Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes

xlomafota13 shared this article with you from Inoreader Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes Via Otolaryngology Indian Abstract Chronic kidney is being increasingly recognized as a global health problem with effects that have implications for both mortality and morbidity; with hearing loss being one of the effects that has an impact on quality of life. This study aimed to describe hearing function in a group of children with chronic renal dysfunction receiving treatment in an academic hospital in Johannesburg, South Africa. One hundred children between the ages 5 and 18 years (mean age 11.68) were included in the study. A cross-sectional, descriptive, quantitative research design was employed. All participants underwent a case history interview and an audiological examination which included otoscopy, immittance testing, pure tone audiometry including extended high frequency testing up to 16 kHz as well as diagnostic distortion product otoacoustic emission testing. A medical record review was also done. Both descriptive and inferential statistics were used to analyze the collecte d data. Results revealed that there was a high prevalence of hearing loss in this group. The most common hearing loss was a low and high to ultrahigh frequency mild sensorineural hearing loss. No relationship between the severity of hearing loss and the severity of renal dysfunction, or the duration of renal dysfunction and the duration of treatment was found. However, a relationship between the severity of hearing loss and certain treatments was found. These were v hemodialysis and the use of ototoxic medication such as loop diuretics, tuberculosis medication, and antimalarial medication. Current findings highlight the importance of extended high frequency audiometry as well as diagnostic distortion product otoacoustic emission testing for early detection of hearing impairment, in pursuit of preventive audiology outcomes, in ototoxic monitoring in this population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autologous reconstructions are associated with greater overall medium-term care costs than implant-based reconstructions in the Finnish healthcare system: A retrospective interim case-control cohort study

xlomafota13 shared this article with you from Inoreader Autologous reconstructions are associated with greater overall medium-term care costs than implant-based reconstructions in the Finnish healthcare system: A retrospective interim case-control cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00407-1. doi: 10.1016/j.bjps.2021.08.020. Online ahead of print. ABSTRACT PURPOSE: Previous studies have mainly reported the short-term costs of different reconstruction techniques. Revision operations may increase costs in longer follow-up. Authors report medium-term data on different reconstruction methods. We hypothesised that the reconstruction method would affect not only the duration of reconstruction process but also total costs. METHODS: The reconstruction database was reviewed from 2008 to 2019. Women with autologous (deep inferior epigastric perforator, transverse musculocutaneous gracilis and latissimus dorsi [LD] without implant) and implant-based (implant and LD with implant) reconstructions were included. Variables evaluated included age, body mass index, smoking, comorbidities, radiotherapy, complications and readmissions. Risk factors for multiple revision s urgeries were analysed. Time to definitive reconstruction and related costs were also calculated. RESULTS: In total, 591 patients with autologous reconstructions and 202 with implant-based reconstructions were included. The median follow-up time was 73 months. Definitive reconstruction was obtained in 443 days in implant-based reconstructions and in 403 days in autologous reconstructions (P = 0.050). Independent risk factors for multiple surgeries were younger age (P < 0.001) and comorbidity (P = 0.008). No statistically significant difference was observed in the rate of overall surgical procedures (P = 0.098), but implant-based reconstructions were more commonly associated with two or more planned operations (P = 0.008). Autologous reconstructions were associated with greater total cost ($22 052 vs. $18 329, P < 0.001). CONCLUSIONS: This review of reconstructions over a 12-year study period revealed that autologous reconstructions are associated with greater overa ll costs, but there is no statistically significant difference in reconstruction time or rate of surgical procedures. However, a full cost assessment between reconstructive techniques requires a much longer follow-up period. PMID:34627717 | DOI:10.1016/j.bjps.2021.08.020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Second dorsal metacarpal artery-based index finger dorsal island flap for the management of thumb defects

