Training, supervision, and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda

xlomafota13 shared this article with you from Inoreader Training, supervision, and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda Via Clinical Otolaryngology Abstract Objectives Community Health Workers are one way to address the shortage of ear and hearing care specialists in low resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers. Design, Setting and Participants We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda. Community Health Workers attended a two-day training workshop and received remote supervision thereafter during service delivery in the community. An ear camp was held at the local health centre every two months, where a local ENT specialist could assess referred cases. Main outcome measures Clinical and diagnostic skills and decision making were assessed using an Objective Structured Clinical Examination, with scores recorded at baseline and six months. Service delivery was evaluated by analysing: (i) number of individuals evaluated; (ii) treatments delivered; (iii) cases referred for specialist opinion; (iv) proportion of appropriately referred cases; (v) agreement between Community Health Worker and specialist diagnosis. Results Observed Structured Clinical Examination scores were high and stable for six months. 312 individuals were screened in the community by the Community Health Workers, with 298 classified as having an abnormality. Care was delivered in the community to 167 of these, and the remaining 131 referred to the ear camp. Diagnostic agreement was 39%, but 98% of referrals were deemed "appropriate" by the ENT specialist. 27 individuals self-presented to the ear camp without prior assessment by a Community Health Worker, and 97% of these were deemed appropriate. Conclusion Trained Community Health Workers can play an important role in delivering ear and hearing services. Future work should look to explore this model in other contexts and/or compare to other models of service delivery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Image‐guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery

xlomafota13 shared this article with you from Inoreader Image‐guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery Via Head & Neck Abstract Image-guided surgery (IGS) has become a widely adopted technology in otolaryngology. Since its introduction nearly three decades ago, IGS technology has developed rapidly and improved real-time intraoperative visualization for a diverse array of clinical indications. As usability, accessibility, and clinical experiences with IGS increase, its potential applications as an adjunct in many surgical procedures continue to expand. Here, we describe the basic components of IGS and review both the current state and future directions of IGS in otolaryngology, with attention to current challenges to its application in surgery of the nonrigid upper aerodigestive tract. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

lncRNA PVT1 promotes cetuximab resistance of head and neck squamous cell carcinoma cells by inhibiting miR‐124‐3p

xlomafota13 shared this article with you from Inoreader lncRNA PVT1 promotes cetuximab resistance of head and neck squamous cell carcinoma cells by inhibiting miR‐124‐3p Via Head & Neck Abstract Background Cetuximab has been widely used in the clinical treatment of head and neck squamous cell carcinoma (HNSCC). However, whether long non-coding RNA plasmacytoma variant translocation 1 (lncRNA PVT1) is correlated with cetuximab resistance remains unclear. Methods Western blot and qRT-PCR were performed to quantify the levels of genes and proteins, respectively. Cell functions were measured using Cell Counting Kit-8 (CCK-8), Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and flow cytometry assays. The methylation level was tested using methylation-specific PCR (MSP). Results PVT1 was upregulated and positively correlated with the poor prognosis of HNSCC. PVT1 overexpression markedly promoted the survival and weakened the cetuximab sensitivity of HNSCC cells, while miR-124-3p overexpression showed opposite effects. Mechanistically, the silence of PVT1 indirectly promoted miR-124-3p expression by reducing its promoter methylation. Importantly, miR-124-3p overexpression impeded the regulatory roles of PVT1 overexpression. Conclusion PVT1 decreased the sensitivity of HNSCC cells to cetuximab by enhancing methylation-mediated inhibition of miR-124-3p, which might provide a new insight for the cetuximab chemoresistance of HNSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Yin and Yang: a disrupted skin microbiome and an aberrant host immune response in Hidradenitis Suppurativa

