Laser‐Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes

xlomafota13 shared this article with you from Inoreader Laser‐Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes Via The Laryngoscope Objective To analyze the long-term symptomatic results of laser-assisted sialolithotripsy (LAS) in cases of obstructive sialolithiasis and correlate with objective criteria using diagnostic sialendoscopy (DS) as a method of examination. Methods This is a retrospective study comprising 50 consecutive patients who underwent holmium-YAG LAS and completed follow-up of at least 6 months. Symptom scoring and endoscopic scoring were done at 6 weeks and 6 months intervals for further study purposes. Results At the end of 6 weeks post-LAS, 70% patients were asymptomatic (A-sym) and only 30% had residual symptoms (Sym). However, obstructed duct (OB-duct) was observed on endoscopic scoring in 88% due to stenosis, residual stones, or both stenosis and residual stones. The obstructed ducts were treated in outpatient clinic and followed up over time, leading to 98% of patients being in A-sym group at the end of study period of 6 months. At the end of study, 82% of patients had clear duct (CL-duct). Conclusion Holmium LAS is a viable option for the management of intermediate-sized stones. LAS if used judiciously, and in properly selected cases, has high rate of stone fragmentation and symptom resolution. A vigilant postoperative protocol taking into account residual mealtime symptoms and altered salivary characteristics combined with early DS can help identify and treat patients with residual stone fragments and ductal stenosis. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral asymmetry in bullfrog testes and fat bodies: correlations with steroidogenic activity, mast cells number and structural proteins

xlomafota13 shared this article with you from Inoreader Bilateral asymmetry in bullfrog testes and fat bodies: correlations with steroidogenic activity, mast cells number and structural proteins Via histochem Acta Histochem. 2022 Mar 11;124(3):151873. doi: 10.1016/j.acthis.2022.151873. Online ahead of print. ABSTRACT In seasonal breeders, such as amphibians, testicular functions depend on complex processes that change according to seasonality, including Leydig cell (LC) differentiation and lipid-dependent steroidogenesis, extracellular proteins remodeling and actin-dependent cellular dynamics. Speculating that fat bodies (FB) could support some of these processes in L. catesbeian us, we evaluated bilaterally the FB weights, correlating them to testicular parameters such as weight, testosterone (T) immunoexpression, mast cells (MC) number, vascularization and structural proteins. In an attempt to better understand the testicular asymmetry in amphibians, correlations between these different testicular parameters were also established. Right testes (RT), left testes (LT) and associated FB of bullfrogs were weighed, and testes were processed for light and transmission electron microscopy. Collagen content (COL) and MC number were quantified. T and actin immunoexpressions and vascular areas were measured. Statistical analyses and Pearson's correlation were performed. The LT and its associated FB were heavier than the right ones, and showed intense T and actin immunoexpressions, numerous lipid-rich LC, and greater MC number, COL and vascularization than the RT. Positive correlations were detected between: a) FB and testis weights, b) T immunoexpression and testis and FB weights, c) T and actin immunoexpressions and COL. Otherwise, MC number was inversely correlated to T immunoexpression and COL. In right and left sides, the proportional correlation between T immunoexpression and FB weight suggests that FB-stored lipid amount depends on the steroidogenic demand of its associated testis. Thus, the asymmetry in the testes and FB may be associated, at least in part, to the LC steroidogenic activity, which tends to be more intense in LT than in RT. The results also point to a role of COL and mast cells in the LC differentiation and steroidogenesis. Actin was also greater in LT and correlated with T immunoexpression, indicating that the amount of this structural protein depends on androgenic control. Therefore, the testicular asymmetry in bullfrogs seems to be associated to different morphofunctional processes occurring, bilaterally, at different intensities. In this case, there is a tendency of LT, in association with its FB, to be more active th an RT. The findings highlight the FB-testis interplay for the comprehension of reproduction in amphibians. PMID:35287007 | DOI:10.1016/j.acthis.2022.151873 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Coblation intracapsular tonsillectomy: a cohort study of NHS practice in England using Hospital Episode Statistics

