Wednesday, September 8, 2021

Stability and radioactive gaseous iodine-131 retention capacity of binderless UiO-66-NH(2) granules under severe nuclear accidental conditions

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J Hazard Mater. 2021 Aug 15;416:125890. doi: 10.1016/j.jhazmat.2021.125890. Epub 2021 Apr 15.

ABSTRACT

In the present work, we aim to investigate the ability of the zirconium-based MOF-type compound UiO-66-NH2, to immobilize molecular gaseous iodine under conditions analogous to those encountered in an operating Filtered Containment Venting System (FCVS) line. Typically, the UiO-66-NH2 particles were exposed to 131I (beta and gamma emitters) and sub mitted to air/steam at 120 °C, under gamma irradiation (1.9 kGy h-1). In parallel to this experiment under simulated accidental conditions, the stability of the binderless UiO-66-NH2 granules under steam and gamma irradiation was investigated. In order to fit with the specifications required by typical venting systems, and to compare the efficiency of the selected MOF to porous materials commonly used by the industry, scale-up syntheses and UiO-66-NH2 millimetric-size shaping were realized. For this task, we developed an original binderless method, in order to analyze solely the efficiency of the UiO-66-NH2 material. The shaped MOF particles were then submitted separately to gamma irradiation, steam and temperature, for confirming their viability in a venting process. Their structural, textural and mechanical behaviors were characterized by the means several techniques including gas sorption, powder X-ray diffraction, infrared spectroscop y and crushing tests. Promising results were obtained to trap gaseous molecular iodine in severe accidental conditions.

PMID:34492828 | DOI:10.1016/j.jhazmat.2021.125890

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The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review

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Ann Otol Rhinol Laryngol. 2021 Sep 7:34894211045262. doi: 10.1177/00034894211045262. Online ahead of print.

ABSTRACT

OBJECTIVES: This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis.

DESIGN: Qualitative systematic review.

METHODS: A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced pe er-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility.

RESULTS: About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management o f ductal stenoses.

CONCLUSION: This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up.

PMID:34493105 | DOI:10.1177/00034894211045262

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Simultaneous immobilization of aqueous co-contaminants using a bismuth layered material

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J Environ Radioact. 2021 Oct;237:106711. doi: 10.1016/j.jenvrad.2021.106711. Epub 2021 Aug 10.

ABSTRACT

The remediation of co-located contaminants in the vadose zone can be challenging due to accessibility and responses of different contaminants to remedial actions. At the Hanford Site (WA, USA), multiple radionuclides and other hazardous contaminants are present in the vadose zone and groundwater, including iodine-129 (I), technetium-99 (Tc), uranium-238 (U), chromium (Cr), and ni trate (NO3-). We evaluated a layered Bi oxyhydroxide material for its potential to remove individual and co-located contaminants with a series of batch experiments that investigated a range of plume conditions, followed by solid phase characterization of the reacted bismuth material. The results demonstrated successful removal of four contaminants (>98% removal of I, Tc, U, and Cr from the aqueous phase after 30 days) when tested individually. When contaminants were combined, a slight decrease in Tc removal occurred (-6%p). The addition of sediment decreased the removal for Tc and I, but U and Cr removal was unaffected. The results of these batch tests demonstrated that the bismuth based oxy-hydroxide material is a promising material for sequestering multiple contaminants in situ.

PMID:34388522 | DOI:10.1016/j.jenvrad.2021.106711

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Detectability of 18F-choline PET/MR in primary hyperparathyroidism

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Eur Arch Otorhinolaryngol. 2021 Sep 8. doi: 10.1007/s00405-021-07046-3. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to evaluate the power of 18F-fluorocholine (FCH) positron emission tomography/magnetic resonance (PET/MR) imaging in unlocalized primary hyperparathyroidism.

METHODS: Thirty-four patients were included. In 17/34 patients, PET/MR was performed immediately after a negative 18F-FCH PET/CT. Sensitivity, specificity, positive and negative predictive values were calculated for MR only (blinded to PET data) and PET only (blinded to MR data) findings.

RESULTS: 18F-FCH PET/MR was positive in 26/34 (76%) patients. PET/MR was also positive in 12/17 (71%) patients with a negative PET/CT. Among 11/34 (32%) patients where 18F-FCH PET-only and MR-only results were discordant, MR was false positive in 7/11 patients (3/7 of the lesions were not 18F-FCH avid and in 4/7 of them PET and MRI pointed different locations. Post operative histopathology revealed that 18F-FCH-positive ones were true positives). Sensitivity, specificity, PPV, NPV and accuracy of neck MR evaluated blinded to PET data were 80%, 50%, 70%, 64% and 68%, respectively, and all were calculated as 100% for PET/MR.

CONCLUSION: 18F-FCH PET/MR is very effective in preoperative localization of parathyroid adenomas even if 18F-FCH PET/CT is negative. Neck MR alone is insufficient in detecting parathyroid adenomas but PET/MR combination helps in precise localisation.

