Αρχειοθήκη ιστολογίου

Δευτέρα 24 Ιανουαρίου 2022

Coronavirus Disease 2019-Associated Mucormycosis

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Open Forum Infect Dis. 2021 Nov 6;9(2):ofab566. doi: 10.1093/ofid/ofab566. eCollection 2022 Feb.

ABSTRACT

We studied COVID-19 associated mucormycosis based on 17 cases reported nationwide and assessed the differences with India. They differed by frequencies of diabetes mellitus (47% in France versus up to 95% in India), hematological malignancies (35% versus 1%), anatomical sites (12% versus >80% rhino-orbito-cerebral) and prognosis (88% mortality versus <50%).

PMID:35071681 | PMC:PMC8773954 | DOI:10.1093/ofid/ofab566

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The Effect of (Val)ganciclovir on Hearing in Congenital Cytomegalovirus: A Systematic Review

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Objective

To search for existing evidence of a beneficial effect of (val)ganciclovir on hearing in children with congenital cytomegalovirus (cCMV) infection and to identify future research questions.

Study Design

Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searches were performed in PUBMED, EMBASE, and WEB OF SCIENCE on December 15, 2021.

Methods

Studies providing ear-specific hearing results after treating children with cCMV-related hearing loss with (val)ganciclovir were retained. A meta-analysis [Peto odds ratio (OR), Review Manager 5.3] was performed to compare hearing outcome between treated and untreated children. The National Institutes of Health tool was used for quality assessment and heterogeneity was assessed with I 2 statistics.

Results

Eighteen studies with a total of 682 treated patients were included for the systematic review. Our meta-analysis showed that treating symptomatic children with hearing loss resulted in more hearing improvement [Peto OR 7.72, 95% confidence interval (CI) 3.08–19.34] and less hearing deterioration (Peto OR 0.23, 95% CI 0.10–0.57). Relative to an improvement and deterioration rate of 9.4% and 28.2% in an untreated group, the rate of the treated group was 44.5% and 6.3%, respectively.

Conclusions

There is sufficient evidence in literature to support treatment with (val)ganciclovir of children with symptomatic cCMV and hearing loss. However, still today, there is insufficient evidence of the potential beneficial role of (val)ganciclovir on hearing outcome of children with isolated hearing loss, late-onset hearing loss, and asymptomatic cCMV. The urgent need for future prospective, randomized clinical trials still exists. A standardization of definitions and treatment protocols would create uniformity in future studies. Laryngoscope, 2022

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Aberrant course of the petrous internal carotid artery associated with ipsilateral type 1 proatlantal artery

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Surg Radiol Anat. 2022 Jan 24. doi: 10.1007/s00276-022-02892-0. Online ahead of print.

ABSTRACT

PURPOSE: To describe an extremely rare case of an aberrant course of the petrous internal carotid artery (ICA) associated with an ipsilateral type 1 proatlantal artery (PA) that was diagnosed by cerebral magnetic resonance (MR) angiography.

CASE REPORT: The patient was a 64-year-old man with double vision. Cerebral MR imaging and MR angiography were subsequently performed us ing a 1.5-T scanner. MR angiography showed an aberrant course of the petrous right ICA that was associated with right type 1 PA. The left vertebral artery (VA) and proximal right VA were absent.

DISCUSSION: An aberrant course of the petrous ICA is rare but clinically significant, because it is dangerous during middle ear surgery. Type 1 PA is an extremely rare type of persistent fetal anastomosis between the carotid and vertebrobasilar systems. Type 1 PA is also clinically significant, because it is dangerous during craniovertebral junction surgery. We found no similar cases in the relevant English-language literature.

CONCLUSION: Although both variations were seen ipsilaterally and were located relatively close to each other, the embryological development of these variations is quite different. In addition, no similar case has been reported previously. Thus, these may have formed incidentally.

PMID:35072739 | DOI:10.1007/s00276-022-02892-0

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Cerebrospinal Fluid Hypovolemia: A Case Report of a Red Herring

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Asian J Neurosurg. 2021 Dec 18;16(4):895-898. doi: 10.4103/ajns.ajns_239_21. eCollection 2021 Oct-Dec.

