Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve

xlomafota13 shared this article with you from Inoreader Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve Via ear nose throat Ear Nose Throat J. 2021 May 28:1455613211020959. doi: 10.1177/01455613211020959. Online ahead of print. ABSTRACT Parathyroid adenomas are responsible for 80% to 85% of cases of primary hyperparathyroidism. Giant parathyroid adenomas are a rare type of parathyroid adenoma defined as weighing >3.5 grams. Although giant parathyroid adenomas are rare entities whose clinical presentation may not be atypical, their surgical management can be challenging, especially in the setti ng of anatomical variants. We present here a case of a 29-year-old female with a 37-gram giant adenoma which was diagnosed after presentation with recurrent severe headaches. The presentation was also unique in that it was associated with a right aberrant subclavian artery and nonrecurrent laryngeal nerve. PMID:34044628 | DOI:10.1177/01455613211020959 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of SMAD4 loss with drug resistance in clinical cancer patients: A systematic meta-analysis

xlomafota13 shared this article with you from Inoreader Association of SMAD4 loss with drug resistance in clinical cancer patients: A systematic meta-analysis Via Head and neck cancers by Wei Xu, Sau Har Lee, Fengjun Qiu, Li Zhou, Xiaoling Wang, Tingjie Ye, Xudong Hu Background Drug resistance frequently led to the failure of chemotherapy for malignant cancers, hence causing cancer relapse. Thus, understanding mechanism of drug resistance in cancer is vital to improve the treatment efficacy. Here, we aim to evaluate the association between SMAD4 expression and the drug resistance in cancers by performing a meta-analysis. Method Relevant studies detecting SMAD4 expression in cancer patients treated with chemo-drugs up till December 2020 were systematically searched in four common scientific databases using selected keywords. The pooled hazard ratio (HR) was the ratio of hazard rate between SMAD4neg population vs SMAD4pos population. The HRs and risk ratios (RRs) with 95% confidence intervals (CIs) were used to explore the association between SMAD4 expression losses with drug resistance in cancers. Result After an initial screening according to the inclusion and exclusion criteria, eleven studies were included in the meta-analysis. There were a total of 2092 patients from all the included studies in this analysis. Results obtained indicated that loss of SMAD4 expression was significantly correlated with drug resistance with pooled HRs (95% CI) of 1.23 (1.01–1.45), metastasis with pooled RRs (95% CI) of 1.10 (0.97–1.25) and recurrence with pooled RRs (95% CI) of 1.32 (1.06–1.64). In the subgroup analysis, cancer type, drug type, sample size and antibody brand did not affect the significance of association between loss of SMAD4 expression and drug resistance. In addition, there was no evidence of publication bias as suggested by Begg's test. Conclusion Findings from our meta-analysis demonstrated that loss of SMAD4 expression was correlated with drug resistance, metastasis and recurrence. Therefore, SMAD4 expression could be potentially used as a molecular marker for cancer resistance. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aberrant gastroduodenal and proper hepatic arteries

xlomafota13 shared this article with you from Inoreader Aberrant gastroduodenal and proper hepatic arteries Via radiol anat Surg Radiol Anat. 2021 May 28. doi: 10.1007/s00276-021-02774-x. Online ahead of print. ABSTRACT PURPOSE: Anatomic variants of the celiac trunk and superior mesenteric artery are common, thus knowledge of these variants is important for preoperative planning of abdominal surgery and interventional procedures. METHODS: We report a rare anatomic variant of replaced proper hepatic and gastroduodenal arteries discovered upon CT angiography and diagnostic angiogram. RES ULTS: Emergent angiogram performed on a 61-year-old male who presented with signs and symptoms of upper gastrointestinal hemorrhage revealed a rare variant of an absent common hepatic artery and its branches with aberrant origins. The replaced proper hepatic artery originated from the superior mesenteric artery and the replaced gastroduodenal artery originated from a gastrosplenic trunk. CONCLUSION: This case emphasizes the importance of evaluating preoperative imaging to identify vascular variants prior to undergoing abdominal surgery or interventional procedures. PMID:34047834 | DOI:10.1007/s00276-021-02774-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bing-Neel syndrome presenting with bilateral lumbar radiculopathy: A case report of a rare clinical entity