xlomafota13 shared this article with you from Inoreader Coblation intracapsular tonsillectomy: a cohort study of NHS practice in England using Hospital Episode Statistics Via Clinical Otolaryngology Abstract Objectives To identify paediatric intracapsular Coblation tonsillectomy procedures from routine administrative data in England, and determine their safety. Design Retrospective observational cohort study of four ENT centres using routine data from Hospital Episode Statistics (HES). Setting Acute NHS trusts in England conducting exclusively intracapsular Coblation tonsillectomy Participants Children (≤16 years old) undergoing bilateral intracapsular Coblation tonsillectomy Main outcome measures Number of procedures, readmissions for pain, readmissions for bleeding and requirement for additional surgery for regrowth. Results 5525 procedures were identified. The median patient age was 4 (IQR 2-5). In-hospital complications occurred in 1%, with 0.1% returning to theatre for arrest of primary tonsil bleeding. Almost half of the procedures were conducted as a day-case (44%), with only a small proportion staying in hospital more than one night (7%). Within 28 days, 1.2% of patients were readmitted with bleeding, 0.7% with infection and 0.3% with pain. 0.2% of patients required return to theatre for control of secondary haemorrhage. Longitudinal follow-up has found that revision tonsil surgery is 0.3% at 1 year (n=4498), 1.1% at 2 years (n=2938), 1.7% at 3 years (n=1781), 1.9% at 4 years (n=905), 2.2% at 5 years (n=305) Conclusions Intracapsular coblation tonsillectomy safety outcomes in this study show primary and secondary bleed rates and emergency return to theatre rates are lower than all tonsillectomy techniques reported in the National Prospective Tonsillectomy Audit and also lower than previously published Hospital Episode Statistics analysis of tonsillectomy procedures. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CircEIF5 contributes to hyperproliferation and inflammation of keratinocytes in psoriasis via p‐NFκB and p‐STAT3 signaling pathway

xlomafota13 shared this article with you from Inoreader CircEIF5 contributes to hyperproliferation and inflammation of keratinocytes in psoriasis via p‐NFκB and p‐STAT3 signaling pathway Via Experimental Dermatology Abstract Psoriasis is a chronic, immune mediated skin disease accompanied by hyperproliferation and inflammation of keratinocytes. Circular RNAs (circRNAs) as new players regulating the development of psoriasis have been reported in recent years. However, its mechanism has not yet been fully revealed. In this study we identified that hsa_circ_0033469 (circEIF5) was highly expressed in psoriasis tissues compared to the normal skin. We investigated the functional roles of circEIF5 in proliferation and inflammatory of HaCat cells under M5-stimulated inflammatory condition. By using a approach of knockdown and overexpression of circEIF5, we showed that circEIF5 could promote proliferation by facilitating the G1/S transition and increase secretion of chemokines in HaCat cells. These moderating effects of circEIF5 were associated with the activating of the NF-κB and STAT3 signaling pathways. Moreover, NF-κB and STAT3 inhibition abrogated circEIF5 induced promotion of cell proliferation and che mokine secretion. These results indicated that through NF-κB and STAT3 signaling pathways, circEIF5 regulated the proliferation and chemokine secretion of HaCat cells and contributed to the pathogenesis of psoriasis, which might become a potent target for psoriasis treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Biodegradation of poly(L-lactic acid) and poly(epsilon-caprolactone) patches by human amniotic fluid in an in-vitro simulated fetal environment