xlomafota13 shared this article with you from Inoreader Second dorsal metacarpal artery-based index finger dorsal island flap for the management of thumb defects Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00403-4. doi: 10.1016/j.bjps.2021.08.016. Online ahead of print. ABSTRACT Index finger dorsal island flaps were frequently utilized by hand surgeons to reconstruct thumb defects. However, the blood supply of the traditional index finger dorsal island flap comes from the first dorsal metacarpal artery, which has a smaller diameter, more anatomical variation, and can be injured in conjunction with thumb injuries. Therefore, we design an alternative index finger dorsal island flap based on the second dorsal metacarpal artery to treat thumb skin defects. From August 2015 to October 2018, we used the index finger dorsal island flaps with the second dorsal metacarpal artery to treat 11 patients with thumb skin defects. All the flaps and skin grafts survived completely without complications. At the last follow-up, the mean 2PD of the flap was 6.4 mm (45.5% for excellent, 54.5% for good) , the mean ROM of the injured thumbs was 115.9° (72.7% for excellent, 27.3% for good), and the mean cosmetics score was 8.6. Our results demonstrate that the index finger dorsal island flap with the second dorsal metacarpal artery is suitable for the reconstruction of thumb skin defects. The flap has an excellent survival rate and good coverage with satisfactory results and represents a promising treatment for the selected patients. Level of Evidence: Therapeutic, level IV. PMID:34627716 | DOI:10.1016/j.bjps.2021.08.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Therapeutic efficacy of selective intra-arterial chemoradiotherapy with docetaxel and nedaplatin for fixed bulky nodal disease in head and neck cancer of unknown primary

xlomafota13 shared this article with you from Inoreader Therapeutic efficacy of selective intra-arterial chemoradiotherapy with docetaxel and nedaplatin for fixed bulky nodal disease in head and neck cancer of unknown primary 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 Oct 10. doi: 10.1007/s00405-021-07121-9. Online ahead of print. ABSTRACT PURPOSE: Fixed bulky nodal disease in patients with head and neck cancer of unknown primary (HNCUP) remains difficult to treat. This retrospective study evaluated the therapeutic efficacy of selective intra-arterial chemoradiotherapy with docetaxel and nedaplatin for fixed bulky nodal disease in HNCUP. METHODS: Data from seven consecutive patients with fixed bulky nodal disease in HNCUP who had undergone selective intra-arterial chemoradiotherapy were analyzed. Whole pharyngeal mucosa and all bilateral nodal areas were irradiated (total dose 50 Gy), and bulky nodal lesions were provided an additional 20 Gy. Intra-arterial chemotherapy used a combination of nedaplatin (80 mg/m2) and docetaxel (60 mg/m2). Outcome measures were local control, disease-free survival, overall survival, and adverse events. Stati stical analyses were performed using the Kaplan-Meier method. RESULTS: Median follow-up period was 24 months (range 9-64). All patients had extracapsular extension (N3b) on imaging and clinical findings. Symptoms due to bulky disease were neck discomfort (100%), tumor bleeding (43%), tracheal obstruction (14%), and carotid sinus syndrome (28%). Median value for maximum diameter of cervical disease was 84 mm (range 70-107), and 3-year local control, disease-free survival, and overall survival rates were 100, 54, and 64%, respectively. Symptoms due to bulky disease disappeared in all patients after intra-arterial chemoradiotherapy. Grade 4 leukopenia occurred in two patients (28%) as an acute adverse event. No other serious acute adverse events were observed. CONCLUSION: Selective intra-arterial chemoradiotherapy with docetaxel and nedaplatin can potentially achieve both favorable local control and survival in in HNCUP with fixed bulky nodal disease. PMID:34628548 | DOI:10.1007/s00405-021-07121-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment modalities, adverse events, and survival outcomes in older patients with head and neck squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Treatment modalities, adverse events, and survival outcomes in older patients with head and neck squamous cell carcinoma Via Head & Neck Abstract Background Chemoradiation with curative intent in older adults with locally advanced head and neck squamous cell carcinoma (HNSCC) has been a challenge, because of its potential toxicities. Methods We selected primary HNSCC cases from the SEER-Medicare linked database, assessed overall survival (OS) and adverse events and their associations with different treatments, across four age groups including the youngest (66–69 years) and the oldest (≥80 years). Results Better OS was associated with chemoradiation compared to radiation alone, not only in all patients (N = 5879) (hazard ratio [HR] = 0.82, p < 0.001), but also in the oldest group (N = 1380) (HR = 0.77, p = 0.006) in whom the adverse events rates were not higher than those in the youngest (N = 1562); more of the latter (26%–30%) than the former (14%–19%) received chemoradiation, regardless of their comorbidity indices. Conclusions Our findings provide evidence that patients' characteristics, other than chronological age, should be equally considered in selecting the best therapy for older patients with HNSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Ewing's sarcoma with orbit involvement: Survival and visual outcomes after eye‐sparing multidisciplinary management in eight patients