xlomafota13 shared this article with you from Inoreader Yin and Yang: a disrupted skin microbiome and an aberrant host immune response in Hidradenitis Suppurativa Via Experimental Dermatology Abstract The skin microbiome plays an important role in maintaining skin homeostasis by controlling inflammation, providing immune education, and maintaining host defense. However, in many inflammatory skin disorders the skin microbiome is disrupted. This dysbiotic community may contribute to disease initiation or exacerbation through the induction of aberrant immune responses in the absence of infection. Hidradenitis Suppurativa (HS) is a complex, multifaceted disease involving the skin, innate and adaptive immunity, microbiota, and environmental stimuli. Herein, we discuss the current state of HS skin microbiome research and how microbiome components may activate pattern recognition receptor (PRR) pathways, metabolite sensing pathways, and antigenic receptors to drive anti-microbial peptide, cytokine, miRNA, and adaptive immune cell responses in HS. We highlight the major open questions that remain to be addressed and how antibiotic therapies for HS likely influence both microbial burden and inflammation. Ultimately, we hypothesize that the two-way communication between the skin microbiome and host immune response in HS skin generates a chronic positive feed-forward loop that perpetuates chronic inflammation, tissue destruction, and disease exacerbation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Defining dipeptidyl peptidase‐4 inhibitors‐related bullous pemphigoid: A single‐centre retrospective study

xlomafota13 shared this article with you from Inoreader Defining dipeptidyl peptidase‐4 inhibitors‐related bullous pemphigoid: A single‐centre retrospective study Via Experimental Dermatology Abstract Background Many studies have corroborated the association of dipeptidyl peptidase-4 inhibitors (DPP4i) use with bullous pemphigoid (BP). It has been speculated that this drug-induced variant presents with a different clinical spectrum than conventional BP. Objective To determine the prevalence of DPP4i-induced cases of BP and to evaluate whether gliptin-related BP has specific clinicopathological and immunological features. Methods We conducted a retrospective, observational study of BP cases attended at our centre between January 2000 and June 2020. Epidemiological, clinical, histopathological and laboratory data were collected. Results A total of 257 cases of BP were collected; 51 (24.3%) were on treatment with DPP4i. When analysing DPP4i-induced BP cases, generalized BP was the predominant pattern and scalp/mucosal involvement was found in 13 patients. Gliptin-related BP cases were associated to a decrease in the eosinophilic infiltrate (p = 0.000) and both the detection rate and concentration of anti-BP180 IgG were lower (p = 0.004, p = 0.001, respectively) than non-DPP4i cases. Limitations Retrospective, single-centre study. Conclusion Our large DPP4i-induced BP case series has highlighted that DPP4i-induced BP is characterized by generalized lesions and scalp involvement. Lower titres of anti-BP180 antibodies and a decrease in eosinophils infiltrating into the skin may be distinct features of DPP4i-related BP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

“The Pruritogenic Role of the Type 2 Immune Response in Diseases Associated with Chronic Itch”

xlomafota13 shared this article with you from Inoreader "The Pruritogenic Role of the Type 2 Immune Response in Diseases Associated with Chronic Itch" Via Experimental Dermatology Abstract While there is a vast array of etiologies that may lead to chronic pruritus, recent data suggests that many of these conditions share similar interactions between keratinocytes, nerves, and the immune system. Specifically, the type 2 immune response, including Th2 T-Cells and their related cytokines, has been noted to play a major role in the development of pruritus in a variety of itchy conditions. To date, atopic dermatitis is the most striking example of this pathogenesis. However, the body of literature supporting its role in many other itchy conditions, including other inflammatory, bullous, as well as systemic diseases, continues to grow. In addition, new treatments targeting this type 2 immune system continue to be developed and investigated. In the current review, we present the current body of literature supporting the role of the type 2 immune response in itchy conditions beyond atopic dermatitis as well as potential therapeutic options that target this pathway for chron ic itch. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of patient- and procedure-related risk factors for nasal septal perforations following septoplasty

