Αρχειοθήκη ιστολογίου

Τετάρτη 1 Σεπτεμβρίου 2021

Association between the levels of CGI-58 and lipoprotein lipase in the placenta of patients with preeclampsia

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Exp Ther Med. 2021 Oct;22(4):1129. doi: 10.3892/etm.2021.10563. Epub 2021 Aug 5.

ABSTRACT

Preeclampsia is an idiopathic disease of pregnancy, which seriously endangers the life of both the mother and the infant. The pathogenesis of preeclampsia has not been fully elucidated, although it is generally considered to be associated with abnormal lipid metabolism during pregnancy. Comparative gene identification-58 (CGI-58) and lipoprotein lipase (LPL) are involved in the first step of triglyceride hydrolysis and serve an important role in lipid transport in the placenta. The present study aimed therefore to investigate the association between CGI-58 and LPL in the placentas of patients with or without preeclampsia and to evaluate blood lipid levels. The patient cohort was divided into two groups, pregnant women with preeclampsia and normal pregnant women (control). According to biochemical analyses, reverse transcription-quantitative PCR, i mmunohistochemistry analysis and western blotting, the expression of CGI-58 and LPL in the placenta was detected, the blood lipid levels were evaluated and other clinical data were collected. Compared with the control group, triglycerides (TGs), low density lipoprotein-cholesterol (LDL-C), apolipoprotein B (ApoB) and atherosclerotic index (AI) were significantly higher in the preeclampsia group, whereas high density lipoprotein-cholesterol (HDL-C) and apolipoprotein A (ApoA) were significantly lower (P<0.05). Furthermore, the expression levels of CGI-58 and LPL in the placental tissue of the preeclampsia group was significantly lower than that of the control group (P<0.05). Linear correlation analysis demonstrated that there was a positive association between CGI-58 and LPL (r=0.602; P<0.05), that CGI-58 was positively associated with HDL-C (r=0.63; P<0.01) but negatively associated with TG and ApoB (r=0.840; P<0.01; and r=0.514; P<0.05, respectively), that LPL was positively associated with HDL-C (r=0.524; P<0.01) but negatively associated with TG and AI (r=0.659; P<0.01; and r=0.496; P<0.01, respectively). These results suggested that the expression of CGI-58 and LPL in the placenta was associated with the pathogenesis of preeclampsia and maternal lipids and the risk of preeclampsia was increased with decreasing expression levels of CGI-58 and LPL. Hence, CGI-58 and LPL may be used as important indicators for the diagnosis of preeclampsia and for the prevention of preeclampsia in pregnant women.

PMID:34466143 | PMC:PMC8383331 | DOI:10.3892/etm.2021.10563

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Effects of endurance exercise on serum inflammatory cytokine level and kidney structure in a rat diabetes model

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Exp Ther Med. 2021 Oct;22(4):1125. doi: 10.3892/etm.2021.10559. Epub 2021 Aug 5.

ABSTRACT

Diabete mellitus (DM) is becoming a global health problem. Whilst many studies have previously focused on the therapeutic effects of exercise on diabetes, insufficient data exist on its effectiveness on disease prevention. The present study was designed to evaluate the effects of endurance exercises on kidney injury and on the expression of metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) and transforming growth factor (TGF)-β1. Type 2 diabetic rat model was created followng 8 weeks of feeding on high fat diet, followed by injection with streptozotocin (STZ; 30 mg/kg). A total of three different intensity endurance exercises, including low-intensity exercise (8 m/min and 0˚ slope), moderate-intensity exercise (15 m/min and 5˚ slope) and high-intensity exercise (20 m/min and 10˚ slope), were arranged during this proces s. Oral glucose tolerance (OGTT) and oral sucrose tolerance tests (OSTT) were performed in all rats 1 week after STZ injection. Serum interleukin-6 and tumor necrosis factor-α levels were measured using ELISA. After OGTT, all rats were sacrificed and kidney samples were removed for hematoxylin and eosin staining and western blot analyzes. Urea and ureatinine levels, representative of renal function, were estimated by using automatic biochemical analyzer. Rats in the DM group showed severe impaired glucose tolerance, which was alleviated in the moderate-intensity exercise (ME) and the high-intensity exercise (HE) groups. Inflammatory cytokines were also significantly reduced rats in the ME group compared with those in the DM group. No difference in renal function, MMP-9/TIMP-1 and TGF-β1 expression was observed. In addition, rats in the DM group exhibited glomerular enlargement with structural renal abnormalities, whilst those in the ME and HE groups showed improved symptoms. To co nclude, no increased expression of inflammatory cytokines and renal fibrotic proteins could be observed in the present rat model of type-2 DM, but evident structural abnormalities can be observed in the kidneys. Medium-intensity endurance exercise can reduce serum inflammatory cytokine levels and prevent aberrant changes in renal structures.