xlomafota13 shared this article with you from Inoreader Primary Ewing's sarcoma with orbit involvement: Survival and visual outcomes after eye‐sparing multidisciplinary management in eight patients Via Head & Neck Abstract Background To describe the clinical presentation, treatment, and overall prognosis in eight patients with primary Ewing's sarcoma (ES) involving the orbit. Methods A retrospective interventional study of all biopsy-proven cases of primary ES involving the orbit was done. Results There were seven males and one female with a median age of 14 years. Imaging showed osseous involvement in all eight cases with extraorbital extension in four. Complete tumor resection was done in four, partial resection in three, and biopsy followed by sinus surgery in one. EWSR1 gene rearrangement analysis was done to confirm diagnosis. All patients received multidrug systemic chemotherapy and seven patients received adjuvant radiotherapy. Eye salvage was achieved in all patients. At a mean follow-up duration of 52.63 months, seven patients were doing well with no evidence of disease. Conclusions ES involving the orbit is sensitive to chemotherapy and radiation. Aggressive multimodality treatment can help salvage the globe and improve overall survival. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of 3D-Printed Model in the Cervical Spine Osteochondroma Surgery: A Case Report

xlomafota13 shared this article with you from Inoreader Application of 3D-Printed Model in the Cervical Spine Osteochondroma Surgery: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Oct 10:1455613211040577. doi: 10.1177/01455613211040577. Online ahead of print. ABSTRACT A 73-year-old woman having a throat lump sensation and dysphagia for the past several months presented at our otorhinolaryngology outpatient clinic. A physical examination disclosed a protruding subepithelial mass over the right tonsil fossa. The mass was not tender and had no mucosal lesions or signs of active infection. Therefore, we arranged face and neck compu ted tomography scans, which reported a solitary osseous lesion over the anterior-right aspect of the C1-2 joint. Considering the rarity and unfamiliar anatomy of this disease, we built a 3D-printed model to assist with the surgical rehearsal of the procedure as well as with a preoperation discussion with the patient and her family. We arranged a combined Otolaryngology-Neurosurgery department approach after discussion with the neurosurgeon and successfully removed the lesion without sacrificing the overlying longus capitis muscle. The pathology examination revealed no evidence of malignancy. The final diagnosis was cervical spine solitary osteochondroma. The patient had a complete recovery of both oral cavity and normal swallowing function. No tumor recurred during the 3-year follow-up. On the basis of this case, in-house 3D-printing technology can offer a rapid, reliable model for an interdisciplinary team to use to enhance personalized presurgical planning, thus providing better p atient engagement during hospitalization. PMID:34628970 | DOI:10.1177/01455613211040577 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Renal tumor biomarkers (Review)

xlomafota13 shared this article with you from Inoreader Renal tumor biomarkers (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1297. doi: 10.3892/etm.2021.10732. Epub 2021 Sep 14. ABSTRACT One of the most common types of cancer worldwide (9th most commonly diagnosed) is renal cell carcinoma (RCC). It is more common in developed countries and it usually develops in individuals between 60 and 70 years of age. The earlier the disease is identified, the lower the morbidity. Therefore molecular markers that exist in blood and urine may be used for earlier detection and diagnosis but also for the follow-up of the patient after treatment, whether surgical or oncological. The trend is to analyze the gene and protein expression as they constitute a source for new biomarkers. These markers are promising but in clinical practice regarding disease management, they are rarely used. Biological markers can be employed in many tumors because they can identify the prognostic value for individual treatment. However, markers for RCC are not validated , and their analysis is currently under investigation. Previous findings have demonstrated that the metastatic potential of RCC can be predicted using the biological features of the tumor cell. It is believed that the transformation from epithelial to mesenchymal phenotype gives the tumor cell the ability to metastasize. The purpose of this review was to identify the most valuable tumor markers that can be clinically used for the prognosis, treatment and follow-up of patients with renal tumors. PMID:34630652 | PMC:PMC8461509 | DOI:10.3892/etm.2021.10732 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

