study was to estimate the incidence of recurrent cerebrospinal fluid (CSF) rhinorrhoea and meningitis in these patients on long-term follow-up and to determine the risk factors associated with them. METHODS: Data on 50 patients with acute TCR who were successfully treated with conservative management between 2013 and 2015 and had long term follow-up was retrieved from our head injury database. Patient variables were analysed to determine the risk factors associated with recurrence of CSF rhinorrhoea and meningitis. RESULTS: All patients in our series developed CSF rhinorrhoea within 48 hours of trauma. The mean duration of follow-up was 6.3 ± 1.3 years. CSF rhinorrhoea recurred in 16 (32%) patients, 15 (93.8%) of whom developed it within 3 years of trauma. Meningitis occurred in 5 (10%) patients and one of them died. Sphenoid sinus fractures and features of raised intracranial pressure on computerised tomography (CT) of the brain at admission were significantly associated with the development of meningitis. There were no risk factors identified for the recurrence of CSF rhinorrhoea. CONCLUSIONS: Patients with acute TCR in whom rhinorrhoea subsides with conservative therapy, have the highest risk for recurrence of leak or meningitis within three years of the trauma. Therefore, we recommend that these patients be counselled about the need for periodic follow up for several years. PMID:35192972 | DOI:10.1016/j.wneu.2022.02.065 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis

xlomafota13 shared this article with you from Inoreader Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis Via Clinical Otolaryngology Abstract NOE is a rare but life-threatening condition. Treatment is long-term intravenous antibiotics. However, there is no evidence on the complications of antibiotic treatment in this complex cohort of patients In our study, patients on average are treated with two different antibiotic regimes 63% of these changes in regimen are due to direct adverse effects from treatment including drug intolerance and lack of significant clinical response leading to deterioration and morbid complications Patients requiring multiple antibiotic regimes have a statistically longer duration of treatment. These adverse effects appear to occur more frequently in patients with additional comorbidities. This novel data provides information clinicians can use when initiating treatment for NOE and counsel patients appropriately View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Similarities and differences of estrogen in the regulation of temporomandibular joint osteoarthritis and knee osteoarthritis

xlomafota13 shared this article with you from Inoreader Similarities and differences of estrogen in the regulation of temporomandibular joint osteoarthritis and knee osteoarthritis Via Cellular and Molecular Biology Histol Histopathol. 2022 Feb 23:18442. doi: 10.14670/HH-18-442. Online ahead of print. ABSTRACT BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) and knee osteoarthritis (knee OA) are two kinds of common osteoarthritis (OA) that are characterized by chronic degeneration of soft and hard tissues around joints. Their gender and age differences suggest that there are similarities and differences between the pathogenic mechanisms of TMJOA and knee OA. OBJECTIVE: To review recent studies on the effect of estrogen on TMJOA and knee OA, and summarize their possible pathogenesis and molecular mechanisms. SOURCES: Articles up to present reporting the relationship of estrogen and TMJOA or knee OA are included. An extensive electronic search was conducted of databases including PubMed, Web of science core collection. CONCLUSION: According to epidemiological investigations, TMJOA primarily happens to females of puberty a nd childbearing age, while knee OA mainly affects postmenopausal women. Epidemiological investigation and experimental research suggest that estrogen may have a different effect on TMJ and on knee. Though estrogen regulates TMJOA and knee OA via estrogen-related receptors (ERR), their pathogenesis and pathway of estrogen regulation are different. To find out the accurate regulation of estrogen on TMJOA and knee OA, specific pathways and molecular mechanisms still need further exploration. PMID:35194774 | DOI:10.14670/HH-18-442 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Measured and self-reported olfactory function