PMID:34466141 | PMC:PMC8383327 | DOI:10.3892/etm.2021.10559

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Management of a giant cervical lipoma: case report and literature review

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Pan Afr Med J. 2021 Jun 3;39:100. doi: 10.11604/pamj.2021.39.100.12727. eCollection 2021.

ABSTRACT

Lipoma is the most common of soft tissue tumours. It rarely occurs in the head and neck. Patients with fast-growing large sized lesion (> 10cm) should be suspected to have a cancer. We here report the case of a patient presenting with unusual cervical lipoma (size: approximately 46cm), diagnosed based on imaging tests, including computed tomography (CT) scan. Patient´s management was based on surgery.

PMID:34466202 | PMC:PMC8379405 | DOI:10.11604/pamj.2021.39.100.12727

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Favorable Early Outcomes With Thyroid Lobectomy for Low-Risk Papillary Thyroid Cancer: The Mayo Clinic Experience

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Am Surg. 2021 Sep 1:31348211038557. doi: 10.1177/00031348211038557. Online ahead of print.

ABSTRACT

BACKGROUND: Until 2015, standard of care for low-risk papillary thyroid cancer (PTC) >1 cm was a total or near-total thyroidectomy. Despite changes in guidelines and surgical management of low-risk PTC since 2015, little data are available regarding the effect on the need for additional surgery or risk for development of lymph node metastases. Our aim was to determine outcomes in patients who underwent initial thyroid lobectomy for low-risk PTC at a high-volume tertiary care institution.

METHODS: Retrospective review of patients ≥18 years old with biopsy proven low-risk PTC 1-4 cm who underwent partial thyroidectomy (eg, lobectomy/isthmusectomy) at Mayo Clinic, Rochester, MN, between March 2016 and June 30, 2019.

RESULTS: From 1481 thyroidectomies performed during study period, 940 contained PTC on final pathology. Of these, 87 (of 123) patients who had an initial thyroid lobectomy met inclusion criteria. Five (6%) of these patients proceeded to completion thyroidectomy (CT), with 3 requiring CT and radioactive iodine in the first postoperative year and 2 undergoing only CT in the second postoperative year. No postoperative complications were reported. No patient in this cohort required additional surgery or treatment for newly discovered lymph node metastases during the follow-up period. 43 (of 72, 60%) patients not on thyroxine therapy preope ratively were started on thyroxine therapy postoperatively.

CONCLUSIONS: Early outcomes for those undergoing thyroid lobectomy for low-risk PTC at our institution have been favorable. These results support the 2015 American Thyroid Association guidelines to offer lobectomy for those with low-risk PTC 1-4 cm.

PMID:34468234 | DOI:10.1177/00031348211038557

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Macroscopic and microscopic changes of the vestibulocochlear nerve after Gamma Knife treatment

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HNO. 2021 Sep 1. doi: 10.1007/s00106-021-01104-2. Online ahead of print.

ABSTRACT

We report on a case in which macroscopic and microscopic changes of the vestibulocochlear nerve could be observed after radiosurgery of an intrameatal vestibular schwannoma. This case shows for the first time a morphological correlate for undesirable effects after radiosurgical treatment of a vestibular schwannoma and indicates that despite a certain distance to the actual tumor, degenerative c hanges in neural structures can be expected.

PMID:34468776 | DOI:10.1007/s00106-021-01104-2

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Τρίτη 31 Αυγούστου 2021

Informational Masking Effects of Speech Versus Nonspeech Noise on Cortical Auditory Evoked Potentials

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J Speech Lang Hear Res. 2021 Aug 31:1-16. doi: 10.1044/2021_JSLHR-21-00048. Online ahead of print.