miR-489-3p overexpression inhibits lipopolysaccharide-induced nucleus pulposus cell apoptosis, inflammation and extracellular matrix degradation via targeting Toll-like receptor 4

xlomafota13 shared this article with you from Inoreader miR-489-3p overexpression inhibits lipopolysaccharide-induced nucleus pulposus cell apoptosis, inflammation and extracellular matrix degradation via targeting Toll-like receptor 4 Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1323. doi: 10.3892/etm.2021.10758. Epub 2021 Sep 20. ABSTRACT Intervertebral disc degeneration (IDD) is a common disease with a high morbidity rate, which results in a significant deterioration in the quality of life of patients. MicroRNAs (miRNAs/miRs) are a class of endogenous small non-coding RNAs that influence target genes and serve critical roles in numerous biological processes. However, the role of miR-489-3p in lumbar disc degeneration is yet to be elucidated. In the present study, human NP cells were treated with 10 ng/ml lipopolysaccharide (LPS) for 24 h to investigate the role of miR-489-3p in IDD in an in vitro model. Reverse transcription-quantitative (RT-q)PCR was performed to determine the expression levels of miR-489-3p. Then, the TargetScan database was used to predict the potential binding sites between miR-489-3p and Toll-like receptor (TLR)4, and a dual-luciferase reporter assay was performed to verify the findings. Subsequently, RT-qPCR and western blotting were used to analyze the expression levels of TLR4. In addition, human nucleus pulposus (NP) cells were transfected with a miR-489-3p mimic and TLR4 overexpression plasmid to study the effects of miR-489-3p on LPS-induced human NP cells. Cell apoptosis and cell viability were also determined using flow cytometry and MTT assays, respectively. Finally, ELISAs were performed to analyze the levels of inflammatory factors. The expression levels of miR-489-3p were discovered to be downregulated in LPS-treated human NP cells. In addition, TLR4 was revealed to be a direct target gene of miR-489-3p, and its expression levels were upregulated in LPS-treated human NP cells. miR-489-3p was found to inhibit the LPS-induced decreases in cell viability and increases in apoptosis, and the concentration of inflammatory cytokines. Furthermore, miR-489-3p suppressed the LPS-induced decreases in extracellular matrix deposi tion via decreasing the expression levels of aggrecan and collagen type II in human NP cells. Finally, the results revealed that miR-489-3p inhibited the LPS-induced activation of the NF-κB signaling pathway in human NP cells. Conversely, all of the effects of miR-489-3p on LPS-induced human NP cells were reversed by the TLR4 overexpression plasmid. These findings suggested that miR-489-3p may represent a novel therapeutic target for the treatment of IDD. PMID:34630677 | PMC:PMC8495590 | DOI:10.3892/etm.2021.10758 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of ulinastatin on renal perfusion evaluated by Doppler ultrasonography in a porcine model of septic shock

xlomafota13 shared this article with you from Inoreader Effects of ulinastatin on renal perfusion evaluated by Doppler ultrasonography in a porcine model of septic shock Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1324. doi: 10.3892/etm.2021.10759. Epub 2021 Sep 20. ABSTRACT The present study aimed to evaluate the effect of ulinastatin (UTI) on renal perfusion using Doppler ultrasonography in a porcine model of septic shock induced by smoking inhalation and live methicillin-resistant Staphylococcus aureus instillation. A total of 32 healthy Landrace pigs were randomly assigned into the following four groups: Sham group (SH; n=5), septic shock group (SS; n=9), septic shock treated with vancomycin (15 mg/kg) group (VAN; n=9) and septic shock treated with UTI (50,000 U/kg) + vancomycin (UTI; n=9) group. Renal perfusion was evaluated by contrast-enhanced ultrasound (CEUS) at baseline and at the end of the protocol (24 h). The spectrum of interlobar or arcuate artery was selected to calculate the corrected resistive index (cRI). Sulphur hexafluoride microbubbles were bolus injected via a venous catheter. The peak i ntensity (Pi) and area under curve (AUC) were calculated using a time-intensity curve. Compared with the baseline group, cRI was increased significantly at the end of the protocol, except for that in the SH group, whereas Pi decreased significantly after injury in all experimental groups but was higher in the UTI group compared with that in the SS and VAN groups (both P<0.001). Linear correlation was found between the cardiac output (CO) and Pi (R2=0.752; P<0.001). The AUC was significantly decreased after injury in the SS and VAN groups compared with the baseline group. All parameters detected by CEUS were improved in the UTI group, and significant differences were found between the UTI and SS or VAN group (all P<0.05). In conclusion, acute renal injury, which occasionally occurs during septic shock, is accompanied with a significantly lower perfusion rate in the renal microcirculation. By contrast, UTI can significantly improve renal perfusion, which can be rel iably evaluated using CEUS. PMID:34630678 | PMC:PMC8495549 | DOI:10.3892/etm.2021.10759 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Honokiol combined with curcumin sensitizes multidrug-resistant human lung adenocarcinoma A549/DDP cells to cisplatin

