Heavily T2-Weighted Magnetic Resonance Myelography as a Safe Cerebrospinal Fluid Leakage Detection Modality for Nontraumatic Subdural Hematoma

xlomafota13 shared this article with you from Inoreader Heavily T2-Weighted Magnetic Resonance Myelography as a Safe Cerebrospinal Fluid Leakage Detection Modality for Nontraumatic Subdural Hematoma Via leak of cerebrospinal fluid J Korean Neurosurg Soc. 2021 Nov 12. doi: 10.3340/jkns.2020.0326. Online ahead of print. ABSTRACT OBJECTIVE: Nontraumatic subdural hematoma (SDH) is a common disease, and spinal cerebrospinal fluid (CSF) leakage is a possible etiology of unknown significance, which is commonly investigated by several invasive studies. This study demonstrates that heavily T2-weighted magnetic resonance myelography (HT2W-MRM) is a safe and clinically effective imaging modality for detecting CSF leakage in patients with nontraumatic SDH. METHODS: All patients who underwent HT2W-MRM for nontraumatic SDH workup at our institution were searched and enrolled in this study. Several parameters were measured and analyzed, including patient demographic data, initial modified Rankin Scale (mRS) score upon presentation, SDH bilaterality, hematoma thickness upon presentation, CSF leakage sites, treatment modalities, followup hematoma thickness, and follow-up mRS scor e. RESULTS: Forty patients were identified, of which 22 (55.0%) had CSF leakage at various spinal locations. Five patients (12.5%) showed no change in mRS score, whereas the remaining (87.5%) showed decreases in follow-up mRS scores. In terms of the overall hematoma thickness, four patients (10.0%) showed increased thickness, two (5.0%) showed no change, 32 (80.0%) showed decreased thickness, and two (5.0%) did not undergo follow-up imaging for hematoma thickness measurement. CONCLUSION: HT2W-MRM is not only safe but also clinically effective as a primary diagnostic imaging modality to investigate CSF leakage in patients with nontraumatic SDH. Moreover, this study suggests that CSF leakage is a common etiology for nontraumatic SDH, which warrants changes in the diagnosis and treatment strategies. PMID:34763379 | DOI:10.3340/jkns.2020.0326 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trends in adult otitis media incidence ‐ a 20‐year national observational study in Sweden

xlomafota13 shared this article with you from Inoreader Trends in adult otitis media incidence ‐ a 20‐year national observational study in Sweden Via Clinical Otolaryngology Abstract Literature on OM incidence in adults is scarce, as are studies about possible herd immunity effects of childhood PCV on adult OM. PCV was introduced in the Swedish paediatric vaccination programme in 2009. Hospital admissions for suppurative OM in adults were halved between 2000 and 2019. In this study, the decrease in hospital admissions for suppurative OM was most apparent in younger adults Outpatient visits for suppurative OM in adults decreased by 38% after 2009, mostly in older adults. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary herpetic oropharyngitis in adults: Differences in clinical features between Herpes simplex virus type 1 and type 2. A retrospective study.

xlomafota13 shared this article with you from Inoreader Primary herpetic oropharyngitis in adults: Differences in clinical features between Herpes simplex virus type 1 and type 2. A retrospective study. Via Clinical Otolaryngology Abstract This is the first report on the differences between adult primary herpetic oropharyngitis caused by the two types of the herpes simplex virus (HSV). Forty-one (25 type 1 and 16 type 2) HSV specific antigen positive cases among 68 immunoserologically confirmed adult primary HSV infection cases were investigated. A significantly low incidence of oral lesions and high incidence of nausea were seen in HSV type 2 oropharyngitis cases, which potentially indicates an association between the vagus nerve and HSV type 2 infection. Significantly increased white blood cell count and elevated C-reactive protein level were observed in HSV type 2 oropharyngitis cases. HSV type 2 possibly causes more severe symptoms and inflammatory reactions than HSV type 1. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

One dose of preoperative, intravenous, prophylactic antibiotics significantly lowers postoperative infection rate in septoplasty – a study of 772 operations

