Epidemiological, Clinical and Radiological Profile of Patients with Foreign Body Oesophagus: A Prospective Study

xlomafota13 shared this article with you from Inoreader Epidemiological, Clinical and Radiological Profile of Patients with Foreign Body Oesophagus: A Prospective Study Via Otolaryngology Indian Abstract To analyse the patients with foreign body oesophagus in relation to the clinico-radiological and socio-economic profile. The present prospective study was conducted on 100 consecutive patients of all age groups who underwent oesophagoscopy for suspected foreign body ingestion in a tertiary care hospital. The most common age group affected was 0–5 years. The median age was 5 ± 14.37 years. There was preponderance in males as compared to females, male to female ratio was 2.23:1. Majority (70%) of the patients, both males and females, belonged to rural areas. Lower socio-economic group was more commonly affected (54%). The most commonly reported symptom was foreign body sensation (55%) followed by vomiting (54%) and difficulty in swallowing (51%). Foreign body ingestion was witnessed in only 19% cases by the family members. The mean time between ingestion of the foreign body and admission to the hospital was found to be 4.5 h. The majority (97% ) of foreign bodies were radio-opaque. The most common site of lodgement was just below the cricopharynx (89%). The most common foreign body retrieved in our series were coins (65%). The majority of foreign bodies (68%) were retrieved in 20–40 min after induction of general anaesthesia. In 99% of the patients we did not encounter any complications. The majority (93%) of the patient's parents/relatives had curiosity to have a glimpse of the foreign body till they actually saw the retrieved foreign body. Foreign body lodgement is more common among children of lower socio-economic strata more so in rural areas. Rigid oesophagoscopy is a safe and effective procedure for removal of the foreign body. Early intervention makes it easier to extract the foreign body without complications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Giant Congenital Mastoid Cholesteatoma With Extension to the Occipital Condyle

xlomafota13 shared this article with you from Inoreader A Giant Congenital Mastoid Cholesteatoma With Extension to the Occipital Condyle Via ear nose throat Ear Nose Throat J. 2021 Apr 18:1455613211007943. doi: 10.1177/01455613211007943. Online ahead of print. ABSTRACT A congenital mastoid cholesteatoma (CMC) is a keratinizing epithelium originating from embryological epithelial tissue of the mastoid. It is often not diagnosed until it becomes large because of its rarity and indolent nature. Although there are a few reports on giant CMC, its exact extensions have not been well described, and detailed information regarding surgic al methods is lacking, especially in giant CMC involving the occipital condyle and the middle and posterior cranial fossae. In this article, we report a case involving a 70-year-old woman with a giant CMC that extended inferiorly to the occipital condyle. The CMC eroded the middle and posterior cranial fossae, sigmoid sinus plate, and fallopian canal of the facial nerve. For complete removal, we used a subtotal petrosectomy in conjunction with an exposure of the cranial cervical junction and a wide decompression of the suboccipit. The boundaries of exposure were similar to those of a petro-occipital transsigmoid approach which is usually used for management of tumor involving the jugular foramen. The wide exposure allowed for complete removal of the lesion without any complications. Thus, we recommend this surgical approach for management of the giant CMC involving the occipital condyle and the middle and posterior cranial fossae. PMID:33866866 | DOI:10.1177/01455613211007943 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Blastomyces Induced Otomastoiditis With Local Soft Tissue Invasion: A Case Report

xlomafota13 shared this article with you from Inoreader Blastomyces Induced Otomastoiditis With Local Soft Tissue Invasion: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Apr 18:1455613211006001. doi: 10.1177/01455613211006001. Online ahead of print. ABSTRACT The aim of this report is to document a very rare case of Blastomycosis dermatitidis mastoiditis with extension into the retromastoid soft tissue and surrounding muscle. Blastomycosis dermatitidis is a dimorphic fungus of endemic areas which classically infiltrates the lungs; however, dissemination presenting as otomastoiditis is exceedingly rare. Th e patient was an immunocompetent 27-year-old male with no significant preexisting health conditions. He had significant work exposure to dust and soil and was referred to our department for evaluation of otalgia with headaches, hearing loss, and intermittent facial paralysis. Initially, the extent of the infection was unknown. Based on extensive disease on magnetic resonance imaging, the patient was scheduled for urgent tympanoplasty and mastoidectomy. Postoperative treatment with itraconazole resolved any further manifestations and halted further soft tissue invasion. It is important to consider uncommon fungal infections in the workup of persistent otalgia, especially when presenting with facial paralysis and a history of environmental exposure to soil and dust. This type of infection should be considered regardless of immunodeficiency status. Early detection may prevent hearing loss and local invasion into surrounding structures. PMID:33866867 | DOI:10.1177/01455613211006001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Association Between Serum Vitamin D Levels and Benign Paroxysmal Positional Vertigo