xlomafota13 shared this article with you from Inoreader Measured and self-reported olfactory function in voluntary Norwegian adults 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 23. doi: 10.1007/s00405-022-07298-7. Online ahead of print. ABSTRACT PURPOSE: The lack of epidemiological data on the proportion of olfactory dysfunction (OD) using comprehensive olfactory assessment in healthy adults in Scandinavia motivated to the present study which aimed to explore the proportion of OD in voluntary healthy Norwegian adults, assessed by Sniffin' Sticks, and its correlation to self-reported olfactory function. Furthermore, sociodemographic and clinical factors associated with olfactory function were analysed. METHODS: The sample included 405 Norwegian participants, aged 18-78 years, 273 women and 132 men, who underwent olfactory testing with extensive Sniffin' Sticks test, allergy testing, clinical examination with nasal endoscopy and completed a self-administered questionnaire, including self-evaluation of olfactory function on a 100 mm Visual Analogue Scale. RESULTS: We found that 37% had OD, of which 1.2% had anosmia assessed with extensive Sniffin' Sticks test. The proportion of hyposmia and anosmia increased with age. Men and participants with low education had poorer olfactory function scores. Allergy, smoking status, general health and endoscopic findings were not associated with measured olfactory function. We found no correlation between self-reported and measured olfactory function. CONCLUSIONS: This study has identified that a large proportion of our sample of voluntary healthy Norwegian adults have OD, considerably more common in older adults and somewhat more common in men and individuals with low education. The lack of correlation between self-reported and measured olfactory function highlights the importance of using validated tests for a reliable olfactory evaluation. PMID:35195760 | DOI:10.1007/s00405-022-07298-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of a tongue training program in Parkinson's disease: Analysis of electrical activity and strength of suprahyoid muscles

xlomafota13 shared this article with you from Inoreader Effects of a tongue training program in Parkinson's disease: Analysis of electrical activity and strength of suprahyoid muscles Via swallowing exercises J Electromyogr Kinesiol. 2022 Feb 12;63:102642. doi: 10.1016/j.jelekin.2022.102642. Online ahead of print. ABSTRACT OBJECTIVE: To assess the electrical activity of the suprahyoid muscle and the tongue pressure in a two-wing program of tongue strengthening in individuals with Parkinson's disease (PD). METHODS: A pre-post-detraining design study included sixty PD patients assigned to two groups randomly. The experimental group (EG) performed tongue isometric pressure exercises using the Iowa Oral Performance Instrument with an increasing scheme of 5% load weekly and traditional tongue therapy for 8 weeks. The control group (CG) performed only traditional therapy. The electrical activity of suprahyoids was measured using surface electromyography (sEMG) during tongue-to-palate pressure. Four selected domains of the Swallowing Quality of Life Questionnaire (SWAL-QOL) mostly related to tongue strength were considered. RESULTS: The experimental group showed increased sEMG values of suprahyoid muscles reaching statistically significant difference at the fourth week of tongue training, while the control did it at the eighth week. Experimental group showed significant improvements in tongue strength (d = 2.128; p = 0.000). Only controls showed detraining effect. Statistically significant difference within groups were found in one and three dimensions of the SWAL-QOL in the CG and EG, respectively. CONCLUSION: Analysis of electrical activity on suprahy oids muscles provided a better understanding of the changes underlying the outcomes of tongue strength gains obtained through a combined tongue strengthening exercises protocol in PD. Such protocol led not only to increased tongue strength but also to a better perceived swallowing function in PD subjects. PMID:35189571 | DOI:10.1016/j.jelekin.2022.102642 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transcervical styloidectomy for Eagle syndrome

xlomafota13 shared this article with you from Inoreader Transcervical styloidectomy for Eagle syndrome Via Head & Neck Abstract We demonstrate a safe and effective surgical technique for the operative management of Eagle syndrome, also known as stylohyoid syndrome, via transcervical styloidectomy. Fifteen patients who presented to our institution for surgical management of Eagle syndrome were included. A detailed video shows the operative techniques used to perform styloidectomy via a transcervical approach. The procedure was well tolerated without complications, and all patients were discharged on postoperative day one. Thirteen patients (87%) endorsed significant improvement or complete resolution of their presenting complaint(s), most commonly throat and neck pain/discomfort (53%), otalgia (47%), and/or tinnitus (40%). The transcervical approach for styloidectomy provides an alternative for operative access that overcomes the limitations associated with the transoral approach. It enables better exposure of the operative field, a more efficient procedure, and, in the senior author's experience, results i n decreased postoperative pain, trismus, and length of hospital stay. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Applicability of Transnasal Echography for Identification of Internal Carotid Artery

