Wednesday, February 10, 2021

Neuromodulation of the anterior thalamic nucleus as a therapeutic option for difficult-to-control epilepsy.

xlomafota13 shared this article with you from Inoreader
Related Articles

Neuromodulation of the anterior thalamic nucleus as a therapeutic option for difficult-to-control epilepsy.

Neurocirugia (Astur). 2021 Feb 04;:

Authors: Moreira-Holguín JC, Barahona-Morán DA, Hidalgo-Esmeraldas J, Guzmán-Rochina C

Abstract
Deep brain stimulation (DBS) consists of the electrical stimulation of the subcortical structures by implanting electrodes connected to a pulse generator. The thalamus, being a structure that has multiple connections with various parts of the central nervous system, is a suitable target for DBS. The anterior thalamic nucleus (ANT) serves as an important relay site for the limbic system by receiving input from the hippocampus and mammillary bodies, and sending input to the cingulate gyrus; thus forming the Papez circuit. Due to these connections, the ANT constitutes an ideal route for the propagation of epileptogenic activity. ANT-DBS has excellent results in the control of complex partial seizures. The vast majority of patients with ANT-DBS have shown a significant reduction in the frequency of their seizures of more than 50%.

PMID: 33551281 [PubMed - as supplied by publisher]

View on the web

Mucosal Grafting Reduces Recurrence After Endonasal Surgery of Petrous Apex Cholesterol Granulomas

xlomafota13 shared this article with you from Inoreader

Objectives/Hypothesis

The endoscopic endonasal approach (EEA) is increasingly utilized for management of petrous apex cholesterol granuloma (PACG). Surgical goals include drainage and marsupialization of the cyst. Various techniques have been described to try to reduce the rates of recurrence. We studied the effect of mucosal grafting on recurrence.

Study Design

Retrospective Cohort study.

Methods

Patients who underwent EEA for PACG at two tertiary care centers between 1999 and 2018 were identified and divided into two cohorts: Mucosal versus no mucosal reconstruction. Surgical approach, reconstructive method, and recurrence were recorded. Primary endpoint was symptomatic or radiographic recurrence.

Results

Thirty‐four patients were identified undergoing 37 surgeries. Four patients developed recurrences of which three elected to undergo revision. Some form of mucosa was used to line the drainage tract in 20 cases. A free mucosal graft was used in 8, and a small customized nasal septal flap (miniflap) in 12. All four recurrences occurred in cases where no mucosa was used, demonstrating decreased recurrences with mucosal reconstruction (P < .05). There was no difference found between free mucosal grafts and miniflaps.

Conclusions

Utilization of mucosa to partially line a circumferentially de‐epithelialized drainage pathway after EEA for PACG reduce recurrence rates.

Level of Evidence

3 Laryngoscope, 2021

View on the web

Bilateral sessile polyps of vocal cords

xlomafota13 shared this article with you from Inoreader
Via Polyps
Related Articles

[Subjective and objective evaluation of the efficacy of different surgical procedures in 48 patients with bilateral sessile polyps of vocal cords].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Feb;35(2):160-163

Authors: Liu J, Xiao C, Deng L, Wu X, Wu X, Hu G, Yu L

Abstract
Objective:The aim of this study is to evaluate the efficacy of CO2 laser and CO2 laser combined with microsuture in the treatment of bilateral sessile polyps of vocal cords. Methods:Forty-eight patients with bilateral sessile polyps of vocal cords were randomly divided into CO2 laser group and CO2 laser combined with microsuture group. The surgical effect of each group and the difference between the two groups were evaluated by subjective score and objective voice analysis. Results:One month and three month after operation, Jitter, Shimmer, dysphonia severity index(DSI), the maximum phonation time(MPT), the parameters of G and voice handicap index(VHI-10) in the two groups were significantly different from pre-operation(P<0.05). There were also significant differences in Jitter, Shimmer, DSI and MPT between the two groups one month and three month after operation respectively(P<0.05). But no significant differences of the parameters of G and VHI-10 was noted between two groups(P>0.05). The incidence of postoperative vocal cord adhesion was 8.3% and 0 in two groups respectively, and there was no significant difference between the two groups(P>0.05). Conclusion:The CO2 laser combined with microsuturing technique can effectively improve the voice quality of patients with bilateral wide-based vocal cord polyps, and the effect is better than that of using CO2 laser alone.

PMID: 33541000 [PubMed - indexed for MEDLINE]

View on the web

Electrogustometry: normative data for stimulus duration, tongue site and age decline

xlomafota13 shared this article with you from Inoreader

Abstract

Objectives

Our primary goal was to evaluate the effect of stimulus‐duration on electrogustometry (EGM) thresholds. Additionally, we sought to evaluate any sex‐related influences and compare the above results to those of taste strips.