xlomafota13 shared this article with you from Inoreader The Association Between Serum Vitamin D Levels and Benign Paroxysmal Positional Vertigo Via ear nose throat Ear Nose Throat J. 2021 Apr 18:1455613211008561. doi: 10.1177/01455613211008561. Online ahead of print. ABSTRACT OBJECTIVE: This study aimed to evaluate the association between serum vitamin D levels and benign paroxysmal positional vertigo (BPPV). PARTICIPANTS AND METHODS: This prospective study consisted of 137 participants. There were 69 participants in the BPPV group compared with 68 healthy participants. Blood samples from both groups were collected from all parti cipants to assess serum vitamin D levels. RESULTS: No significant difference in demographic data between BPPV and control groups. The results showed that the mean serum vitamin D levels in the BPPV group was lower than that of the control group (P value = .001). Among BPPV participants, there was no statistically significant difference between mean serum vitamin D levels of participants with recurrent BPPV, and that of newly diagnosed BPPV participants (P value = .313). CONCLUSION: A statistically significant association between lower mean serum vitamin D levels in the BPPV group compared with that of the control group. Therefore, low serum vitamin D levels may be one of the risk factors for BPPV. PMID:33866868 | DOI:10.1177/01455613211008561 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relative Humidity Affects Acute Otitis Media Visits of Preschool Children to the Emergency Department

xlomafota13 shared this article with you from Inoreader Relative Humidity Affects Acute Otitis Media Visits of Preschool Children to the Emergency Department Via ear nose throat Ear Nose Throat J. 2021 Apr 18:1455613211009151. doi: 10.1177/01455613211009151. Online ahead of print. ABSTRACT OBJECTIVE: The associations between climate variables and diseases such as respiratory infections, influenza, pediatric seizure, and gastroenteritis have been long appreciated. Infection is the main reason for acute otitis media (AOM) incidence. However, few previous studies explored the correlation between climatic parameters and AOM infections. The most importan t meteorological factors, temperature, relative humidity, and fine particulate matter (PM2.5), were included in this study. We studied the relationship between these meteorological factors and the AOM visits. MATERIALS AND METHODS: It was a retrospective cross-sectional study. A linear correlation and a linear regression model were used to explore the AOM visits and meteorological factors. RESULTS: A total of 7075 emergency department visits for AOM were identified. Relative humidity was found an independent risk factor for the AOM visits in preschool children (regression coefficient = -10.841<0, P = .039 < .05), but not in infants and school-age children. Average temperature and PM2.5 were not correlated with AOM visits. CONCLUSION: Humidity may have a significant inverse impact on the incidence of AOM in preschool-age children. PMID:33866869 | DOI:10.1177/01455613211009151 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interpersonal functioning and body image dissatisfaction in patients referred for NHS aesthetic surgery: A mediating role between emotion regulation and perfectionism?

