Migraine induced recurrent bloody otorrhea: A spontaneous extra-cranial hemorrhagic phenomena: Case series

xlomafota13 shared this article with you from Inoreader Migraine induced recurrent bloody otorrhea: A spontaneous extra-cranial hemorrhagic phenomena: Case series Via American Journal of Otolaryngology Publication date: January–February 2022 Source: American Journal of Otolaryngology, Volume 43, Issue 1 Author(s): Mashudu Tshifularo View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical outcomes of 34 patients with resistance to thyroid hormone beta: a twenty-year experience in Japan

xlomafota13 shared this article with you from Inoreader Clinical outcomes of 34 patients with resistance to thyroid hormone beta: a twenty-year experience in Japan Via radioactive iodine Endocr J. 2021 Sep 22. doi: 10.1507/endocrj.EJ21-0390. Online ahead of print. ABSTRACT Resistance to thyroid hormone beta (RTHβ) caused by germline mutations in genes encoding thyroid hormone receptor beta (TRβ) is a rare disorder. Little information is available regarding the clinical experience of this syndrome in Japan. We retrospectively reviewed the records of 34 patients with RTHβ (21 adult females and 13 adult males) with positive TRβ mutations identified at our division between 2000 and 2020. Of the 24 patients with available clinical history, 10 (41.7%) received inappropriate treatments such as antithyroid drugs, thyroidectomy, or radioactive iodine. Diagnostic delay and inappropriate management of RTHβ are still present in Japan. Every patient except one demonstrated thyroid hormone profiles indicative of syndrome of inappropriate secretion of thyrotropin (SITSH), characterized by a hormonal profile of hyperthyroxinemia with a non-suppressed TSH concentration. Since the most common forms of hyperthyroidism including Graves' disease feature elevated thyroid hormone levels with suppressed TSH concentrations, early diagnosis of SITSH is critical for preventing inappropriate management. One patient positive for anti-thyroglobulin antibody (Tg-Ab) and anti-thyroperoxidase antibody (TPO-Ab) showed remarkably elevated TSH (>200 μIU/mL) despite thyroid hormone concentrations within the reference ranges. At least one thyroid autoantibody (Tg-Ab, TPO -Ab, or thyrotropin receptor antibodies) was identified in 37.9% (11/29) of the patients tested. One patient developed overt Graves' disease nine years after ‍RTHβ diagnosis. These findings suggest that RTHβ is frequently comorbid with additional autoimmune thyroid disorders. ‍Further research is required to identify the most appropriate treatments for RTHβ patients who develop a second thyroid ‍disorder. PMID:34556608 | DOI:10.1507/endocrj.EJ21-0390 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis Via ear nose throat Ear Nose Throat J. 2021 Sep 23:1455613211044224. doi: 10.1177/01455613211044224. Online ahead of print. ABSTRACT Objective: To evaluate the clinical efficacy of topical nasal Pomegranate Fruit Extract (PFE) for Chronic Rhinitis (CR), Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP), and Chronic Rhinosinusitis without Nasal Polyposis (CRSsNP). Methods: Prospective, double-blinded, randomized study including 111 consecutive patients, between April 2012 and Ja nuary 2017, afflicted by CRSwNP, CRSsNP, and CR. Patients from each group were randomly assigned to either PFE treatment or placebo twice daily for 30 days. Therapeutic efficacy was assessed by Ear Nose and Throat, blood and tomographic examinations, and the SNOT-20 questionnaire. Results: CR patients treated with PFE suffered significantly less from thick nasal discharge, difficulty falling asleep, reduced productivity, reduced concentration, and sadness (P = .004, P = .02, P = .03, P = .007 and P = .02, respectively). Conclusions: Topical nasal PFE was found to have some benefits for CR patients, however, not for CRS with or without Nasal Polyposis. PMID:34555945 | DOI:10.1177/01455613211044224 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical de-escalation for head and neck cancer surgery

xlomafota13 shared this article with you from Inoreader Surgical de-escalation for head and neck cancer surgery Via Association française pour l'étude du cancer Bull Cancer. 2021 Sep 20:S0007-4551(21)00302-7. doi: 10.1016/j.bulcan.2021.06.008. Online ahead of print. ABSTRACT Head and neck cancer surgery often has functional and aesthetic consequences. De-escalation surgery is a major concern for surgeons with a constant desire to develop surgical techniques with less invasive approaches and to preserve anatomical structures as much as possible. This was made possible by the appearance of minimally transoral and endonasal surgery as well as by the limitation of the surgical procedure by neoadjuvant treatments or by the limitation of surgical excision without compromising the oncological outcome and patient survival. This evolution continues with the arrival of new technologies such as virtual reality or artificial intelligence. PMID:34556292 | DOI:10.1016/j.bulcan.2021.06.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rupture of a superficial temporal artery pseudoaneurysm following craniotomy