xlomafota13 shared this article with you from Inoreader One dose of preoperative, intravenous, prophylactic antibiotics significantly lowers postoperative infection rate in septoplasty – a study of 772 operations Via Clinical Otolaryngology ABSTRACT Objectives  Postoperative infection is the most common complication after septoplasty. Pre- or postoperative prophylactic antibiotics are commonly used, although no official guidelines exist. Design  We retrospectively collected data on postoperative infections from 772 septoplasties performed in 2015, 2016, and 2018, and classified the infections according to surgical-site infection (SSI) criteria by the Centers for Disease Control and Prevention (CDC). We evaluated the infections according to antibiotic use (preoperative or postoperative, both, or none) and accounted for patient and surgical confounding factors. We compared the results with three previous studies from our department to find out the trend in the occurrence of postoperative infections and in the use of antibiotics. Results  Twenty-nine cases (3.8%) fulfilled CDC infection criteria. Any kind of antibiotic prophylaxis reduced the risk of SSI (p=0.018). One dose of intravenous cefuroxime before incision was the most effective preventive measure (p=0.045). We found no significant effect of postoperative antibiotics. However, postoperative antibiotics lowered the infection rate to 1.8% compared to 6.1% among those not treated with any antibiotics. The only other factor reducing the risk of SSI was local anaesthesia compared to general anaesthesia. Conclusion  Preoperative antibiotic prophylaxis effectively reduced postoperative infection rate after septoplasty. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic value of three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging sequences at 1.5 Tesla in management of sudden sensorineural hearing loss: Our experience in 20 patients

xlomafota13 shared this article with you from Inoreader Diagnostic value of three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging sequences at 1.5 Tesla in management of sudden sensorineural hearing loss: Our experience in 20 patients Via Clinical Otolaryngology Abstract 3D-FLAIR 1.5-Tesla MRI sequences can detect abnormalities that show as signal hyperintensity in patients with unilateral SSHL. We propose a simple objective method to detect these abnormalities based on the quantitative calculation of affected versus healthy contralateral ear signal intensity ratios. This signal hyperintensity may involve the cochlea, vestibule or the entire inner ear of affected ears. Such abnormalities were found in 45% of patients with SSHL, and hyperintensity was associated with lower initial and final hearing levels, as well as a lower ≥ 10 dB hearing recovery and more vertigo. We put hyperintensity itself forward as a marker of poor prognosis for patients with SSHL. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A randomised trial of single or extended dosing ciprofloxacin versus no intervention for Prevention of Ventilation Tube Otorrhoea and Obstruction (PreVenTO2)

xlomafota13 shared this article with you from Inoreader A randomised trial of single or extended dosing ciprofloxacin versus no intervention for Prevention of Ventilation Tube Otorrhoea and Obstruction (PreVenTO2) Via Clinical Otolaryngology Abstract Objectives To determine the effectiveness of ciprofloxacin 0.3% antibiotic eardrops in preventing clinically significant postoperative otorrhoea and tube obstruction following grommet insertion in children. Design 3-arm parallel assessor-blinded randomised controlled trial. Randomisation in 1:1:1 ratio to single intraoperative application of ciprofloxacin drops, extended 5-day postoperative application and no drops. Patients were assessed by blinded assessors at 6 weeks postoperatively. Setting The study was conducted in a large tertiary health network in Melbourne, Australia. Participants All children, 17 years and under, undergoing bilateral MEVT surgery with or without concurrent upper airway surgery for recurrent acute otitis media and chronic otitis media with effusion were approached. Main Outcome Measures Presence of postoperative otorrhoea and ventilation tube obstruction at 6 weeks postoperatively. Results 256 paediatric patients completed the study with a median age of 4.02 years. 153 participants were male. By ear-analysis (n=512) showed intraoperative antibiotics were more effective than no drops in preventing otorrhoea (RR=0.341, 95%CI 0.158–0.738, NNT= 11.25, p=.006). Postoperative antibiotics were more effective than no drops in preventing ventilation tube obstruction (RR=0.424, 95%CI 0.193 to 0.930, NNT=14.7 p=.032). Conclusion Intraoperative topical ciprofloxacin was effective at preventing early postoperative otorrhoea and a prolonged course was effective at preventing ventilation tube obstruction. Future studies on this topic should seek to clarify whether particular subgroups of patients benefit more from prophylactic topical antibiotics and model for cost-effectiveness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interpositional vein grafting for significant size discrepancy: The important role for short, sequential grafts in step-up and step-down microvascular anastomoses