xlomafota13 shared this article with you from Inoreader Biodegradation of poly(L-lactic acid) and poly(epsilon-caprolactone) patches by human amniotic fluid in an in-vitro simulated fetal environment Via leak of cerebrospinal fluid Sci Rep. 2022 Mar 10;12(1):3950. doi: 10.1038/s41598-022-07681-8. ABSTRACT Open spina bifida or myelomeningocele (MMC) is a devastating neurologic congenital defect characterized by primary failure of neural tube closure of the spinal column during the embryologic period. Cerebrospinal fluid leak caused by the MMC spinal defect in the developing fetus can result in a constellation of encephalic anomalies that include hindbrain herniation and hydrocephalus. The exposure of extruded spinal cord to amniotic fluid also poses a significant risk for inducing partial or complete paralysis of the body parts beneath the spinal aperture by progressive spinal cord damage in-utero. A randomized trial demonstrated that prenatal repair by fetal surgery, sometimes using patches, to cover the exposed spinal cord with a watertight barrier is effective in reducing the postnatal neurologic morbidity as evidenced by decreased incidence and severity of postnatal hydrocephalus and the reduced need for ventricular-peritoneal shunting. Currently, the use of inert or collagen-based patches are associated with high costs and inadequate structural properties. Specifically, the inert patches do not degrade after implantation, causing the need for a post-natal removal surgery associated with trauma for the newborn. Our present study is aimed towards in-vitro degradation studies of a newly designed patch, which potentially can serve as a superior alternative to existing patches for MMC repair. This novel patch was fabricated by blending poly(L-lactic acid) and poly(ε-caprolactone). The 16-week degradation study in amniotic fluid was focused on tracking changes in crystallinity and mechanical properties. An additional set of designed patches was exposed to phosphate-buffered saline (PBS), as a time-paired control. Crystallinity studies indicate the progress of hydrolytic degradation of the patch in both media, with a preference to bulk erosion in ph osphate buffered saline and surface erosion in amniotic fluid. Mechanical testing results establish that patch integrity is not compromised up to 16 weeks of exposure either to body fluids analog (PBS) or to amniotic fluid. PMID:35273223 | PMC:PMC8913814 | DOI:10.1038/s41598-022-07681-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Local estrogen for nonsurgical recontouring of auricular cartilage

xlomafota13 shared this article with you from Inoreader Local estrogen for nonsurgical recontouring of auricular cartilage Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 18:S1748-6815(22)00073-0. doi: 10.1016/j.bjps.2022.02.002. Online ahead of print. ABSTRACT INTRODUCTION: 5% of children are born with auricular deformities. Permanent recontouring can be achieved through splinting during early infancy. Beyond this time, splinting is ineffective, and patients require surgical correction. Neonatal cartilage malleability is hypothesized to be secondary to retained maternal estrogens, increasing hyaluronic acid concentration. In this article, we evaluate the efficacy of local estrogen treatments for the nonsurgical recontouring of mature auricular cartilage. METHODS: Ears of New Zealand rabbits were folded and splinted and then were randomly assigned to an experimental group, n = 10 (injected estrogen, topical estrogen, saline, or untreated). Treatment ears received injected estrogen or saline twice weekly or topical estrogen daily for 4 weeks. Two weeks post-t reatment, splints were removed, and ear angles were measured. Biopsies were taken for histologic and mechanical analysis, and systemic estrogen levels were assayed. RESULTS: Ear angles stabilized by 9 days post-splinting. Topical estrogen led to a significantly smaller resting angle (121.6° ± 13.5°) compared with saline and control (135.9° ± 11.2° and 145.3° ± 13.0°, respectively). Injected estrogen led to the most pronounced angle decrease (64.5° ± 35.3°). Ears injected with estrogen also showed a significant increase in cartilage thickness. Hyaluronic acid concentration was increased in both estrogen treatment groups compared with saline. At 3 weeks post-treatment, there was no significant differences in the elastic modulus of the cartilage or serum estrogen levels among the groups. CONCLUSION: Results show the potential result of local estrogen treatment to achieve a stable nonsurgical remodeling of mature auricular cartilage. Further study is needed to ev aluate the molecular mechanism and improve the transdermal estrogen delivery to optimize treatment regimen. PMID:35288037 | DOI:10.1016/j.bjps.2022.02.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of Graves' hyperthyroidism: present and future