Design

EGM‐ thresholds of various stimulus durations (0.5, 1.0, 1.5, and 2.0 s) were measured in 212 non‐smokers (age range: 10 – 80 years, divided into eight age groups) without self‐reported gustatory impairment. Furthermore, taste strips chemogustometry measurements in 132 participants were performed.

Setting

Tertiary referral medical centre.

Participants

212 non‐smokers, divided in eight age‐groups participated in the study.

Main outcome measures

EGM‐thresholds and taste strips, duration of EGM‐stimuli

Results

EGM‐thresholds increased progressively with age and with stimulus duration from 0.5 to 2 seconds. This pattern was consistent in all six anatomic areas, irrespective of sex. In contrast, when using chemogustometry, no age‐ or sex‐related differences were observed.

Conclusions

EGM threshold values increase progressively with age and with stimulus duration. Therefore, we recommend documenting stimulus duration in future EGM recordings as it may significantly affect EGM amplitude threshold values.

View on the web

Sociodemographic and Survival Characteristics of 253 Human Papilloma Virus‐related Oropharyngeal Cancer Cases in Glasgow, Scotland – A retrospective analysis

xlomafota13 shared this article with you from Inoreader

Abstract

Human Papilloma Virus (DNA)‐positive oropharyngeal cancer patients from more affluent areas have lower mortality compared to their socioeconomically deprived counterparts following adjustment for smoking, alcohol use, staging and treatment intent. This suggests that socioeconomic deprivation worsens survival even in Human Papilloma Virus (DNA)‐positive disease. Current world literature suggests that Human Papilloma Virus (DNA)‐positive oropharyngeal cancer patients present at a younger age and are more affluent, which is in contrast to this study, where patients present at an older age and have a lower socioeconomic background. Socioeconomic deprivation and high smoking rates may contribute towards poorer survival of oropharyngeal cancer in the West of Scotland. In contrast to findings from existing literature, this cohort of patients most frequently presented with neck adenopathy, rather than throat pain or ulceration. Late stage at presentation remains a common problem with oropharyngeal cancer patients in Scotland.

View on the web

Xerostomia and hyposalivation in patients with obstructive sleep apnea

xlomafota13 shared this article with you from Inoreader

Abstract

Objective

(a) To report the xerostomia prevalence and severity in patients with obstructive sleep apnea (OSA). (b) To assess the saliva pH in patients with OSA.

Design

Simultaneous cohort observational clinical study.

Setting

In Sleep Medicine Centre at Lomonosov Moscow State University from March to June 2019.

Participants

The study was conducted on 30 patients with OSA aged from 35 to 65 years.

Main Outcomes Measures:

The diagnosis of sleep apnea was made after standard polysomnography using the Domino program. The severity of OSA was indicated using the Apnea‐Hypopnea Index. Xerostomia was evaluated using Fox's test. Hyposalivation was evaluated by measurement of salivary flow rate. Determination of the saliva pH was carried out with a pH meter. Statistical analysis was performed by one‐way ANOVA and Tukey‐Kramer multi‐comparison test.

Results

Twenty‐two out of 30 (73.3%) patients were diagnosed with "dry mouth". Hyposalivation was observed in 6 out of 30 (20%). Dry mouth on awakening was observed in 60.0%, 72.7% and 88.9% of patients with mild, moderate and severe OSA, respectively. The average salivary flow rate was 0.28ml/min, 0.24ml/ min and 0.14ml/ min, respectively. The average pH value in patients with mild, moderate and severe apnea was 6.40±0.017, 6.15±0.27 and 5.87±0.24, respectively.

Conclusions

In patient with mild and moderate OSA the saliva amount and rate are similar (P>0.05). With the increase of OSA severity both these parameters change (P<0.001). The acidity of the saliva was correlated with the level of OSA and it statistically increased with the increment of the OSA severity (P<0.05‐P<0.001).

View on the web

Determination of variables for a more accurate diagnostic approach in suspected acute invasive fungal rhinosinusitis: A non‐concurrent cohort study

xlomafota13 shared this article with you from Inoreader

Abstract

Objective

To describe a group of patients with suspected acute invasive fungal rhinosinusitis (AIFRS) diagnosis, and identify factors associated with a greater risk of presenting this disease.

Design

Non‐concurrent cohort study.

Setting

A single center non‐concurrent follow‐up of patients with suspected AIFRS between August 2015 and July 2018.