xlomafota13 shared this article with you from Inoreader Bing-Neel syndrome presenting with bilateral lumbar radiculopathy: A case report of a rare clinical entity Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 May 24:S1130-1473(21)00045-2. doi: 10.1016/j.neucir.2021.03.004. Online ahead of print. ABSTRACT The differential diagnosis of bilateral lower extremity weakness is broad. We present a very rare case of a 48-year old male patient, with walking difficulties due to Bing-Neel syndrome. On clinical examination, there was a significant loss of muscle power in all his lower extremities key-muscle groups. The lumbar spine magnetic resonance imaging (MRI) showed only mild degenerative changes, whereas the MRI of the head indicated a diffuse meningeal thickening at the right temporal region, characterized by significant enhancement after contrast administration. Serum protein electrophoresis detected an IgM-kappa monoclonal protein. The patient received intrathecal chemotherapy with methotrexate and cytarabine, and was started on oral ibrutinib 420mg daily. In conclusion, a past medical history of Waldenstrom macroglobulinem ia in conjunction with neurological manifestations should alert the treating physician for Bing-Neel syndrome. A complete diagnostic imaging and serologic protocol helps in setting the final diagnosis. Steroids are part of the treatment, but should be given after the diagnosis is set. Neurosurgical intervention is indicated for histologic confirmation in the case of diagnostic uncertainty. PMID:34045126 | DOI:10.1016/j.neucir.2021.03.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Post-dural puncture headache

xlomafota13 shared this article with you from Inoreader Post-dural puncture headache Via leak of cerebrospinal fluid Nervenarzt. 2021 May 27. doi: 10.1007/s00115-021-01147-4. Online ahead of print. ABSTRACT Post-dural puncture headache belongs to the group of secondary headache disorders and is a typical complication of intended or unintended dural puncture. The main symptom is orthostatic headache, which can be accompanied by neurological symptoms such as diplopia depending on the extent of the cerebrospinal fluid leak. The course of this headache is predominantly benign, showing spontaneous improvement over a couple of days, although severe cases are described in the literature. The following article provides an overview of the current knowledge about the headache's pathophysiology, diagnostic work-up and therapy. PMID:34046723 | DOI:10.1007/s00115-021-01147-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The environmental impact of personal protective equipment in a pre and post COVID era in the ENT clinic

xlomafota13 shared this article with you from Inoreader The environmental impact of personal protective equipment in a pre and post COVID era in the ENT clinic Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 27. doi: 10.1007/s00405-021-06860-z. Online ahead of print. ABSTRACT PURPOSE: The use of single use plastic items and plastic wrapping has increased over the last number of decades. Outside of the medical field there has been a conscious drive to reduce single use plastic and reuse items to reduce the amount of waste we produce. We undertook this investigation to quantify our plastic waste production and generate ideas to reduce this volume. METHODOLOGY: Data was collected from a University Hospital ENT outpatient department via real-time recording methods using standard data collection forms. We measured plastic unit usage pre and post COVID restrictions and compared this to our number of patient encounters. Projections of plastic usage were determined via a hypothetical resumption of patient services model. RESULTS: In total there were 440 patients included. In period one the mean units of plastic used per day was 65.1 (median 67; range 27-84). In the second period, the mean number of plastic units was 23.4 (median 22; range 1-7). Blue nitrile gloves and masks were the most commonly used single use items. The hypothetical projection model predicted a 147.6% increase in single use items following the introduction of COVID precautions. CONCLUSION: We have a duty of care not only to our patients but future generations of patients and the environment which we share. Single use items and excessive plastic wrapping have benefits in terms of convenience and sterility, but these conveniences can be easily extended to reusable types to limit our volume of waste, reduce our waste management costs and protect our environment. PMID:34046749 | DOI:10.1007/s00405-021-06860-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is the 3D exoscope better than the surgical microscope in parotid surgery: a prospective, randomized single-center study

