Validität präoperativ entnommener SARS-CoV-2-Abstriche bei Kindern

xlomafota13 shared this article with you from Inoreader Validität präoperativ entnommener SARS-CoV-2-Abstriche bei Kindern Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1494-3341 Hintergrund Aufgrund der eingeschränkten Compliance ist bei Kindern die technisch korrekte Entnahme eines gepoolten Nasopharyngealabstrichs deutlich erschwert. Vor allem bei Operationen im Bereich der oberen Atemwege besteht für alle im Operationssaal Anwesenden infolge der intraoperativen Aerosolbildung ein deutlich erhöhtes Infektionsrisiko für eine Erkrankung an COVID-19. Ziel der Studie ist die Analyse der Validität präoperativ unter im Einzelfall suboptimalen Bedingungen entnommener SARS-CoV-2-Abstriche bei Kindern. Material und Methoden Retrospektiver Vergleich der PCR-Ergebnisse von präoperativ und intraoperativ abgenommenen SARS-CoV-2-Abstrichen bei 62 Kindern im Zeitraum April-Juli 2020. Das Alter der Kinder lag zwischen einem und 14 Jahren (Median 4,49 Jahre). Insgesamt 56 der 62 untersuchten Operationen wurden hinsichtlich des erhöhten Infektionsrisikos als Risikoeingriffe gewertet. Die PCR-Diagnostik erfolgte 1–2 Tage (bei Notfalleingriffen am selben Tag) präoperativ sowie erneut intraoperativ mittels gepooltem Nasopharyngealabstrich. Ergebnisse Alle 62 präoperativ abgenommenen Abstriche waren negativ. Abweichend vom präoperativen Testergebnis war ein intraoperativ gewonnener Abstrich positiv. Schlussfolgerungen Aufgrund eingeschränkter Compliance kann bei Kindern nicht immer von einer korrekten präoperativen Abstrichtechnik (Präanalytik) ausgegangen werden. Infolgedessen sind die Testergebnisse im Hinblick auf eine mögliche SARS-CoV-2-Infektion womöglich inkorrekt. Ausreichende Schutzmaßnahmen für alle im Operationssaal Anwesenden sind daher zwingend erforderlich. Zum Schutz des Personals und zur Prävention möglicher Infektionsketten perioperativ erscheint in dieser Altersgruppe trotz der guten Reproduzierbarkeit der präoperativen Abstrichergebnisse eine erneute intraoperative Testung erwägenswert, falls der präoperative Abstrich unter erschwerten Bedingungen erfolgte oder eine umfassende Anamnese, z. B. vor Notfalleingriffen oder bei Sprachbarriere, nicht möglich ist. [...] Georg Thieme Verlag KG R üdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Wideband tympanometry as a diagnostic tool for Meniere's disease: a retrospective case-control study

xlomafota13 shared this article with you from Inoreader Wideband tympanometry as a diagnostic tool for Meniere's disease: a retrospective case-control 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 19. doi: 10.1007/s00405-021-06882-7. Online ahead of print. ABSTRACT PURPOSE: The main purpose of this study was to investigate the usefulness of wide band tympanometry (WBT) as a diagnostic tool for Ménière's disease (MD) by comparing differences in absorbance measures between normal hearing ears and patient diagnosed with MD. METHODS: We conducted a retrospective case-control study. From a cohort of 116 patients diagnosed with Ménière disease, 52 MD patients and 99 normal hearing adults with no history of otological disease served as subjects. Wideband tympanometry was conducted using at Titan Impedance module and audiometry was performed with a MADSEN Astera2. Mean energy absorbance curves with 95% confidence intervals were computed across cases with MD and controls in the frequency range 226-8000 Hz. An overall test for difference between curves of cases and controls was calc ulated by multivariate analysis of variance. RESULTS: The MD group and the subpopulations of MD patients who fulfilled the International criteria for MD showed a statistically significant lower absorbance at tympanic peak pressure compared to the control group (p < 0.001). No overlap of confidence intervals between mean curves was found within the frequency range of 2000-4000 Hz. CONCLUSION: Absorbance measures obtained by WBT were able to distinguish between MD ears and normal ears within the frequency range of 2000-4000 Hz. The results indicate that WBT potentially could be a useful and simple non-invasive diagnostic tool for MD. However, more research on the association between absorbance measures and inner ear pathologies is needed. PMID:34009459 | DOI:10.1007/s00405-021-06882-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Homeopathy-a therapeutic option for medical practice? : An evaluation from the perspective of evidence-based medicine