xlomafota13 shared this article with you from Inoreader Applicability of Transnasal Echography for Identification of Internal Carotid Artery Via The Laryngoscope Objective To study the applicability of transnasal echography for the internal carotid artery (ICA) imaging during endoscopic procedures, primarily nasopharyngectomy. Study Design Non-randomized controlled cohort. Methods The tip of a pediatric transducer for transesophageal echography was inserted into each nostril under endoscopic control and placed in the ipsilateral Rosenmuller's fossa. The ICA's internal diameter and distance between the nasopharyngeal wall and the artery's closest point were measured on each side. Two independent examiners measured the same parameters on the axial plane of the skull base computer tomography (CT). Agreement between CT and echography measurements was estimated by the Bland–Altman approach. Results Twenty-seven ICAs (sides) were available for the echography-CT agreement analysis. Inter method agreement for both parameters was similar to the inter examiner agreement for the CT measurements. Conclusions Our first study on endoscopic echography demonstrated that this method is applicable, potentially allowing safer transnasal surgery in the ICA vicinity. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical outcomes of a cohort of 271 patients with lung metastases from differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Clinical outcomes of a cohort of 271 patients with lung metastases from differentiated thyroid carcinoma Via radioactive iodine Clin Endocrinol (Oxf). 2022 Feb 22. doi: 10.1111/cen.14700. Online ahead of print. ABSTRACT CONTEXT: Lung is the most common site of distant metastases from differentiated thyroid carcinoma (DTC). OBJECTIVE: To investigate the outcomes of a cohort of patients with DTC and lung metastases (LM). METHODS: A retrospective analysis of a cohort of 271 patients with LM was performed. RESULTS: The female-to-male ratio was 1:1 and the median follow-up time was 5.9 (1.1-38. 4) years. Papillary thyroid carcinoma (PTC) was the most frequent type (83.4%), mainly the classic variant, followed by follicular thyroid carcinoma (FTC, 10.3%) and Hürthle cell carcinoma (HTC, 6.3%). The prevalence of PTC, FTC and HCC was different between the micronodular and macronodular LM groups [87.4%, 6.3% and 6.3 % vs 74.6%, 19.0% and 6.3%, respectively (p=0.013)]. Only 5.0% of the patients had LM diagnosed after a period of remission. LM were submitted to radioactive iodine treatment (RAIT) in 84.5% (52.8% showed 131iodine avid metastases). Complete remission was only achieved in 12.2%. Micronodular disease and age <55 years at LM diagnosis were associated with a better prognosis (p<0.05). We found no difference in survival between patients with LM treated or not with RAIT. However, in patients submitted to RAIT, there was a tendency for longer survival in the group of patients with 131I avid lesions. CONCLUSION: The classic variant of PTC was the most frequen t histology found in LM of DTC. LM are rarely diagnosed in the follow-up when complete remission is achieved after surgery and 131I. Younger age at LM diagnosis and a micronodular pattern are associated with a better prognosis. This article is protected by copyright. All rights reserved. PMID:35192239 | DOI:10.1111/cen.14700 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype

xlomafota13 shared this article with you from Inoreader Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype Via Journal of Otolaryngology - Head & Neck Surgery Anaplastic thyroid cancer (ATC) is a rare, aggressive form of undifferentiated thyroid cancer, which exhibits rapid progression and is almost universally fatal. At least a subset of ATC is thought to arise fro... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Selumetinib Plus Adjuvant Radioactive Iodine in Patients With High-Risk Differentiated Thyroid Cancer: A Phase III, Randomized, Placebo-Controlled Trial (ASTRA)