ABSTRACT

Purpose Background noise has been categorized as energetic masking due to spectrotemporal overlap of the target and masker on the auditory periphery or informational masking due to cognitive-level interference from relevant content such as speech. The effects of masking on cortical and sensory auditory processing can be objectively studied with the cortical auditory evoked potential (CAEP). However, whether effects on neural response morphology are due to energetic spectrotemporal differences or informational content is not fully understood. The current multi-experiment series was designed to assess the effects of speech versus nonspeech maskers on the neural encoding of speech information in the central auditory system, specifically in terms of the effects of speech babble noise maskers varying by talker number. Method CAEPs were recor ded from normal-hearing young adults in response to speech syllables in the presence of energetic maskers (white or speech-shaped noise) and varying amounts of informational maskers (speech babble maskers). The primary manipulation of informational masking was the number of talkers in speech babble, and results on CAEPs were compared to those of nonspeech maskers with different temporal and spectral characteristics. Results Even when nonspeech noise maskers were spectrally shaped and temporally modulated to speech babble maskers, notable changes in the typical morphology of the CAEP in response to speech stimuli were identified in the presence of primarily energetic maskers and speech babble maskers with varying numbers of talkers. Conclusions While differences in CAEP outcomes did not reach significance by number of talkers, neural components were significantly affected by speech babble maskers compared to nonspeech maskers. These results suggest an informational masking influence on neural encoding of speech information at the sensory cortical level of auditory processing, even without active participation on the part of the listener.

PMID:34464537 | DOI:10.1044/2021_JSLHR-21-00048

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Awake Rhinology Surgery in Response to the COVID-19 Pandemic in Europe

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Background: European health-care systems are faced with a backlog of surgical procedures following the suspension of routine surgery during the COVID-19 crisis. Routine rhinology surgery under general anaesthetic (GA) is now faced with significant challenges which include limited theatre capacity, the negative ramifications of surgical prioritization, reduced patient throughput in secondary care, and additional personal protective equipment requirements. Delayed surgery in rhinology, particularly with regards to chronic rhinosinusitis, has previou sly been shown to have poorer surgical outcomes, a detrimental effect on quality of life and long-term negative health socio-economic effects. Awake rhinology surgery under local anaesthetic (LA) provides an ideal alternative to GA. It provides a means of operating on patients in a setting alternative to currently oversubscribed main theatres, by utilizing satellite facilities, while ensuring identical surgical outcomes for patients who may otherwise have been forced to wait a long time for their procedure. It also confers additional benefits in terms of shorter recovery time and hospital stay for patients. Objectives: We have developed a set of recommendations that are intended to help support clinicians and managers to better adopt LA rhinology protocols and minimize the risk to the patient and health-care professionals involved. Methodology: International roundtable forums were conducted and supplemented by individual interviews. The international boar d consisted of 12 rhinologists experienced in awake rhinology surgery. Feedback was analysed and shared to develop a consensus of best practice. Recommendations: Local and national guidelines need to be adhered to with specific focus on patient and clinician safety. When performing awake rhinology procedures in the COVID-19 recovery process, consider implementing specific safety measures and workflow practices to safeguard patients and staff and minimize the risk of infection. Conclusion: Awake surgery potentially provides quicker access to routine rhinology surgery in the post-COVID-19 recovery phase, ensuring patients are treated in a timely matter, thereby avoiding higher downstream costs, and improving outcomes.
ORL
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Complications of facial cosmetic botulinum toxin A injection: analysis of the UK Medicines & Healthcare Products Regulatory Agency registry and literature review

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J Plast Reconstr Aesthet Surg. 2021 Jun 17:S1748-6815(21)00332-6. doi: 10.1016/j.bjps.2021.05.074. Online ahead of print.

ABSTRACT

BACKGROUND: Botulinum toxin A (BoNT-A) injection is one of the most frequently undertaken procedures in aesthetic medicine. The Medicines & Healthcare products Regulatory Agency (MHRA) is the government body in the United Kingdom (UK) mandated to ensure that the provision and administration of medicines is safe. We analyzed adverse events of facial cosmetic BoNT-A injections reported to the MHRA and assessed whether the incidence of reported adverse events in this government registry is comparable to published retrospective and prospective studies.