xlomafota13 shared this article with you from Inoreader Homeopathy-a therapeutic option for medical practice? : An evaluation from the perspective of evidence-based medicine Via hno HNO. 2021 May 19. doi: 10.1007/s00106-021-01061-w. Online ahead of print. ABSTRACT Many publications declare homeopathy to be "controversial." However, based on the findings of extensive research on homeopathy, there has long been a broad scientific consensus that there is no reliable evidence of specific medical effectiveness. Overall, the evidence clearly denies effects beyond those of placebo and context. All the more must it be seen as a phenomenon that homeopathy is stil l the subject of medical and therapeutic practice. This may lie largely in the fact that the homeopathic scene appropriates medical research and the concept of evidence in a way that is suitable to maintain the appearance that there is still a scientifically relevant discourse to dispute. The following article aims to justify that this is not the case, and that homeopathy is, therefore, obsolete as a therapeutic option, even according to the principles of contemporary medical ethics. PMID:34009440 | DOI:10.1007/s00106-021-01061-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese

xlomafota13 shared this article with you from Inoreader A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese Via radioactive iodine Arch Toxicol. 2021 May 18. doi: 10.1007/s00204-021-03065-5. Online ahead of print. ABSTRACT Radioactive iodine released in nuclear accidents may accumulate in the thyroid and by irradiation enhances the risk of cancer. Radioiodine uptake into the gland can be inhibited by large doses of stable iodine or perchlorate. Nutritional iodine daily intake may impact thyroid physiology, so that radiological doses absorbed by the thyroid as well as thyroid blocking efficacy may differ in Jap anese with a very rich iodine diet compared to Caucasians. Based on established biokinetic-dosimetric models for the thyroid, we derived the parameters for Caucasians and Japanese to quantitatively compare the effects of radioiodine exposure and the protective efficacy of thyroid blocking by stable iodine at the officially recommended dosages (100 mg in Germany, 76 mg in Japan) or perchlorate. The maximum transport capacity for iodine uptake into the thyroid is lower in Japanese compared to Caucasians. For the same radioiodine exposure pattern, the radiological equivalent thyroid dose is substantially lower in Japanese in the absence of thyroid blocking treatments. In the case of acute radioiodine exposure, stable iodine is less potent in Japanese (ED50 = 41.6 mg) than in Caucasians (ED50 = 2.7 mg) and confers less thyroid protection at the recommended dosages because of a delayed responsiveness to iodine saturation of the gland (Wolff-Chaikoff effect). Perchlo rate (ED50 = 10 mg in Caucasians) at a dose of 1000 mg has roughly the same thyroid blocking effect as 100 mg iodine in Caucasians, whereas it confers a much better protection than 76 mg iodine in Japanese. For prolonged exposures, a single dose of iodine offer substantially lower protection than after acute radioiodine exposure in both groups. Repetitive daily iodine administrations improve efficacy without reaching levels after acute radioiodine exposure and achieve only slightly better protection in Japanese than in Caucasians. However, in the case of continuous radioiodine exposure, daily doses of 1000 mg perchlorate achieve a high protective efficacy in Caucasians as well as Japanese (> 0.98). In Caucasians, iodine (100 mg) and perchlorate (1000 mg) at the recommended dosages seem alternatives in case of acute radioiodine exposure, whereas perchlorate has a higher protective efficacy in the case of longer lasting radioiodine exposures. In Japanese, considering pro tective efficacy, preference should be given to perchlorate in acute as well as prolonged radioiodine exposure scenarios. PMID:34003340 | DOI:10.1007/s00204-021-03065-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spontaneous acute bleeding within subdural effusion from dural metastasis of gastric cancer: A case report

xlomafota13 shared this article with you from Inoreader Spontaneous acute bleeding within subdural effusion from dural metastasis of gastric cancer: A case report Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 May 14:S1130-1473(21)00047-6. doi: 10.1016/j.neucir.2021.04.001. Online ahead of print. ABSTRACT Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding. PMID:34001435 | DOI:10.1016/j.neucir.2021.04.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiotherapy for prevention or management of gynecomastia recurrence: Future role for general gynecomastia patients in plastic surgery given current role in management of high-risk prostate cancer patients on anti-androgenic therapy