xlomafota13 shared this article with you from Inoreader Management of Graves' hyperthyroidism: present and future Via radioactive iodine Expert Rev Endocrinol Metab. 2022 Mar 14:1-14. doi: 10.1080/17446651.2022.2052044. Online ahead of print. ABSTRACT INTRODUCTION: Graves' disease (GD) is an autoimmune disorder due to loss of tolerance to the thyrotropin receptor (TSHR) and ultimately caused by stimulatory TSHR antibodies (TSHR-Ab). GD may be associated with extrathyroidal manifestations, mainly Graves' orbitopathy. Treatment of GD relies on antithyroid drugs (ATDs), radioactive iodine (RAI), thyroidectomy. The major ATD limitation is the high recurrence rate after treatment. The major drawback of RAI and thyroidectomy is the inevitable development of permanent hypothyroidism. AREAS COVERED: Original articles, clinical trials, systematic reviews, meta-analyses from 1980 to 2021 were searched using the following terms: Graves' disease, management of Graves' disease, antithyroid drugs, radioactive iodine, thyroidectomy, Graves' orbitopathy, thyroid-eye disease. EXPERT OPINION: ATDs are the first-line treatment worldwide, are overall safe and usually given for 18-24 months, long-term treatment may decrease relapses. RAI is safe, although associated with a low risk of GO progression, particularly in smokers. Thyroidectomy requires skilled and high-volume surgeons. Patients play a central role in the choice of treatment within a shared decision-making process. Results from targeted therapies acting on different steps of the autoimmune process, including iscalimab, ATX-GD-59, rituximab, b locking TSHR-Ab, small molecules acting as antagonists of the TSHR, are preliminary or preclinical, but promising in medium-to-long perspective. PMID:35287535 | DOI:10.1080/17446651.2022.2052044 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trends in the Management of Localized Papillary Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Trends in the Management of Localized Papillary Thyroid Carcinoma in the United States (2000–2018) Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of Vocal Fold Image Obstructions in High-Speed Videoendoscopy During Connected Speech in Adductor Spasmodic Dysphonia: A Convolutional Neural Networks Approach

xlomafota13 shared this article with you from Inoreader Detection of Vocal Fold Image Obstructions in High-Speed Videoendoscopy During Connected Speech in Adductor Spasmodic Dysphonia: A Convolutional Neural Networks Approach Via Journal of Voice Adductor spasmodic dysphonia (AdSD) is a neurogenic voice disorder, affecting the intrinsic laryngeal muscle control. AdSD leads to involuntary laryngeal spasms and only reveals during connected speech. Laryngeal high-speed videoendoscopy (HSV) coupled with a flexible fiberoptic endoscope provides a unique opportunity to study voice production and visualize the vocal fold vibrations in AdSD during speech. The goal of this study is to automatically detect instances during which the image of the vocal folds is optically obstructed in HSV recordings obtained during connected speech. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skin-sparing mastectomy and mastopexy: A safe 'one step' option with immediate DIEP flap and simultaneous Nipple areola complex reconstruction

xlomafota13 shared this article with you from Inoreader Skin-sparing mastectomy and mastopexy: A safe "one step" option with immediate DIEP flap and simultaneous Nipple areola complex reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 26:S1748-6815(22)00104-8. doi: 10.1016/j.bjps.2022.02.035. Online ahead of print. NO ABSTRACT PMID:35279420 | DOI:10.1016/j.bjps.2022.02.035 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018

xlomafota13 shared this article with you from Inoreader Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018 Via The Laryngoscope Objectives 1) To determine the prevalence polysomnogram (PSG) and continuous positive airway pressure (CPAP) therapy use in children who received adenotonsillectomy (AT) for sleep symptoms. 2) To identify health care disparities in these regards. Study Design Retrospective database analysis. Methods This study used data from Optum (Health Services Innovation Company) to identify 92,490 children who received AT for sleep symptoms between 2004 and 2018. Prevalence of preoperative PSG and postoperative PSG and CPAP were described. Clinical and demographic characteristics were compared between children who had preoperative PSG and those who did not. Characteristics of children with trisomy 21 (T21) were compared to assess PSG and CPAP use in a high-risk cohort. Predictive modeling was used to identify patient characteristics associated with postoperative PSG and CPAP use. Results Preoperative PSG was obtained in 5.5% of children overall and 33.2% of children with T21. Male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with preoperative PSG. Fewer than 3% of children received postoperative PSGs and approximately 3% went on to receive CPAP therapy postoperatively. Multiple logistic regression showed that age at surgery, male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with postoperative PSG and CPAP use. Conclusions and Relevance This study described the prevalence pre-AT PSG use and post-AT PSG and CPAP use for persistent symptoms and identified sleep health care disparities in these regards. These results show that increased, equitable access to PSG is needed in children, particularly in the workup and treatment persistent symptoms after AT. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.