xlomafota13 shared this article with you from Inoreader Rupture of a superficial temporal artery pseudoaneurysm following craniotomy Via leak of cerebrospinal fluid J Surg Case Rep. 2021 Sep 8;2021(9):rjab379. doi: 10.1093/jscr/rjab379. eCollection 2021 Sep. ABSTRACT Pseudoaneurysm of the superficial temporal artery (STA) is a rare entity that has been reported in the literature after trauma or iatrogenic injuries. We describe a unique case of STA pseudoaneurysm rupture and the clinical sequelae associated with its rupture. We report a case of pseudoaneurysm rupture of the STA that occurred 14 days after craniotomy for cerebrospinal fluid leak repair. We also review the literature, diagnosis and treatment of external carotid artery aneurysms. Rupture of a STA pseudoaneurysm is a previously unreported and serious complication that must be quickly recognized in order to control hemorrhage that may have life threatening complications. PMID:34557290 | PMC:PMC8453294 | DOI:10.1093/jscr/rjab379 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study

xlomafota13 shared this article with you from Inoreader Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric 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 Sep 24. doi: 10.1007/s00405-021-07076-x. Online ahead of print. ABSTRACT PURPOSE: Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC. METHODS: We collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan-Meier method. RESULTS: We identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi's sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI95 2.15-16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies. CONCLUSION: Non-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival. PMID:34557960 | DOI:10.1007/s00405-021-07076-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parapharyngeal Lymph Node Metastasis From Papillary Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Parapharyngeal Lymph Node Metastasis From Papillary Thyroid Carcinoma Via ear nose throat Ear Nose Throat J. 2021 Sep 24:1455613211045566. doi: 10.1177/01455613211045566. Online ahead of print. ABSTRACT Metastatic parapharyngeal lymph nodes (LNs) from papillary thyroid carcinomas (PTC) are uncommon and can easily remain undetected. We describe a case that involves a 62-year-old woman treated for a PTC, who presented a rise in serum thyroglobulin (TG) levels. A computed tomography scan was performed, and revealed metastatic nodes in the left parapharyngeal space (P PS). A surgical resection of the nodes was performed with external cervical approach. A histological exam confirmed the diagnosis of a metastatic LN of a PTC. The aim of this report is to emphasize on the possibility of parapharyngeal metastatic nodes in PTC and to describe the diagnosis methods, treatment options, and impact on the prognosis. PMID:34558348 | DOI:10.1177/01455613211045566 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alternate dosage formulations of oral targeted anticancer agents

xlomafota13 shared this article with you from Inoreader Alternate dosage formulations of oral targeted anticancer agents Via swallowing exercises J Oncol Pharm Pract. 2021 Sep 24:10781552211037976. doi: 10.1177/10781552211037976. Online ahead of print. ABSTRACT OBJECTIVE: Oral anticancer therapies have demonstrated superior outcomes compared to traditional cytotoxic chemotherapy in many disease states. However, certain patients may not be candidates for these agents due to odynphagia or dysphagia. The purpose of this review is to summarize the data for extemporaneous compounding of oral anticancer agents. DATA SOURCES: Food and drug administration approvals of oncology agents were reviewed to identify oral anticancer therapies. In order to find alternative administration options: the package inserts of each of these agents were reviewed, each medication was searched in a tertiary drug information resource, the medical information teams of each drug manufacturer were contacted to inquire about proprietary data, sites with pediatric trials were contacted, a primary literature search was performed, and listservs for national pharmacy and oncology organizations were reviewed. DATA SUMMARY: Eighty-five food and drug administration-approved oral anticancer therapies were identified to be included. Of those agents, nine (11%), had information in the package insert related to alternative administration. After further research, 46 (54%) of the agents had some information related to alternate formulations for administration. The recipes and stability of each of these compounds is included. CONC LUSIONS: The majority of agents do not have Phase I or II trials that assess safety or pharmacokinetics of alternative formulations. Clinicians should exercise caution when recommending or administering these agents outside of food and drug administration-approved indicated use and utilize clinical judgment in assessing the risks and benefits of altering anticancer compounds. However, the alternative administration considerations presented can increase access to oncology patients who have difficulty swallowing. PMID:34558356 | DOI:10.1177/10781552211037976 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual bilateral variation of the flexor digitorum accessorius longus muscle and its relation on tarsal tunnel syndrome