xlomafota13 shared this article with you from Inoreader Analysis of patient- and procedure-related risk factors for nasal septal perforations following septoplasty 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 24. doi: 10.1007/s00405-021-06887-2. Online ahead of print. ABSTRACT OBJECTIVES: To assess the possible relationship between various predictive factors (patient or surgery related) and the development of nasal septal perforations (NSP) with the help of a large study group. METHODS: One hundred and forty-three patients were included in the study. The presence of the following factors was evaluated and compared between the NSP and healthy group: types of surgeries, presence of unilateral or bilateral mucosal tears, concomitant inferior turbinate interventions, smoking, accompanying diabetes mellitus (DM) or allergic rhinitis (AR), types of nasal packings, duration of the surgery (minutes), and the experience of the surgeon (senior/junior). Nasal septal deviations were grouped into two: simple cartilage crests at the septum base and other-more complicated-deviations. RESULTS: NSP was detecte d in six (4.2%) patients after a mean follow-up of 9.3 ± 3.7 (min: 6 max: 14) months. None of these patients suffered from (AR) or DM. Four of these patients had unilateral and one patient had bilateral mucosal tears during the surgeries. None of the above-mentioned factors-including mucosal tears, type of the deviation or experience of the surgeon-had a significant effect on NSP. CONCLUSION: Untreated bilateral corresponding mucosal tears are the main cause of NSP. When immediately repaired, unilateral or bilateral tears do not affect the development of NSP significantly. Patient-related factors such as age, DM, smoking, AR, and procedure-related factors such as duration, the complexity of the septal deviation, type of the nasal packing, and experience of the surgeon also do not have a significant effect on NSP. PMID:34028581 | DOI:10.1007/s00405-021-06887-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Learning curve and technical nuances of endoscopic skull base reconstruction with nasoseptal flap to control high-flow cerebrospinal fluid leakage: reconstruction after endoscopic skull base surgery other than pituitary surgery

xlomafota13 shared this article with you from Inoreader Learning curve and technical nuances of endoscopic skull base reconstruction with nasoseptal flap to control high-flow cerebrospinal fluid leakage: reconstruction after endoscopic skull base surgery other than pituitary 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 May 24. doi: 10.1007/s00405-021-06877-4. Online ahead of print. ABSTRACT PURPOSE: Although reconstruction techniques after endoscopic skull base surgery have been improved, there are difficulties in reconstructing the skull base with a nasoseptal flap (NSF), especially in the case of high-flow cerebrospinal fluid (CSF) leak. The aim of this study was to analyze risk factors for the development of postoperative CSF leaks in terms of less experienced surgeon practices. METHODS: Retrospective review of medical records was performed for 125 patients who underwent endoscopic skull base surgery for intradural pathology with intraoperative high-flow CSF leakage between Oct 2012 and Apr 2017. Basic demographic data were collected, including body mass index (BMI), tumor pathology, comorbidities, and outcomes. To assess the learning curve effect, patients were divided into early cohort (n = 30) and late coho rt (n = 95) groups. RESULTS: Overall postoperative CSF leakage was 10.4% (13/125) in this series. There were no significant risk factors for postoperative CSF leakage among the demographic data including BMI, comorbidities, or radiation history. Postoperative CSF leakage was most prevalent in the transclival approach than in other approaches, but the difference was not statistically significant (20.8%, p = 0.351). When dividing the results by timetable, the patients who underwent skull base reconstruction in the early cohort experienced more postoperative CSF leakage (23.3%, 7 cases out of 30) than in the late cohort (6.3%, 6 cases out of 95, p = 0.014). The learning curve was steeper in the early cohort (30 early cases 23.3%, 31-60 10%, 61-90 6.7%, 91-125 2.9%). CONCLUSIONS: To improve the success rate of endoscopic skull base reconstruction, surgeons have to keep the basic technical details in mind to reduce the learning curve. PMID:34028580 | DOI:10.1007/s00405-021-06877-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic significance of tumor-infiltrating lymphocytes and macrophages in nasopharyngeal carcinoma: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Prognostic significance of tumor-infiltrating lymphocytes and macrophages in nasopharyngeal carcinoma: a systematic review and meta-analysis 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 24. doi: 10.1007/s00405-021-06879-2. Online ahead of print. ABSTRACT PURPOSE: Many studies have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) and tumor-infiltrating macrophages (TIMs) in patients with nasopharyngeal carcinoma (NPC), but the results remain controversial. Here, we performed a meta-analysis to evaluate the prognostic significance of TILs/TIMs in patients with NPC METHODS: The study was registered with PROSPERO (CRD42021234078). PubMed, Embase, and Web of Science databases were searched up to Dec 30, 2020. We reviewed studies that evaluated the relationship between TILs/TIMs and overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) in NPC. For TILs, CD3, CD4, CD8, and FOXP3 were searched as T-cell markers, CD19 and CD20 as B-cell markers, and CD56 as a natural killer cell marker. For TIMs, CD68 and CD163 were searched as total and M2 macrophage markers, respectively. RESULTS: In total, 19 studies with 3708 NPC were included in this meta-analysis. We found that high total numbers of TILs were significantly associated with favorable OS [hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.38-0.57 and PFS (HR 0.48, 95% CI 0.38-0.62)]. In contrast, tumor infiltration by CD3+ T cells (HR 0.55, 95% CI 0.39-0.76), CD4+ T cells (HR 0.40, 95% CI 0.18-0.85), and CD8+ T cells (HR 0.56, 95% CI 0.34-0.93) correlated positively with OS. No significant relationship was found between survival and tumor infiltration by FOXP3+ T cells, CD68+ macrophages, or CD163+ macrophages. CONCLUSION: Our findings revealed that tumor infiltration by CD3+ , CD4+ , and CD8+ T cells could be prognostic biomarkers in NPC. PMID:34027599 | DOI:10.1007/s00405-021-06879-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Broad Autism Phenotype Traits in Parents of Children with Language Impairments: A Comparative Study