Participants

50 inpatients referred due to suspected AIFRS at Hospital Clínico Universidad Católica based on the association of a predisposing factor (neutropenia/immunodeficiency/poorly controlled diabetes) with fever of unknown origin.

Main outcome measure

The primary outcome was AIFRS diagnosis, defined as a concordant tissue biopsy.

Results

AIFRS was confirmed in 18% (9/50) of the evaluated patients. AIFRS was significantly associated with a positive galactomannan (p=0.04), and a paranasal sinus MRI with lack of contrast enhancement (LoCE) (p=0.04) orbit compromise (p=0.03) or global extrasinusal extension (p=0.04). LoCE and extrasinusal extension in the paranasal sinus/brain MRI were risk factors for AIFRS (OR 16; CI 1.2–210.6 and OR 12.75; CI 1.3–128.8 respectively). Conversely, a nasal endoscopy showing healthy mucosa was identified as a protective factor for AIFRS (OR 0.06; CI 0.007–0.57).

Conclusions

In patients with suspected AIFRS we identified laboratory and radiologic variables associated with the disease, which may help for a more accurate diagnostic algorithm and approach in this population.

View on the web

Radioactive iodine therapy may not improve disease‐specific survival in follicular variant papillary thyroid cancer without distant metastasis: A propensity score‐matched analysis

xlomafota13 shared this article with you from Inoreader

Abstract

Background

Whether radioactive iodine (RAI) therapy is effective in improving disease‐specific survival (DSS) in patients with follicular variant papillary thyroid cancer (FVPTC) without distant metastasis remains unclear.

Methods

Patients with FVPTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The Kaplan–Meier method and the Cox proportional hazards regression model were used to evaluate DSS. Propensity score‐matched analysis was performed to reduce the influence of confounding bias.

Results

RAI did not improve DSS, even in patients with aggressive features such as T4 classification (p = 0.658), extrathyroidal extension (p = 0.083), lateral lymph node metastasis (p = 0.544), and ≥5 metastatic lymph nodes (p = 0.599).

Conclusion

RAI did not affect DSS in patients with FVPTC without distant metastases in this SEER database study. Multicenter, prospective studies including recurrence and molecular information should be conducted to comprehensively evaluate the effects of RAI on FVPTC.

View on the web

Olfactory Dysfunction Among Asymptomatic Patients with SARS CoV2 Infection: A Case–Control Study

xlomafota13 shared this article with you from Inoreader

12070.jpg

Abstract

Olfactory dysfunction (hyposmia, anosmia) is a well-recognized symptom in patients with coronavirus disease-19 (COVID-19). Studies of olfactory dysfunction in asymptomatic patients have not been reported. We conducted a study looking for the presence of olfactory dysfunction with an objective assessment tool in asymptomatic Covid 19 and compared it with patients with mild COVID-19 and age-matched controls. We recruited 57 male patients each of Mild COVID-19, asymptomatic Covid 19, and healthy controls for the study. All participants underwent evaluation of smell threshold by Butanol Threshold test (BTT) and ability to distinguish common odors by Smell identification test. The scores of each test were recorded on a numerical scale. The participants in all three arms were matched for age, history of smoking, and pre-existing medical conditions. The mean scores of the Butanol Threshold test in Mild COVID-19, asymptomatic Covid 19 and controls were 2.95 ± 2.25 ( 0–7.5), 3.42 ± 2.23 (0–7.5), and 4.82 ± 1.86 (0–8), respectively. A one-way ANOVA showed a significant difference between groups (df 2, MS 53.78, F 11.94, p < 0.005). Intergroup differences using the student T-test showed significantly low BTT scores in Mild COVID-19 (p < 0.005) and asymptomatic (p < 0.005) as compared to control. BTT scores could not distinguish between asymptomatic patients and control. The smell threshold was impaired in asymptomatic Covid 19 and Mild COVID-19. Butanol Threshold Test score could not differentiate between asymptomatic Covid 19 and controls.

View on the web

Early detecting cervical necrotizing fasciitis from deep neck infections: a study of 550 patients.

xlomafota13 shared this article with you from Inoreader
Related Articles

Early detecting cervical necrotizing fasciitis from deep neck infections: a study of 550 patients.