ABSTRACT

Mild intracranial hypotension can lead to classically recognizable symptoms such as positional headaches, nausea, vomiting, and occasionally blurred vision. Less commonly, severe cerebrospinal fluid (CSF) hypovolemia can lead to a life-threatening condition that mimics intracranial hypertension, including transtentorial herniation and subsequent rapid neurologic decline. In this report we present a unique case of severe intracranial hypotension from a thoracic tumor resection that led to symptoms initially mistaken for intracranial hypertension, however ultimately correctly diagnosed as severe CSF hypovolemia that improved with dural repair. Additionally, we describe a rare angiography finding associated with CSF hypovolemia, kinking of the basilar artery. Here we report a 47-year-old female with neurofibromatosis Type 2 found to ha ve a T3 intradural extramedullary tumor. She initially presented with urinary incontinence and gait/balance difficulty. She underwent thoracic laminectomies at T3 and T4 for the excision of the lesion. She was discharged on postoperative day 4. On postoperative day 9, she was noted to have nausea, vomiting, and decreased consciousness. Head computed tomography (CT) demonstrated acute downward herniation. She was transferred to our institution from a community facility obtunded and was intubated for airway protection. She was placed in the Trendelenburg position with immediate improvement, and declined every time her head was raised. Angiogram showed significant kinking of her basilar artery. A CT myelogram revealed a CSF leak from her recent thoracic surgery. She underwent exploration of her thoracic wound, and a ventral durotomy was repaired. Following this, she began to tolerate the head of bed elevations and recovered back to her neurologic baseline. A postoperative head CT angio graphy obtained before discharge showed improvement of her basilar kink. Mild intracranial hypotension is a common finding in patients who undergo procedures that enter the CSF space. Severe intracranial hypotension can easily be missed diagnosed as the signs on the exam are similar to patients with signs of intracranial hypertension. It is of paramount importance that the clinician recognizes brain sag, as the treatment algorithms are vastly different from that of intracranial hypertension leading to transtentorial herniation.

PMID:35071098 | PMC:PMC8751512 | DOI:10.4103/ajns.ajns_239_21

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Influence of head orientation and implantation site of a novel transcutaneous bone conduction implant on MRI metal artifact reduction sequence

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Eur Arch Otorhinolaryngol. 2022 Jan 24. doi: 10.1007/s00405-022-07272-3. Online ahead of print.

ABSTRACT

PURPOSE: The use of magnetic resonance imaging (MRI) is often limited in patients with auditory implants because of the presence of metallic components and magnets. The aim of this study was to evaluate the clinical usefulness of a customized MRI sequence for metal artifact suppression in patients with BONEBRIDGETM BCI 602 implants (MED-EL, Innsbruck, Austria), the successor of the BCI 601 model.

METHODS: Using our in-house developed and customized metal artifact reduction sequence (SEMAC-VAT WARP), MRI artifacts were evaluated qualitatively and quantitatively. MRI sequences were performed with and without artifact reduction on two whole head specimens with and without the BCI 602 implant. In addition, the influence of two different implantation sites (mastoid versus retrosigmoid) and head orientation on artifact presence was investigated.

RESULTS: Artifact volume was reduced by more than the 50%. Results were comparable with those obtained with the BCI 601, showing no significant differences in the dimensions of artifacts caused by the implant.

CONCLUSION: SEMAC-VAT WARP was once more proved to be efficient at reducing metal artifacts on MR images. The dimensions of artifacts associated with the BCI 602 are not smaller than those caused by the BCI 601.

PMID:35072767 | DOI:10.1007/s00405-022-07272-3

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Hearing outcome after tympanoplasty type III

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Eur Arch Otorhinolaryngol. 2022 Jan 24. doi: 10.1007/s00405-021-07190-w. Online ahead of print.

ABSTRACT

PURPOSE: We assessed overall hearing outcome after tympanoplasty type III in chronically infected ears with cholesteatoma (CH) and without cholesteatoma: otitis media chronica mesotympanalis, tympanosclerosis, and adhesive process (COM_T_AP).