xlomafota13 shared this article with you from Inoreader Radiotherapy for prevention or management of gynecomastia recurrence: Future role for general gynecomastia patients in plastic surgery given current role in management of high-risk prostate cancer patients on anti-androgenic therapy Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00202-3. doi: 10.1016/j.bjps.2021.03.098. Online ahead of print. ABSTRACT PURPOSE: Several technologies and innovative approaches continue to emerge for the optimal management of gynecomastia by plastic surgeons; the present study investigates the role of radiation therapy in this context. METHODS: A systematic review was performed to evaluate the utility of radiotherapy for the prevention and treatment of gynecomastia incidence or recurrence by plastic surgeons. RESULTS: Fifteen articles met the inclusion criteria for review. The mean incidence of gynecomastia was 70% in the high-risk population examined representing prostate cancer patients on estrogen or anti-androgen therapy. Radiotherapy was shown to significantly reduce the incidence to a median of 23%, with all six randomized control studies assessed demonstrating a statistically significant decrease in inciden ce following radiotherapy prophylaxis. Doses examined ranged from 8 to 16 Gy, delivered between 1 and 11 fractions. Complications following radiotherapy were minor and self-limiting in all cases, restricted to minor skin reactions, and associated with larger radiotherapy doses delivered in fewer fractions. The median complication rate was 12.4% with no major complications, such as neoplastic, pulmonary, or adverse cardiac outcomes. While the efficacy of radiation therapy as a treatment modality for gynecomastia was also established, it was shown to be less effective than other available options. CONCLUSIONS: Low-dose radiotherapy to the male breast might be a safe and effective strategy to prevent gynecomastia incidence or recurrence in high-risk patients; further studies are indicated within the common gynecomastia population managed by plastic surgeons to assess the clinical and economical utility of this intervention before a recommendation for its ubiquitous adoption in pl astic surgery can be made to continue improving outcomes for high-risk gynecomastia patients. PMID:34001449 | DOI:10.1016/j.bjps.2021.03.098 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metastatic tumour of the hand - Three new cases and a literature review

xlomafota13 shared this article with you from Inoreader Metastatic tumour of the hand - Three new cases and a literature review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 19:S1748-6815(21)00189-3. doi: 10.1016/j.bjps.2021.03.084. Online ahead of print. ABSTRACT Metastatic tumours of the hand are rare, and therefore, is the subject of only a few publications in the literature. We report on three new cases along with a retrospective and descriptive study with file and literature analysis dating from 1900 to 2017, which reported on 337 studies. To perform the statistical analysis, ordinary lease square regression was used to group the metastases into distal phalanx, proximal/middle phalanx, thumb, hand and carpus. We found 564 metastases at the hand for a total of 482 patients. Of the reported cases, 60% were male. The average age was 59 years. The main primary cancers were lung cancer (40%), followed by gastrointestinal (19%), genito-urinary (13%), gynaecological (11%) and ear, nose and throat (6%) cancers. The mean survival time was 7.2 months. Fifty-nine per cent was bone metastasis, 18% tissue metastasis and 3% cutaneous metastasis. In 20% of cases, the type of metastasis was not mentioned. Of all the tissue metastases, 47 (54%) were subungual and in that group, the thumb was the finger most commonly affected. Overall, metastases most commonly appeared in the distal phalanx, which can be explained by a greater vascularisation as well as microtraumatisms. Survival was independent of the epidemiological criteria and of the location and type of metastasis. Patients with primary urological cancer lived on average 3 months longer than patients with other types of primary cancers. PMID:34001450 | DOI:10.1016/j.bjps.2021.03.084 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of the knowledge and attitudes about the management of dental trauma among ear, nose and throat physicians