xlomafota13 shared this article with you from Inoreader Is the 3D exoscope better than the surgical microscope in parotid surgery: a prospective, randomized single-center study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 28. doi: 10.1007/s00405-021-06876-5. Online ahead of print. ABSTRACT BACKGROUND: High-definition, three-dimensional (3D) exoscopes are being used to perform a growing number of head and neck surgeries. However, the use of the 3D exoscope in parotid gland surgery has not been previously described. Our initial experience with the VITOM 3D exoscope in the surgical treatment of parotid gland tumors is detailed here. METHODS: We made a prospective study of patients with benign parotid gland tumors indicated for surgical resection. Between January and December 2018, patients were randomly assigned to undergo surgery assisted with the VITOM 3D system (n = 31) or an operating microscope (n = 40). Visualization quality (greater auricular nerve, digastric muscle, tragal pointer), operating time, conversion rates, and surgical outcomes were compared. RESULTS: A total of 71 patients underwent superfi cial (n = 18) or total parotidectomy (n = 53). No exoscope-related complications were observed. Five patients undergoing exoscope-guided deep lobe surgery required intraoperative conversion to a microscope. No differences were observed in the subjective quality of intraoperative visualization of key anatomical structures. However, a significantly higher percentage of patients in the exoscope group developed transient facial nerve paralysis (n = 9; 29% vs. n = 4, 10%). CONCLUSIONS: These findings suggest that the VITOM 3D is a valid visualization tool for parotid gland surgery, comparable to the operating microscope but with higher resolution 3D visualization, an increased degree of freedom of movement, and better ergonomics. However, the high rate of transient nerve palsy, possibly related to decreased depth perception and the brief learning curve, merits further investigation. PMID:34047839 | DOI:10.1007/s00405-021-06876-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Distribution of skin cancers of the head and neck according to anatomical subunit

xlomafota13 shared this article with you from Inoreader Distribution of skin cancers of the head and neck according to anatomical subunit Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 28. doi: 10.1007/s00405-021-06901-7. Online ahead of print. ABSTRACT PURPOSE: The skin tumors can occur on any part of the body, these anatomical subunits are considered prognostic factors for localized carcinomas. Tumor size is a prognostic criterion that also varies according to the anatomical location of these tumors. Head and neck region is the most common location. This study aimed to investigate the distribution of BCC, SCC, and MM in the anatomical subunits of the head and neck region and their relationships with these anatomical subunits. MATERIALS AND METHODS: Patients who underwent surgery for BCC, SCC, BSCC and/or MM in the head and neck region. The head and neck region was divided topographically into the following subunits: scalp, forehead, orbital region, ear and periauricular region, cheeks, nose, perioral region, and neck. Patients were analyzed according to age, sex, and tumor location, type, and size. RESULTS: The SCC group was found to have significantly larger mean tumor size than the BCC group (p = 0.003). SCC was more frequently located in the perioral region (p = 0.001), BCC was more frequently located on the nose (p = 0.001), and MM was more frequently located on the forehead and scalp (p = 0.034, p = 0.49) when compared with the other types. BCC was more frequently located in the orbital region than SCC (p = 0.018) CONCLUSIONS: In this study, we observed statistically significant differences in the distribution of BCC, SCC, and MM, the most common types of skin cancer, among the topographical subunits of the head and neck region. PMID:34047838 | DOI:10.1007/s00405-021-06901-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cytokeratin 7 and 19 expression in oropharyngeal and oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Cytokeratin 7 and 19 expression in oropharyngeal and oral squamous cell carcinoma Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 27. doi: 10.1007/s00405-021-06894-3. Online ahead of print. ABSTRACT PURPOSE: The precise etiopathogenesis of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), and reasons for predilection for crypt epithelium, remain uncertain. The purpose of this study is to investigate the interaction between HPV and specific cytokeratins 7 (CK7) and 19 (CK19) in crypt epithelium. METHODS: This is a retrospective cohort study of patients presenting between 1999 and 2015 at a tertiary referral center. CK7 and CK19 positivity and H Scores were determined by immunohistochemistry. Disease-specific and overall survival rates were analyzed. RESULTS: There were 253 patients presenting with OPSCC (134), squamous cell carcinoma (SCC) of unknown primary site (22), and oral tongue SCC (97). Primary tumor CK7 and CK19 positivity and H Scores were significantly higher in HPV-positive OPSCC than HPV-negative OPSCC and oral tongue SCC. Higher CK19 Scores, but not CK7 Scores, were also seen in regional metastases from HPV-positive OPSCC than other sites. No impact on disease-specific or overall survival was identified on multivariate analysis. CONCLUSION: The increased expression of CK7 and CK19 in HPV-positive OPSCC compared to HPV-negative disease supports the theory for a role for these cytokeratins in the etiopathogenesis of HPV-related OPSCC. PMID:34046748 | DOI:10.1007/s00405-021-06894-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proteomics reveals urine apolipoprotein A-I as a potential biomarker of acute kidney injury following percutaneous coronary intervention in elderly patients