xlomafota13 shared this article with you from Inoreader Interpersonal functioning and body image dissatisfaction in patients referred for NHS aesthetic surgery: A mediating role between emotion regulation and perfectionism? Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jan 31:S1748-6815(21)00046-2. doi: 10.1016/j.bjps.2021.01.003. Online ahead of print. ABSTRACT BACKGROUND: Few studies have explored psychological factors associated with body image dissatisfaction in individuals seeking aesthetic surgery on the NHS. In NHS Scotland, The Adult Exceptional Aesthetic Referral Protocol (AEARP) states that individuals are only eligible for consideration for surgery where there is significant psychological distress and physical criteria associated with perceived problem of appearance. The AEARP necessitates that individuals seeking aesthetic surgery on the NHS must have a psychological assessment. It is therefore crucial to identify psychological factors associated with body image dissatisfaction that may highlight contraindications for surgery or are amenable to psychological intervention. METHOD: A total of 311 consecutive patients seeking aesthetic surgery who we re referred for psychological assessment under the AEARP completed a series of psychometric measures as part of routine clinical practice. Multiple mediation analyses using bootstrapped method was used to explore the relationship between interpersonal functioning, emotion regulation, perfectionism, and body image dissatisfaction. RESULTS: Multiple mediation analysis indicated that emotion regulation partially mediates the relationship between interpersonal functioning and body image dissatisfaction in this clinical population. CONCLUSION: This study indicates that interpersonal functioning and emotion regulation significantly relate to body image dissatisfaction in this patient group. Psychological assessment of patient suitability for aesthetic surgery should include assessment of interpersonal functioning and emotion regulation which may be amenable to psychological intervention and be of significant benefit to patients either pre- or post-operatively or instead of sur gery. PMID:33867281 | DOI:10.1016/j.bjps.2021.01.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lymph-interpositional-flap transfer (LIFT) based on lymph-axiality concept: Simultaneous soft tissue and lymphatic reconstruction without lymph node transfer or lymphatic anastomosis

xlomafota13 shared this article with you from Inoreader Lymph-interpositional-flap transfer (LIFT) based on lymph-axiality concept: Simultaneous soft tissue and lymphatic reconstruction without lymph node transfer or lymphatic anastomosis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 25:S1748-6815(21)00104-2. doi: 10.1016/j.bjps.2021.03.014. Online ahead of print. ABSTRACT BACKGROUND: Lymphatic system is important to maintain homeostasis. Lymph-axiality concept has been reported, which suggests possibility of lymphatic reconstruction using flap transfer without lymph node or supermicrosurgical lymphatic anastomosis. METHODS: Medical charts of 122 free flap reconstruction cases, either with conventional flap transfer (control) or lymph-interpositional-flap transfer (LIFT), for extremity soft tissue defects including lymphatic pathways were reviewed. Lymph vessels' stumps in a flap were placed as close to those in a recipient site as possible under indocyanine green (ICG) lymphography navigation in LIFT group. LIFT group was subdivided into LIFT(+) and LIFT(-) groups; lymph vessels' stumps could be approximated within 2 cm in LIFT(+) group, whereas those could not be in L IFT(-) group. Lymph flow restoration (LFR) and lymphedema development (LED) rates were compared between the groups on postoperative 6 months. RESULTS: No flap included lymph node. LFR was observed in 50 cases and LED in 72 cases. LFR rate in LIFT group (n = 75) was significantly higher than that in control group (n = 47) (57.3% vs. 14.9%; P < 0.001). LED rate in LIFT group was significantly lower than that in control group (20.0% vs. 48.9%; P < 0.001). Sub-group analysis showed significantly higher LFR and lower LED rates in LIFT(+) group (n = 44) than those in LIFT(-) group (n = 31; 88.6% vs. 12.9%; P < 0.001, 4.5% vs. 41.9%; P < 0.001). CONCLUSIONS: LIFT allows simultaneous soft tissue and lymphatic reconstruction without lymph node transfer or lymphatic anastomosis, which prevents development of secondary lymphedema. PMID:33867280 | DOI:10.1016/j.bjps.2021.03.014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Traumatic rupture of a cystic parathyroid adenoma resulting in malignant hypercalcaemia

xlomafota13 shared this article with you from Inoreader Traumatic rupture of a cystic parathyroid adenoma resulting in malignant hypercalcaemia Via oto-rhino-laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Apr 15:S1879-7296(21)00063-6. doi: 10.1016/j.anorl.2021.04.001. Online ahead of print. NO ABSTRACT PMID:33867248 | DOI:10.1016/j.anorl.2021.04.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (CRSwNP) in Brazil