xlomafota13 shared this article with you from Inoreader Assessment of the knowledge and attitudes about the management of dental trauma among ear, nose and throat physicians 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 16. doi: 10.1007/s00405-021-06880-9. Online ahead of print. ABSTRACT PURPOSE: Ear, nose and throat physicians (ENTp) encounter dental trauma (DT) when patients refer to the emergency department, as well as during operations such as tonsillectomy and suspension laryngoscopy. This study aimed to investigate the attitudes and knowledge of ENTp about managing DT, and motivation for further education. METHODS: This study was a cross-sectional observational survey on a sample of ENTp from 15 different private/public hospitals. A questionnaire of 22 questions was divided into three parts: the level of professional experience and the frequency of encountering DT; specific questions on the management of DT; self-assessment of educational approach and level of knowledge regarding DT. RESULTS: A total of 128 surveys were accomplished and included in the evaluation. A larger percentage (96.9%) of the participants have experienced at least one case in the practice, and one-third (31.3%) have encountered more than ten DT cases. Although the duration of experience significantly affected the total number of correct responses to knowledge and attitudes regarding DT questions (p:0.028), more than half of the participants (44.38%) responded incorrectly to the questions. The majority of participants (97.7%) stated that they had no education on DT, and 90.6% were willing to receive DT training. CONCLUSIONS: The results of this study emphasize the deficiency of ENTp' knowledge level about the management of DT. In addition, results demonstrated the enthusiasm of ENTp for further training, which can contribute to the requirement of education for providing appropriate management of DT cases. PMID:33993345 | DOI:10.1007/s00405-021-06880-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Follow-up logbook of patients receiving CAR T-cell therapy: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

xlomafota13 shared this article with you from Inoreader Follow-up logbook of patients receiving CAR T-cell therapy: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) Via Association française pour l'étude du cancer Bull Cancer. 2021 May 12:S0007-4551(21)00162-4. doi: 10.1016/j.bulcan.2021.02.012. Online ahead of print. ABSTRACT In the attempt to harmonize practices and to create a national CAR T-cells patient follow-up care logbook, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) worked on the design of a common national care logbook during the eleventh annual workshops of practice harmonization. The purpose of this logbook was to explain the different phases of the treatment with CAR T-cells and to allow useful monitoring for the patient. This logbook can be also helpful for the different healthcare professionals involved in the patient care. This national logbook will provide important information to the patients undergoing CAR T-cell therapy. In addition to the information booklets already in use, the national logbook simplifies patient follow-up by recording various medical appointments and possible adver se events. This work has been based on tools that had already been put in place by different CAR T-cell centers. This national logbook represents a common "base" and is prepared in the form of index cards to be classified using dividers in a binder. Therefore, the national care logbook will be adaptable for local procedures and guidelines of each center. PMID:33992416 | DOI:10.1016/j.bulcan.2021.02.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New drug approval: Dostarlimab - second line in advanced MSI endometrial cancer

xlomafota13 shared this article with you from Inoreader New drug approval: Dostarlimab - second line in advanced MSI endometrial cancer Via Association française pour l'étude du cancer Bull Cancer. 2021 May 13:S0007-4551(21)00177-6. doi: 10.1016/j.bulcan.2021.04.006. Online ahead of print. NO ABSTRACT PMID:33994164 | DOI:10.1016/j.bulcan.2021.04.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gluteoperinealis muscle: a surgically important variation

xlomafota13 shared this article with you from Inoreader Gluteoperinealis muscle: a surgically important variation Via radiol anat Surg Radiol Anat. 2021 May 16. doi: 10.1007/s00276-021-02766-x. Online ahead of print. ABSTRACT BACKGROUND: Anatomical variations are common in gluteal region. This report presents two cases of gluteoperinealis muscles detected during radiological imaging. CASE PRESENTATION: Our study was conducted on two patients. This report describes an accessory muscle detected in the gluteal region on MRI examination of a patient who admitted to our clinic after a firearm injury a nd a second patient examined with CT imaging who had signs of pelvic infection. In the first case, this accessory muscle originated bilaterally from the fascia of the gluteus maximus throughout its posteromedial side and was attached to the perineal body. In the second case, it extended forward from the fascia of the gluteus maximus muscle and inserted to the cavernous body of penis on the left side and to the perineal body on the right. In the literature, this accessory muscle has been described as the gluteoperinealis muscle being a rare variation. CONCLUSION: Considering the origin and insertion of the muscle, this variation may be important during the surgical operations of the gluteal and perineal regions. PMID:33993323 | DOI:10.1007/s00276-021-02766-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.