METHODS: 303 surgeries were evaluated: 229 CH-group and 74 COM_T_AP-group. Air-bone gaps (PTA-ABG) with pure-tone averages (PTA-4) at four frequencies (0.5, 1, 2 and 4 kHz) were compared preoperatively, early postoperatively (< 40 days) and late postoperatively (40-400 days). Hearing outcome was compared in various types of middle-ear reconstruction and in smokers and non-smokers. Correlations between hearing outcome and predictive staging indices were evaluated: Middle Ear Risk-Index (MER-I) and Ossiculoplasty Outcome Parameter Staging-Index (OOPS-I).

RESULTS: Mean PTA-ABG in th e CH-group increased from 20.9 ± 11.3 dB to 22.3 ± 10.4 dB early postoperatively and decreased significantly to 19.2 ± 10.1 dB late postoperatively. Mean PTA-ABG in the COM_T_AP-group decreased significantly from 27.3 ± 10.9 dB to 20.6 ± 10.9 dB early postoperatively and decreased to 20.0 ± 12.2 dB late postoperatively. No significant difference was seen between PTA-ABG-closures of partial or total ossicular replacement prosthesis (PORP/TORP) and cartilage ossiculoplasty in the CH-group. Patients receiving TORP showed a significantly higher preoperative PTA-ABG. All reconstruction types exhibited postoperative PTA-ABG around 20 dB. In the COM_T_AP-group, smokers had a significantly higher mean PTA-ABG early postoperatively; this equalized with that of non-smokers late postoperatively. PTA-ABG-closures and MER-I or OOPS-I were not significantly correlated.

CONCLUSION: Tympanoplasty type III maintains hearing in patients with cholesteatoma and significantly improves hearin g in chronically inflamed ears without cholesteatoma. All investigated ossicular replacement prostheses are equally beneficial. Healing postoperatively takes longer in smokers, but they eventually catch up with non-smokers.

PMID:35072768 | DOI:10.1007/s00405-021-07190-w

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Κυριακή 23 Ιανουαρίου 2022

MAKO Robotic Assisted Total Hip Replacement (THR) for Patients with Fused Hips

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Abstract

Background

: Previous articles about MAKO robotic-assisted total hip replacement (THR) were mainly in patients with comparatively normal anatomy.

Methods

: From July 2020 to June 2021, we performed MAKO robotic-assisted THR in three hip-fused patients. We assessed the accuracy of prostheses implantation, collected clinical data, and discussed the value of this technique in this kind of patients.

Result

: All three patients achieved good leg length and prostheses position. A patient got femoral artery injury during the surgery. Moreover, she developed a thrombus. All three patients got acceptable Visual Analogue Scale (VAS) scores and function recovery six months later.

Conclusion

: MAKO robotic-assisted THR achieved excellent prosthesis position in hip fused patients. More cases are needed to confirm this advantage. The function recovery was acceptable. Caution should be paid to protect the surrounding abnormal arteries, especially in a limited surgical field.

This article is protected by copyright. All rights reserved.

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DNA methylation‐derived systemic inflammation indices and their association with oropharyngeal cancer risk and survival

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Lidocaine represses the malignant behavior of lung carcinoma cells via the circ_PDZD8/miR-516b-5p/GOLT1A axis

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Histol Histopathol. 2022 Jan 21:18423. doi: 10.14670/HH-18-423. Online ahead of print.