xlomafota13 shared this article with you from Inoreader Honokiol combined with curcumin sensitizes multidrug-resistant human lung adenocarcinoma A549/DDP cells to cisplatin Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1301. doi: 10.3892/etm.2021.10736. Epub 2021 Sep 16. ABSTRACT The aim of the present study was to discuss the effects and underlying mechanisms of honokiol (HNK) and/or curcumin (CUR) in sensitization of multidrug-resistant human lung adenocarcinoma A549/DDP cells to cisplatin (DDP). An MTS assay was performed to detect the cytotoxicity of HNK, CUR and DDP in A549 and A549/DDP cells and compare their sensitivity. The A549/DDP cells were then divided into 8 groups: Control, HNK, CUR, DDP, HNK + CUR, HNK + DDP, CUR + DDP and HNK + CUR + DDP. Cell proliferation was measured by MTS assay and colony formation assay, cell apoptosis was detected by flow cytometry, cell invasion was evaluated by Transwell assay and cell migration was determined by a wound healing assay. In order to investigate the possible mechanisms, P-glycoprotein (P-gp) protein expression was measured by western blotting and immunofluorescence a ssays. The mRNA expression levels of AKT, Erk1/2, cyclin-dependent kinase inhibitor 1 (P21), caspase 3, cleaved caspase 3, caspase 9, cleaved caspase 9, poly (ADP-ribose) polymerase (PARP), cleaved PARP, matrix metalloproteinase (MMP)-2 and MMP-9 were examined by reverse transcription-quantitative (RT-q) PCR assay, and the protein expression levels of phosphorylated (p)-AKT, p-Erk1/2, P21, caspase 3, cleaved caspase 3, caspase 9, cleaved caspase 9, PARP, cleaved PARP, MMP-2 and MMP-9 proteins expression by western blot assay. The MTS assay demonstrated that HNK (5 µg/ml), CUR (10 µg/ml) and DDP (5 µg/ml) had no obvious toxicity to A549/DDP cells, and HNK, CUR and DDP were more sensitive in A549 cells compared with A549/DDP cells. The optimal concentrations of HNK (5 µg/ml), CUR (10 µg/ml) and DDP (5 µg/ml) were chosen to carry out the further experiments. Compared with the control group, no significant change was observed in cell proliferation, apoptosis, migration, invasion a nd related mRNA and protein expression in HNK, CUR, DDP and HNK + CUR groups. The cell proliferation rate in the HNK + DDP and CUR + DDP groups was significantly suppressed with cell apoptosis significantly increased, respectively. The invasion cell number and wound healing rate of HNK + DDP and CUR + DDP groups were significantly depressed compared with the control group, respectively. Immunofluorescence demonstrated that the nuclear volume of P-gp in HNK + DDP and CUR + DDP groups were significantly downregulated compared with the control group, respectively. The RT-qPCR assay demonstrated that the AKT, Erk1/2 and P21 mRNA expression levels were significantly decreased and cleaved caspase 3, cleaved caspase 9 and cleaved PARP were increased in HNK + DDP and CUR + DDP groups compared with the control group. The western blotting results were consistent with the RT-qPCR results. NK + CUR + DDP had improved effects on A549/DDP compared with HNK + DDP or CUR + DDP group, respectively. HNK and/or CUR could improve the sensitivity of DDP to A549/DDP cell by the regulation of P-gp, inducing apoptosis, and inhibiting migration and invasion via AKT/ERK signal pathway in an in vitro study. PMID:34630656 | PMC:PMC8461625 | DOI:10.3892/etm.2021.10736 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.