xlomafota13 shared this article with you from Inoreader Selumetinib Plus Adjuvant Radioactive Iodine in Patients With High-Risk Differentiated Thyroid Cancer: A Phase III, Randomized, Placebo-Controlled Trial (ASTRA) Via radioactive iodine J Clin Oncol. 2022 Feb 22:JCO2100714. doi: 10.1200/JCO.21.00714. Online ahead of print. ABSTRACT PURPOSE: Selumetinib can increase radioactive iodine (RAI) avidity in RAI-refractory tumors. We investigated whether selumetinib plus adjuvant RAI improves complete remission (CR) rates in patients with differentiated thyroid cancer (DTC) at high risk of primary treatment failure versus RAI alone. METHODS: ASTRA (NCT01843062) is an international, phase III, randomized, placebo-con trolled, double-blind trial. Patients with DTC at high risk of primary treatment failure (primary tumor > 4 cm; gross extrathyroidal extension outside the thyroid gland [T4 disease]; or N1a/N1b disease with ≥ 1 metastatic lymph node(s) ≥ 1 cm or ≥ 5 lymph nodes [any size]) were randomly assigned 2:1 to selumetinib 75 mg orally twice daily or placebo for approximately 5 weeks (no stratification). On treatment days 29-31, recombinant human thyroid-stimulating hormone (0.9 mg)-stimulated RAI (131I; 100 mCi/3.7 GBq) was administered, followed by 5 days of selumetinib/placebo. The primary end point (CR rate 18 months after RAI) was assessed in the intention-to-treat population. RESULTS: Four hundred patients were enrolled (August 27, 2013-March 23, 2016) and 233 randomly assigned (selumetinib, n = 155 [67%]; placebo, n = 78 [33%]). No statistically significant difference in CR rate 18 months after RAI was observed (selumetinib n = 62 [40%]; placebo n = 30 [38%]; odds ratio 1.07 [95% CI, 0.61 to 1.87]; P = .8205). Treatment-related grade ≥ 3 adverse events were reported in 25/154 patients (16%) with selumetinib and none with placebo. The most common adverse event with selumetinib was dermatitis acneiform (n = 11 [7%]). No treatment-related deaths were reported. CONCLUSION: Postoperative pathologic risk stratification identified patients with DTC at high risk of primary treatment failure, although the addition of selumetinib to adjuvant RAI failed to improve the CR rate for these patients. Future strategies should focus on tumor genotype-tailored drug selection and maintaining drug dosing to optimize RAI efficacy. PMID:35192411 | DOI:10.1200/JCO.21.00714 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear Fluid Spaces and Structures of the Gerbil High-Frequency Region Measured Using Optical Coherence Tomography (OCT)

xlomafota13 shared this article with you from Inoreader Cochlear Fluid Spaces and Structures of the Gerbil High-Frequency Region Measured Using Optical Coherence Tomography (OCT) Via Journal of the Association for Research in Otolaryngology Abstract Since it has been difficult to directly observe the morphology of the living cochlea, our ability to infer the mechanical functioning of the living ear has been limited. Nearly all our knowledge about cochlear morphology comes from postmortem tissue that was fixed and processed using procedures that possibly distort the structures and fluid spaces of the organ of Corti. In this study, optical coherence tomography was employed to obtain volumetric images of the high-frequency hook region of the gerbil cochlea, as viewed through the round window, with far better resolution capability than had been possible before. The anatomical structures and fluid spaces of the organ of Corti were segmented and quantified in vivo and over a 90-min postmortem period. We find that the arcuate-zone and pectinate-zone widths change very little postmortem. The volume of the scala tympani between the round-window membrane and basilar membrane and the volume of the inner spiral sulcus d ecrease in the first 60-min postmortem. While textbook drawings of the mammalian organ of Corti and cortilymph prominently depict the tunnel of Corti, the outer tunnel is typically missing. This is likely because textbook drawings are typically made from images obtained by histological methods. Here, we show that the outer tunnel is nearly twice as big as the tunnel of Corti or the space of Nuel. This larger outer tunnel fluid space could have a substantial, little-appreciated effect on cochlear micromechanics. We speculate that the outer tunnel forms a resonant structure that may affect reticular-lamina motion. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.