ABSTRACT

Lung carcinoma is the most prevalent malignancy in adults. Lidocaine (Lido) has been confirmed to exert an anti-tumor role in many human cancers. However, the role and underlying mechanism of Lido in lung carcinoma remain poorly understood. Cell proliferation ability, migration, invasion, and apoptosis were measured by Colony formation, 5-ethynyl-2'-deoxyuridine (EdU), Cell Counting Kit-8 (CCK-8), transwell, and flow cytometry assays. Circ_PDZD8, microRNA-516b-5p (miR-516b-5p), and Golgi transport 1A (GOLT1A) levels were detected by real-time quantitative polymerase chain reaction (RT-qPCR). Protein levels of proliferating cell nuclear antigen (PCNA) and GOLT1A were examined by western blot assay. The binding relationship between miR-516b-5p and circ_PDZD8 or GOLT1A was predicted by circular RNA Interactome or Starbase 3.0 and then verified by a dual-luciferase reporter assay. The biological roles of circ_PDZD8 and Lido on lung carcinoma cell growth were examined by the xenograft tumor model in vivo. Lido suppressed proliferation, migration, invasion, and induced apoptosis in lung carcinoma cells. Circ_PDZD8 and GOLT1A were increased, miR-516b-5p was decreased in lung carcinoma tissues and cell lines. Their expression presented the opposite trend in Lido-triggered lung carcinoma cells. Circ_PDZD8 might overturn the repression of Lido on cell growth ability and metastasis in this tumor. Mechanically, circ_PDZD8 might regulate GOLT1A expression by sponging miR-516b-5p. Circ_PDZD8 weakened the anti-lung carcinoma effect of Lido in vivo. Circ_PDZD8 might mitigate the inhibitory effect of Lido on tumor cell malignancy by modulating the miR-516b-5p/GOLT1A axis, providing a novel insight for lung carcinoma treatment.

PMID:35060113 | DOI:10.14670/HH-18-423

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Patient experience of diagnosis and management of spontaneous intracranial hypotension: a cross-sectional online survey

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BMJ Open. 2022 Jan 20;12(1):e057438. doi: 10.1136/bmjopen-2021-057438.

ABSTRACT

OBJECTIVES: To present the results of a survey of patients with spontaneous intracranial hypotension (SIH) secondary to spinal cerebrospinal fluid (CSF) leak, documenting the patient experience of its diagnosis and management as well as quantifying its impact on quality of life.

DESIGN: A cross-sectional anonymous online survey was designed in conjunction with the CSF Leak Association patient charity. The survey included questions on diagnosis, investigations and treatments received, as well as validated disability and quality of life questionnaires.

PARTICIPANTS: Sixty-four patients with a confirmed diagnosis of SIH who were receiving treatment within the UK were included in the analysis. The mean age was 42.8 years, 94% were female and 43 had ongoing symptoms of SIH.

RESULTS: Patients who presented to their general practitioner with symptoms of SIH were seen an average three times before being referred to a specialist, and in just under half of patients, the diagnosis was not made by the first specialist they saw. There was variability in which investigations were performed and how urgently they were organised. The mean EuroQol (EQ-5D-5L) Visual Analogue Scale score was 36.4/100 and median Headache Impact Test-6 score was 68/78 (very severe impact). More than half of the respondents reported that they had to amend work duties due to SIH, more than a quarter reported that they had lost their job and two-thirds reported that their condition had affected their financial health. Only 23.4% of patients felt that they had received enough help and advice to manage their pain due to SIH.

CONCLUSIONS: SIH is a highly disabling disorder, affecting multiple domains, including pain, mobility, activities of daily living, financial circumstances and employment. Diagnostic delay and misdiagnosis are common, and currently there is a lack of consistency in the investigation and management of SIH in the UK.

PMID:35058269 | DOI:10.1136/bmjopen-2021-057438

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Aberrant origin of bilateral vertebral arteries associated with bovine aortic arch

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Surg Radiol Anat. 2022 Jan 21. doi: 10.1007/s00276-021-02880-w. Online ahead of print.

ABSTRACT

PURPOSE: Variance of aortic arch branches are clinically significant as they are encountered in multiple endovascular treatments. The knowledge of different variants is crucial to perform successful vascular interventions.

METHODS: We report a novel anatomical variant of aortic arch found on contrast-enhanced computed tomography scan during a workup of cervical lymphadenopat hy.

RESULTS: The CT neck revealed a bovine aortic arch with an aberrant origin of bilateral vertebral arteries from the aortic arch. The right vertebral artery arose between the bovine trunk and the left subclavian artery, while the left vertebral artery was present distal to the left subclavian artery.

CONCLUSION: This article sheds light on the potential clinical significance of these various types of aortic arch branches. Knowing the exact type of variant is particularly important in patient undergoing management involving carotid and surrounding vessels.

PMID:35061096 | DOI:10.1007/s00276-021-02880-w< /a>

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