xlomafota13 shared this article with you from Inoreader Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (CRSwNP) in Brazil Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Apr 3:S1808-8694(21)00062-8. doi: 10.1016/j.bjorl.2021.03.003. Online ahead of print. ABSTRACT INTRODUCTION: Severe uncontrolled chronic rhinosinusitis with nasal polyps has a negative impact on an individual's quality of life. Therefore, new biologics have emerged for use in specific phenotypes of chronic rhinosinusitis, changing the paradigms of its treatment. OBJECTIVE: To review the current status of biologic treatment indications in chronic rhinosinusitis. METHODS: The Brazilian Academy of Rhinology brought together different specialists to suggest a course of action, considering its particularities and aspects related to the national reality. RESULTS: Of particular interest for decision making will be the identification of subgroups of patients refractory to pre-existing treatment options and the construction of a strategy that improves their quality of life, with the best cost-bene fit ratio. CONCLUSION: The use of biologics is a valid option for treatment in more severe cases. This strategy must be better understood and improved in the future, with more studies and greater clinical experience. PMID:33867274 | DOI:10.1016/j.bjorl.2021.03.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case of cavernous hemangioma of the infratemporal fossa causing recurrent secretory otitis media

xlomafota13 shared this article with you from Inoreader A case of cavernous hemangioma of the infratemporal fossa causing recurrent secretory otitis media Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 26:S1808-8694(21)00060-4. doi: 10.1016/j.bjorl.2021.03.001. Online ahead of print. ABSTRACT Secretory otitis media causes aural fullness and hearing loss secondary to Eustachian tube obstruction or incomplete resolution of acute otitis media. Every patient with unilateral middle ear effusion should undergo nasopharyngoscopy to assess the nasopharyngeal space. Expansive lesions at the level of pterygopalatine fossa may cause Eustachian tube compression with tube dysfunction with clinical findings of recurrent unilateral secretory otitis media. In this paper, a 55 years old man presented with a history of hearing loss and fullness in the left ear. Brain MRI scan showed the presence on the left side of a solid mass in the infratemporal masticatory space and the patient underwent endoscopic transnasal resection of the lesion. At 6 months follow-up there was no evidence of disease recurrency. In our opinion , it is important to add an imaging tool to the diagnostic algorithm in all those cases of secretory otitis media lasting more than 3 months that present a negative nasopharyngoscopy evaluation. PMID:33867275 | DOI:10.1016/j.bjorl.2021.03.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hepatic Macrophage activation and the LPS pathway in patients with different degrees of severity and histopathological patterns of drug induced liver injury

xlomafota13 shared this article with you from Inoreader Hepatic Macrophage activation and the LPS pathway in patients with different degrees of severity and histopathological patterns of drug induced liver injury Via Cellular and Molecular Biology Histol Histopathol. 2021 Apr 15:18340. doi: 10.14670/HH-18-340. Online ahead of print. ABSTRACT BACKGROUND: Inflammatory activation of hepatic macrophages plays a primary role in drug-induced liver injury (DILI). However, the exact mechanism underlying DILI remains unclear. METHODS: A total of 328 DILI patients and 80 healthy individuals were prospectively enrolled in this study. The DILI patients were categorized into subgroups based on either disease severity or histopathological patterns. Plasma soluble CD163 (sCD163) and hepatic CD163 were examined to determine hepatic macrophage activation, and CD8, CD20, and MUM-1 were assessed to determine cellular immunity using immunohistochemistry. The lipopolysaccharide (LPS) pathway proteins [e.g. LPS, soluble CD14 (sCD14), and LPS-binding protein (LBP)] were measured using enzyme-linked immunosorbent assay. RESULTS: Plasma sCD163 levels were nine-fold higher in DILI patients th an in healthy controls at the baseline, but significantly decreased at the 4-week follow-up visit after treatment. The numbers of hepatic macrophages, B cells, and plasma cells were significantly higher in the liver tissues from DILI patients than those from healthy controls. Furthermore, the baseline levels of LPS pathway proteins in the DILI patients were significantly higher than those in the controls. Notably, these proteins significantly decreased at the 4-week follow-up visit but remained significantly higher than the levels for the controls. CONCLUSIONS: Hepatic inflammation in DILI involves the activation of hepatic macrophages and cellular immunity, in which the LPS pathway likely plays a role, at least in part. As such, this study has improved our understanding of the pathological mechanisms for DILI and may facilitate the development of better treatments for patients with DILI. PMID:33870482 | DOI:10.14670/HH-18-340 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.