xlomafota13 shared this article with you from Inoreader Interpositional vein grafting for significant size discrepancy: The important role for short, sequential grafts in step-up and step-down microvascular anastomoses Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 8:S1748-6815(21)00447-2. doi: 10.1016/j.bjps.2021.09.012. Online ahead of print. ABSTRACT INTRODUCTION: Anastomotic vessel size discrepancy may be addressed by numerous techniques, including the end-to-side. Most of these conventional methods are less suited with larger flap vessels relative to recipients, such as the vessel-depleted oncological neck with prior radiotherapy or in supermicrosurgical techniques with perforator recipients. We describe how short segment (single or double) interpositional vein grafts can be used to safely graduate this discrepancy in a 'step-up' or 'step-down' manner. METHODS: We conducted a retrospective review of all cases where interpositional vein grafts had been utilised. Furthermore, the technique for harvest, vessel preparation and anastomotic sequence is described. RESULTS: Over fifteen years, 116 short segment interpositional vein grafts (in 83 pa tients) were employed to address vessel discrepancy. Concerning patient demographics, there were 81 male:2 female, mean age 51 years (range 27-68 years), and aetiology was oral cancer (75), trauma(7) and congenital(1). Single (50) and double (33) grafts were used for 65 arterial anastomoses (8 step-down: 57 step-up) and 18 for venous anastomoses (12 step-down: 6 step-up). Flaps employed were osteocutaneous fibula (28), anterolateral thigh (24), free ileocolon (11), radial forearm (11), SCIP (7) and others (2). Six flaps (of 83) were lost (5 arterial and 1 venous thrombosis). CONCLUSION: Short segment interpositional vein grafts may be safely utilised for 'step-up' and 'step-down' anastomoses. Planned use in the primary case, minimum required length and meticulous preparation are fundamental for success and to dispel traditional concerns over poorer outcomes when vein grafts are used. PMID:34764041 | DOI:10.1016/j.bjps.2021.09.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pneumatosis intestinalis associated with lenvatinib during thyroid cancer treatment: a case report

xlomafota13 shared this article with you from Inoreader Pneumatosis intestinalis associated with lenvatinib during thyroid cancer treatment: a case report Via radioactive iodine J Med Case Rep. 2021 Nov 12;15(1):556. doi: 10.1186/s13256-021-03158-w. ABSTRACT BACKGROUND: Pneumatosis intestinalis is a rare disease characterized by gas-filled cysts within the submucosa or serosa of the intestinal tract. In recent years, pneumatosis intestinalis was reported in patients undergoing cancer treatment, and some case reports exist that report that pneumatosis intestinalis occurs during administration of vascular endothelial growth factor inhibitors, such as bevaciz umab and sunitinib. Here, we report the first case of pneumatosis intestinalis during lenvatinib treatment. CASE PRESENTATION: A 77-year-old Japanese man presented to our hospital with a chief complaint of numbness in the right leg and weakness of the lower limbs 9 years after right thyroid lobectomy. Computed tomography showed a tumor 90 mm in size from the lumbar spine to the sacrum, causing spinal cord compression. Blood tests showed that the patient's thyroglobulin level was increased to 11,600 ng/ml. We diagnosed him with thyroid cancer with bone metastases. External beam radiotherapy (39 Gy/13 Fr) was performed on the bone metastases, followed by total thyroidectomy and radioactive iodine therapy. Four months after radioactive iodine therapy, lenvatinib was introduced because the symptoms of numbness and weakness recurred. Lenvatinib was introduced at dose of 24 mg, and then it was reduced to 14 mg owing to Common Terminology Criteria for Adverse Event grade 3 paronychia of the right foot. Although no further significant adverse events occurred, a scheduled computed tomography image showed pneumatosis intestinalis of the ascending colon 14 weeks after the introduction of lenvatinib. No abdominal or digestive symptoms were observed; therefore, we selected conservative treatment. We discontinued lenvatinib for a week, but we were required to restart lenvatinib as the numbness in the right leg worsened after withdrawal. Since the introduction of lenvatinib, 3 years and 5 months passed; we continued lenvatinib treatment, and the therapeutic effect remains partial response. There has been no recurrence of pneumatosis intestinalis. CONCLUSIONS: Although rare, it is important to recognize that pneumatosis intestinalis can occur in association with lenvatinib and should be differentiated from intestinal perforation. Pneumatosis intestinalis association with lenvatinib can be improved by withdrawal. PMID:34763724 | DOI:10.1186/s13256-021-03158-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Demographic, anthropometric, and metabolic characteristics of obstructive sleep apnea patients from Romania before the COVID-19 pandemic