Eur Arch Otorhinolaryngol. 2021 Feb 09;:

Authors: Sideris G, Sapountzi M, Malamas V, Papadimitriou N, Maragkoudakis P, Delides A

Abstract
PURPOSE: The aim of this retrospective review study is to evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score as an indicative parameter in early detecting cervical necrotizing fasciitis (CNF) from deep neck infections (DNI).
METHODS: We reviewed 12 cases of CNF and 538 cases of non-necrotizing deep neck infection hospitalized in our hospital over the last decade. Cervical necrotizing fasciitis was histologically confirmed.
RESULTS: Using an LRINEC score of 6 as a cutoff sensitivity was calculated at 100% (95% CI 99.9-100) and specificity 72.5% (95% CI 72.4-72.6). Negative predicted value (NPV) was 100% and positive predicted value (PPV) was 7.5%. C-reactive protein (CRP), white blood count (WBC), and glucose (Glu) levels have a higher correlation. Haemoglobin (Hb), sodium (Na), and creatinine (Cr) do not seem to have a big impact in our study.
CONCLUSION: LRINEC score proves to be a useful "rule-out" tool that works on the safe side with high sensitivity and poor specificity. WBC, CRP, and Glu seem to be the most significant variables of the LRINEC score. Hb, Na, and Cr make the score safer. Decision for surgery must be based on medical history, clinical symptoms and signs, imaging findings, and laboratory tests and not according to the LRINEC score itself.

PMID: 33559743 [PubMed - as supplied by publisher]

View on the web

Unilateral absence of pulmonary artery associated with lung cancer: analysis of operation strategy based on digital preoperative planning and surgical simulation with three-dimensional visualization.

xlomafota13 shared this article with you from Inoreader

pubmed-meta-image.png

Related Articles

Unilateral absence of pulmonary artery associated with lung cancer: analysis of operation strategy based on digital preoperative planning and surgical simulation with three-dimensional visualization.

Surg Radiol Anat. 2021 Feb 09;:

Authors: Liu Y, Zhang S

Abstract
Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly. The occurrence of lung cancer in association with UAPA is even rarer, and clinical experience is very limited. This report aims to describe a case of unilateral absence of the right pulmonary artery that was associated with primary carcinoma of the contralateral lung. Both ipsilateral and contralateral lung cancer operations in patients with UAPA are extremely rare, with limited clinical experience. This article provides insights into the operative tolerability and outcomes after lung surgery in patients with UAPA, with an analysis of the operation strategy based on digital preoperative planning and surgical simulation with three-dimensional (3D) visualization, which may enable lung cancer surgery to be performed safely.

PMID: 33559715 [PubMed - as supplied by publisher]

View on the web

The posterior horn of the medial and lateral meniscus both reduce the effective posterior tibial slope: a radiographic MRI study.

xlomafota13 shared this article with you from Inoreader

pubmed-meta-image.png

Related Articles

The posterior horn of the medial and lateral meniscus both reduce the effective posterior tibial slope: a radiographic MRI study.

Surg Radiol Anat. 2021 Feb 09;:

Authors: Hohmann E, Tetsworth K, Glatt V, Ngcelwane M, Keough N

Abstract
PURPOSE: The purpose of this study was to quantify the posterior horn meniscal slope and determine its contribution to the reduction in posterior tibial slope.
METHODS: Patients aged between 16 and 60 years and had intact menisci with no evidence of previous injury or surgery were included. Patients with radiological evidence of osteoarthritis Grade II-IV, any acute or chronic meniscus injuries, fractures, and ligamentous injuries were excluded. The posterior bony slope (PTS) and the meniscus slope (MS) of the posterior horns were measured at 25, 50, and 75% from the medial and lateral borders of the tibial plateau.
RESULTS: 325 MR images (mean age 37.1 ± 10.9 years) were included. There were 194 males and 131 females, with 162 left and 163 right knees. The PTS in the medial compartment ranged from (-) 2.8° to 3.7° and from (-) 1.3° to 1.9° in the lateral compartment (p = 0.0001). The MS in the medial compartment ranged from 27.4° to 28.2°, and from 27.8° to 28.7° in the lateral compartment (p > 0.05). The differences between the medial and lateral knee compartment were statistically significant. At the 25% interval the p level was 0.037, at 50% p = 0.00001, and at 75% p = 0.0001. There were no significant between gender differences.
CONCLUSIONS: The results of this study demonstrated a significant reduction in posterior tibial bone slope by the posterior horns of both the medial and lateral meniscus, from a mean of (-) 1° to 2° to a more horizontal anterior slope. The posterior bone slope was larger in the medial compartment by 1°, resulting in a smaller slope reduction in the lateral compartment.

PMID: 33559716 [PubMed - as supplied by publisher]

View on the web

Collaboration request

Hi there How would you like to earn a 35% commission for each sale for life by selling SEO services Every website owner requires the ...