xlomafota13 shared this article with you from Inoreader Proteomics reveals urine apolipoprotein A-I as a potential biomarker of acute kidney injury following percutaneous coronary intervention in elderly patients Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jul;22(1):745. doi: 10.3892/etm.2021.10177. Epub 2021 May 11. ABSTRACT The aim of the present study was to investigate how changes in the lipid composition are involved in early stages of acute kidney injury (AKI) following percutaneous coronary intervention (PCI-AKI) in elderly patients. A prospective nested case-control study was performed. Alterations in the urine protein accumulation were investigated in patients with and without PCI-AKI using isobaric tags for relative and absolute quantitation (iTRAQ). In addition, differentially expressed proteins (DEPs) related to lipids were confirmed using parallel reaction monitoring (PRM)-based targeted proteomics. From the cohort of elderly patients (>60 years of age), 14 (12.28%) developed AKI within 48 h after PCI. No significant differences were detected between the AKI and control (CON) groups for serum creatinine at 24 h following treatment (P=0.27). Among the DE Ps that overlapped in both the AKI-24 h/AKI-Pre (AKI group at 24 h post-PCI vs. pre-PCI) and AKI-24 h/CON-24 h groups (AKI group vs. CON group at 24 h post-PCI), only apolipoprotein A-I (apoA-I) was related to lipids, which displayed a significant upregulation in expression levels. The protein expression levels of apoA-I displayed a 5.98-fold increase at 24 h after PCI from the baseline and a 2.09-fold increase compared with the control group as determined using PRM, which exhibited a similar trend to the iTRAQ results. Using protein-protein interaction analyses, apoA-I was determined to be functionally linked to the complement and coagulation cascades, the renin-angiotensin system and the hypoxia-inducible factor-1 signaling pathway. Using the pathway analysis tool from the Kyoto Encyclopedia of Genes and Genomes, several pathways were identified to be associated with apoA-I, including fat digestion and absorption, vitamin digestion and absorption, as well as the peroxisome prolife rator activated receptor signaling pathway. In conclusion, apoA-I may be a promising biomarker for the early diagnosis of PCI-AKI in elderly patients. The role of apoA-I in the pathobiology of PCI-AKI requires further exploration. PMID:34046095 | PMC:PMC8141962 | DOI:10.3892/etm.2021.10177 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of NSAIDs on pre-osteoblast viability and osteogenic differentiation

xlomafota13 shared this article with you from Inoreader Effects of NSAIDs on pre-osteoblast viability and osteogenic differentiation Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jul;22(1):740. doi: 10.3892/etm.2021.10172. Epub 2021 May 10. ABSTRACT Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of a variety of musculoskeletal conditions, injuries and after surgery for postoperative pain management. Their use has been associated with impaired bone healing, possibly due to a multifactorial function, which may include inhibition of osteoblast recruitment and differentiation. However, up to date, there is no consensus regarding the impact of NSAIDs on bone-healing. The aim of the current study was to investigate the effects of five NSAIDs on the cellular functions of mouse MC3T3-E1 pre-osteoblasts. Cells were treated with the non-selective COX inhibitors lornoxicam and diclofenac, the COX-2 selective inhibitors parecoxib, meloxicam and paracetamol, as well as steroidal prednisolone at different doses and exposure times. The PrestoBlue™ technique was used to mea sure cell viability, an enzymatic assay was employed for alkaline phosphatase (ALP) activity and alizarin red S mineral staining was used to determine osteogenic differentiation. All drugs had a negative impact on pre-osteoblast cell growth, with the exception of paracetamol. Lornoxicam, diclofenac and meloxicam reduced ALP activity, while the other NSAIDs had no effect and prednisolone strongly increased ALP activity. In contrast, calcium deposits were either unaffected or increased by NSAID treatments but were significantly decreased by prednisolone. These results provide evidence that NSAIDs may adversely affect the viability of mouse pre-osteoblast cells but their actions on the osteogenic differentiation are drug-specific. The direct comparison of the effects of different NSAIDs and prednisolone on pre-osteoblasts may serve to place some NSAIDs in a preferential position for analgesic and anti-inflammatory therapy during bone repair. PMID:34046094 | PMC:PMC8141960 | DOI:10.3892/etm.2021.10172 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.