xlomafota13 shared this article with you from Inoreader Broad Autism Phenotype Traits in Parents of Children with Language Impairments: A Comparative Study Via Folia Phoniatrica et Logopaedica Introduction: The broad autism phenotype (BAP) comprises milder language and cognitive deficits seen in the nonautistic relatives of individuals with autism. BAP represents the range of individuals with a higher number of these characteristics than average but a lower number than would point to a diagnosis of autism. The Broad Autism Phenotype Questionnaire (BAPQ) is one of the efficient and reliable tools to explore and measure BAP traits, namely, aloofness, pragmatic language, and rigid personality, which represent a few of the diagnostic features of autism. Against the background of positive familial history and common causes across the developmental disorders, this study aimed to compare BAP traits in the parents of children with autism spectrum disorder (ASD), specific language impairment (SLI), and social communication disorder (SCD) by means of the BAPQ. Methods: A total of 120 parents (60 mothers and 60 fathers) of children with ASD, SCD, and SLI participated in the study. All mothers filled in the self-report version and fathers filled in the informant version of BAPQ simultaneously in the communication intervention setting. Results: Obtained data was analyzed with the t test and ANOVA to compare self-ratings, informant ratings, and BAPQ scores across groups. The results of the study revealed no statistically significant difference for the overall BAPQ scores (except on the Pragmatic Language subscale). Furthermo re, mothers in all 3 groups presented with BAP traits, with pragmatic language deficits being common. These observations point towards an overlap of BAP traits in the mothers of children with language disorders. Conclusion: These findings indicate the value of a detailed assessment of BAP in parents of children with developmental disorders. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The framing of judgement by counter: how appraisal analysis of six sentencing remarks provides an insight into judges’ sentencing practices

xlomafota13 shared this article with you from Inoreader The framing of judgement by counter: how appraisal analysis of six sentencing remarks provides an insight into judges' sentencing practices Via International Journal of Speech Language and the Law Studies on sentencing in England and Wales are dominated by normative studies prescribing how judges should sentence. Few examine how judges actually sentence. This article provides an insight into the empirical reality of judges' sentencing practices by examining how judges use counter to frame their judgement of offenders and their behaviour in six sentencing remarks. The six sentencing remarks were selected to ensure that variations in sentencing decisions of the six cases were, at least to a large extent, subject to judicial discretion. It finds that the statutory point exercises a binding effect on judicial sentencing despite judges having the discretion& nbsp;to disregard the starting point. The finding leads to the further inference that judges might possibly perceive the Court of Appeal and the public as two important audiences for their sentencing remarks. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.