xlomafota13 shared this article with you from Inoreader Unusual bilateral variation of the flexor digitorum accessorius longus muscle and its relation on tarsal tunnel syndrome Via radiol anat Surg Radiol Anat. 2021 Sep 24. doi: 10.1007/s00276-021-02840-4. Online ahead of print. ABSTRACT PURPOSE: During standard anatomical dissection for a medical anatomy course, we encountered an unusual bilateral variant of a unipennate flexor digitorum accessorius longus (FDAL) muscle, a supernumery muscle of the deep posterior leg and medial ankle. METHODS: We documented the muscles course and measured the diameter and length of the FDAL muscle belly, as well as the full length of its tendinous attachments. RESULTS: On both right and left legs, the FDAL originated from the proximal posterior fibula and distal one-third of the flexor hallucis longus muscle. The tendon had a distal attachment on the flexor digitorum longus (FDL) tendon and traveled with the FDL tendon as it inserted on the third distal phalanx. The left FDAL full length was 42.54 cm; the length of the muscle belly was 16.26 cm; and the circumference of the muscle belly was 4.44 cm. The right FDAL full length was 44.20 cm; the length of muscle belly was 12.06; and the circumference (belly) was 4.44 cm. Surrounding musculature and neurovasculature follow standard anatomical courses. CONCLUSION: This anatomical documentation provides opportunities for clinicians to consider mechanical influences of the FDAL on plantar foot function and further consider the accessory ankle muscles that have the potential to cause compressive neuropathies such as tarsal tunnel syndrome. P MID:34559293 | DOI:10.1007/s00276-021-02840-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical results of tympanoplasty after conversion to the endoscopic approach performed by a surgeon experienced in microscopic surgery

xlomafota13 shared this article with you from Inoreader Surgical results of tympanoplasty after conversion to the endoscopic approach performed by a surgeon experienced in microscopic surgery 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 Sep 24. doi: 10.1007/s00405-021-07093-w. Online ahead of print. ABSTRACT PURPOSE: The aim of this study was to analyze the surgical outcomes of endoscopic tympanoplasty (ET) type I, and to investigate the learning curve of ET type I in a surgeon experienced in microscopic surgery. METHODS: We retrospectively studied patients with tympanic membrane perforations who had undergone ET type I from January 2015 to June 2020. All procedures were performed by a single senior surgeon with considerable microscopic experience. We compared the perforation closure rate in relation to age, previous ear surgery history, graft material, size, and location of perforation. We compared the operation time according to the number of operated patients. RESULTS: A total of 399 patients were enrolled. The success rate of ET type I was 92.7%. Age, prior ear surgery, graft material, size, and location of perforation d id not influence the surgical outcomes. The surgical time for the initial ten cases was the longest (78.3 min), and stabilized after the first 100 cases to under 60 min. The surgical success rate was 96.0% in the first 50 cases, and decreased to approximately 92% afterwards. CONCLUSION: The surgical time largely decreased with the number of operated patients. Since the operations were performed by a surgeon experienced in microscopy, the success rate of initial cases was not low, even though the operation time of these initial cases was longer. We believe that endoscope provides a new perspective on ear surgery if it could overcome the difficulties in the early stage. PMID:34559270 | DOI:10.1007/s00405-021-07093-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of hyaluronic acid on the bone healing after lateral osteotomy: an experimental animal model

xlomafota13 shared this article with you from Inoreader Effects of hyaluronic acid on the bone healing after lateral osteotomy: an experimental animal model 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 Sep 24. doi: 10.1007/s00405-021-07096-7. Online ahead of print. ABSTRACT OBJECTIVE: Postoperative comfort of the patients undergoing rhinoplasty might be poor because of edema and ecchymosis caused by lateral osteotomy. In this animal experiment, we aimed at performing a quantitative assessment of effects of hyaluronic acid usage on healing process of lateral osteotomy. METHODS: Fourteen New Zealand rabbits with a weight of 2000-2500 kg and an age of 8-12 weeks were included. Under anesthesia, nasal dorsums were exposed with midline incision and lateral osteotomies on both sides were performed using a 2 mm chisel. A hyaluronic acid-based mesh (Hyalonect®) (1 × 1 cm) was embedded on the left osteotomy areas of all rabbits. Right osteotomy areas were left blank as control group. Collagen density and capillary development were quantitatively compared. RESULTS: Convergence of fractur e lines was observed in 6 (60%) of 10 samples from Hyalonect® group, while was observed in 4 (40%) of 10 samples from control group. Although a higher rate of convergence was seen in the Hyalonect® group (60% vs 40%), the difference was not statistically significant (p = 0.5). Median collagen score was 2 (1-3) in the Hyalonect® group and 1 (1-2) in the control group. Median capillary count value was 4 (1-23) in the Hyalonect® group and 3 (1-17) in the control group. Both collagen score and capillary count values were significantly greater in the in the Hyalonect® group compared with the control group (p = 0.023 and p = 0.019, respectively). CONCLUSION: The effects of hyaluronic acid-based meshes on the bone healing process of the lateral osteotomy area might be investigated furthermore, on more comprehensive studies, as a material facilitating collagen organization and capillary development. PMID:34559272 | DOI:10.1007/s00405-021-07096-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.