xlomafota13 shared this article with you from Inoreader Demographic, anthropometric, and metabolic characteristics of obstructive sleep apnea patients from Romania before the COVID-19 pandemic Via Experimental and therapeutic medicine Exp Ther Med. 2021 Dec;22(6):1487. doi: 10.3892/etm.2021.10922. Epub 2021 Oct 26. ABSTRACT Obstructive sleep apnea (OSA) syndrome is one of the major pathologies of modern life, with multiple etiologies intertwining: the increase in life expectancy, facial and dental changes, metabolic syndrome, and others. The current diagnosis is based on sleep studies, flexible endoscopy, imaging studies and a complete differential diagnosis from other possible pathologies. We present a retrospective study of 80 cases with OSA managed in 2019 prior to the beginning of the COVID-19 pandemic. We analyzed various demographic, anthropometric and metabolic data recorded in our study group. Some of the results, such as high levels of cholesterol and triglycerides, were consistent with worldwide literature. However, regarding the anthropometric data, we underline a general decrease in height in the Romanian population. In addition, demographic data have ch anged in the last decade due to the work immigration in the European Union. This data will be used in a future analysis for comparison with variables recorded from cases with OSA during the COVID-19 pandemic. Current cases with OSA are not a priority for healthcare systems, and patients avoid referral to a specialist as much as possible. PMID:34765028 | PMC:PMC8576615 | DOI:10.3892/etm.2021.10922 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Environmental allergens house dust mite-induced asthma is associated with ferroptosis in the lungs

xlomafota13 shared this article with you from Inoreader Environmental allergens house dust mite-induced asthma is associated with ferroptosis in the lungs Via Experimental and therapeutic medicine Exp Ther Med. 2021 Dec;22(6):1483. doi: 10.3892/etm.2021.10918. Epub 2021 Oct 26. ABSTRACT Previous studies have indicated that allergens such as house dust mites (HDM) in the environment can induce allergic asthma. Ferroptosis is a newly discovered form of regulatory cell death characterized by aberrant lipid peroxidation and the accumulation of reactive oxygen species (ROS) in cells. However, whether ferroptosis participates in the pathological process of asthma remains to be elucidated. The present study used a HDM-induced mouse asthma model to determine the effect of HDM exposure on allergic asthma and its underlying mechanisms. Female BALB/c mice were intranasally exposed to HDM to induce allergic asthma. Airway hyperresponsiveness (AHR), lung inflammation, mucus secretion, IgE levels, cytokine levels and inflammatory cell counts in bronchoalveolar lavage fluid (BALF) were investigated. In addition, the morphological changes of mi tochondria, ROS levels, glutathione (GSH) levels and changes in ferroptosis pathway proteins were also determined in murine lungs. As a result, HDM exposure significantly increased AHR, inflammatory cell infiltration and mucus secretion around the airways. Furthermore, elevated IgE levels in the BALF, lung eosinophilia and a concomitant increase in IL-13 and IL-5 levels in BALF were observed. HDM inhalation increased ROS and decreased GSH levels in the lungs. HDM inhalation induced dysmorphic small mitochondria with decreased crista, as well as condensed, ruptured outer membranes. Western blotting demonstrated that the activities of glutathione peroxidase 4 and catalytic subunit solute carrier family 7 member 11 were significantly decreased, and that protein expression levels of acyl-CoA synthetase long-chain family member 4 and 15 lipoxygenase 1 were upregulated compared with mice in the normal control group. Overall, these results indicated that the AHR, airway inflammation, lipid peroxidation and ROS levels increased in HDM-induced asthma, and that HDM inhalation induced ferroptosis in the lungs, which helped to form an improved understanding of the pathogenesis of allergic asthma. PMID:34765024 | PMC:PMC8576623 | DOI:10.3892/etm.2021.10918 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epigenetic approaches for cervical neoplasia screening (Review)

xlomafota13 shared this article with you from Inoreader Epigenetic approaches for cervical neoplasia screening (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2021 Dec;22(6):1481. doi: 10.3892/etm.2021.10916. Epub 2021 Oct 25. ABSTRACT Human papillomavirus (HPV) infection is the leading cause of cervical cancer. The Papanicolaou cytology test is the usually employed type of screening for this infection; however, its sensibility is limited. Only a small percentage of women infected with high-risk HPV develop cervical cancer with an array of genetic and epigenetic modifications. Thus, it is necessary to develop rapid, reproducible and minimally invasive technologies for screening. DNA methylation has gained attention as an alternative method for molecular diagnosis and prognosis in HPV infection. The aim of the present review was to highlight the potential of DNA methylation in cervical neoplasia screening for clinical applications. It was observed that the methylation human and viral genes was correlated with high-grade lesions and cancer. Methylation biomarkers have shown a goo d capacity to discriminate between high-grade lesions with a transformative potential and cervical cancer, being able to detect these modifications at an early stage. With further research, the epigenetic profiles and subtypes of the tumors could be elaborated, which would aid in therapy selection by opening avenues in personalized precision medicine. Response to therapy could also be evaluated through such methods and the accessibility of liquid biopsies would allow a constant monitoring of the patient's status without invasive sampling techniques. PMID:34765022 | PMC:PMC8576616 | DOI:10.3892/etm.2021.10916 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.