METHODS: A freedom of information (FOI) request was submitted to the MHRA to obtain recorded complications of BoNT- A. Complications reported to the MHRA between 1991 and 2020 were analyzed. Only cases with BoNT-A where the indication was specified as f or facial cosmetics were included in the analysis. Additionally, the literature was reviewed on adverse events of facial cosmetic BoNT- A injections, and a statistical meta-analysis of complication rates was carried out.

RESULTS: A total of 188 adverse events of aesthetic BoNT-A injections were reported to the MHRA. The literature search resulted in 30 studies and a total of 17,352 injection sessions, where the complication rate was 16% (95% CI = 8% to 25%). Frequent adverse events included localized skin reactions such as bruising with an incidence of 5% (95% CI = 3% to 7%), headache in 3% (95% CI = from 1% to 5% ), and facial paresis in 2% (95% CI = 1% to 3%) of injection sessions.

CONCLUSIONS: This is the first paper to obtain and evaluate data on adverse events of BoNT-A from the MHRA. An estimate of the likely complication rate of aesthetic BoNT-A in the UK, according to the MHRA database, is significantly lower than the rate recorded from our meta-analysis of the i nternational literature. This suggests that the MHRA may be underestimating the adverse events of aesthetic BoNT-A treatment, which would have implications for patient safety and informed consent. Therefore, legislative changes may be required to ensure more robust reporting of aesthetic BoNT-A in the UK.

PMID:34456155 | DOI:10.1016/j.bjps.2021.05.074

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Burnout in microvascular reconstructive otolaryngology – head and neck surgeons: Potential modifiable workplace factors

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Abstract

Background

Burnout has been previously assessed in head and neck microvascular reconstructive surgeons (HNMVS), but not in the context of modifiable workplace factors.

Methods

Anonymous, cross-sectional survey. The Abbreviated Maslach Burnout Inventory – Human Services Survey for Medical Personnel (aMBI-HSS) was utilized to assess emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Modifiable risk factors were also evaluated.

Results

High risk of burnout by EE, DP, and PA was demonstrated in 24%, 9%, and 27% of respondents, respectively. EE was associated with <10% dedicated research time, lack of autonomy over clinic schedule, inadequate inpatient support, and lack of supportive clinical partner. DP was associated with >3 operative days, difficulty balancing academic commitments, and lack of supportive clinical partner. Dedicated research time and two or fewer days of block time were protective.

Conclusions

Burnout was associated with several modifiable workplace factors. Addressing these may prevent moderate to severe burnout in HNMVS.

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Microwave ablation of benign thyroid nodules: 3‐year follow‐up outcomes

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Abstract

Purpose

To evaluate the effectiveness of microwave ablation (MWA) for the treatment of thyroid nodules according to nodule composition.

Materials and methods

This study evaluated 171 patients with 180 benign thyroid nodules (BTNs) that had been treated with ultrasound-guided MWA. The volume reduction rate (VRR) of thyroid nodules and factors, which had an influence on the VRR, were assessed. Therapeutic success was defined as a >50% volume reduction at the 12-month follow-up. Multivariate regression analysis was used to identify independent predictors of VRR for BTNs after MWA treatment.

Results

The mean diameter and volume of the nodules were 4.3 ± 1.3 cm and 18.9 ± 2.1 ml, respectively. The VRRs at the 1-, 3-, 6-, 12-, 24-, and 36-month follow-ups were 47.1%, 68.2%, 79.7%, 87.4%, 90.1%, and 93.2%, respectively. Of the 180 BTNs, there were 87 solid, 74 predominantly solid, and 19 predominantly cystic nodules. Solid nodules showed significantly lower VRRs compared with the predominantly solid and predominantly cystic nodules at the 1-, 3-, and 6-month follow-ups. For the multivariate regression analysis, the cyst component was an active prognostic factor for the VRR at the 1-, 3-, and 6-month follow-ups; the cyst component was not significantly associated with the VRR at the 12-, 24-, and 36-month follow-ups.

Conclusion

Our study suggested that ultrasound-guided MWA is an effective and safe procedure for the treatment of BTNs. Solid nodules indicate a lower VRR and less efficient than predominant solid nodules and predominant cystic nodules after MWA.

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Acute appendicitis secondary to desmoplastic melanoma metastasis in immune-checkpoint inhibitors era

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