PMID:34495350 | DOI:10.1007/s00405-021-07046-3

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Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children

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Eur Arch Otorhinolaryngol. 2021 Sep 8. doi: 10.1007/s00405-021-07068-x. Online ahead of print.

ABSTRACT

PURPOSE: The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children.

METHODS: Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12).

RESULTS: The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° a nd from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional.

CONCLUSION: The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children.

PMID:34495 351 | DOI:10.1007/s00405-021-07068-x

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Tuesday, September 7, 2021

Transient asystole related to carbon dioxide embolism during transoral endoscopic parathyroidectomy vestibular approach

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Abstract

Background

Rarely, during the endoscopic thyroidectomy, carbon dioxide (CO2) embolism may occur.

Methods

Case 1: A 65-year-old female who was seen with prolonged fatigue and generalized bone pain was diagnosed primary hyperparathyroidism (PHPT) based on her preoperative biochemical profile. Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) was planned.

Case 2: A 52-year-old male patient was seen with weakness and hepatosteatosis and was diagnosed PHPT based on the laboratory workup. TOEPVA was planned.

Results

After subplatysmal dissection with vascular tunnel probe, both of the patients developed severe bradycardia and hypotension leading to asystole during the CO2 insufflation. The possibility of CO2 embolism was considered and insufflation was terminated. After a successful cardiac massage, sinus rhythm returned.

Conclusion

TOEPVA may develop CO2 embolism leading to asystole during the CO2 insufflation.

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Pooled analysis of nivolumab treatment in patients with recurrent/metastatic squamous cell carcinoma of the head and neck in the United States and Germany

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Abstract

Background

In the Phase-III clinical trial, CheckMate 141, nivolumab significantly improved survival versus standard of care in patients with platinum-refractory recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN).

Methods

This pooled analysis investigated the real-world effectiveness of nivolumab, following prior platinum-based therapy, in patients with R/M SCCHN from the United States (US) Flatiron Health database and German HANNA prospective observational study.

Results

Overall, 782 patients (56% US; 44% Germany) were included. Median overall survival (OS) was 8.71 months, and progression-free survival was 4.11 months. Eastern Cooperative Oncology Group Performance Status 0 or 1, platinum sensitivity, and older age were associated with longer OS, in which number of prior lines of therapy had no significant effect.

Conclusion

These findings demonstrate survival benefits of nivolumab in patients with R/M SCCHN in the real-world setting. The observed real-world effectiveness of nivolumab aligns with the efficacy of nivolumab in CheckMate 141.

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Endoscopic endonasal management of skull base defects in pediatric patients

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Int J Pediatr Otorhinolaryngol. 2021 Sep 1;150:110902. doi: 10.1016/j.ijporl.2021.110902. Online ahead of print.

ABSTRACT

PURPOSE: Skull base defects in children may be the result of congenital anomalies or trauma. They often present as cerebrospinal fluid (CSF) rhinorrhea, meningitis, brain abscess or nasal obstruction. Surgical intervention is predominantly the treatment of choice. Our goal is to assess the efficacy of endoscopic endonasal approach in treating skull base defects in pediatric patients.

MATERIAL AND METHODS: In this retrospective study we identified 38 patients (mean age 8.7 ± 5.6 years old, ranging 2 months-18 years) who underwent endoscopic endonasal repair of skull base defects, between March 2010 and February 2020. Patients who had skull base reconstruction after tumor resection, those who were lost to follow-up or did not sign the consent forms were excluded from the study.

RESULTS: The clinical indications for endoscopic endonasal repair were trauma (n = 24, 63.1%) and congenital defects (n = 14, 36.9%). Congenital skull base defects included basal meningoencephalocele (n = 5, 35.7%) and frontoethmoidal defects (n = 9, 64.3%). Mean follow up time was 32 ± 29.04 months, ranging 2-103 months. Fat graft (alone or in combination) was the most commonly used material to repair the skull base defects. Thirty-seven patients (97%) showed successful results after endoscopic endonasal surgery and were symptom free.

CONCLUSION: The endoscopic endonasal repair of CSF leak and skull base defects proved to be safe and feasible with 97% success rate.

PMID:34488041 | DOI:10.1016/j.ijporl.2021.110902

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The Risk of Benign Paroxysmal Positional Vertigo After Head Trauma

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Objectives

Head trauma may cause dislodgement of otoconia and development of benign paroxysmal positional vertigo (BPPV). The risk of developing BPPV is expected to be highest shortly after the trauma, then decrease and approach the risk seen in the general population. The aim of this study was to estimate the risk-time curve of BPPV development after head trauma.

Study Design

Prospective observational study.

Methods

Patients with minimal, mild, or moderate head trauma treated at the Department of Neurosurgery or the Department of Orthopedic Emergency at Oslo University Hospital, were interviewed and examined for BPPV using the Dix-Hallpike and supine roll maneuvers. BPPV was diagnosed according to the International diagnostic criteria of the Bárány Society. Telephone interviews were conducted at 2, 6, and 12 weeks after the first examination.

Results

Out of 117 patients, 21% developed traumatic BPPV within 3 months after the trauma. The corresponding numbers were 12% with minimal trauma, 24% with mild, and 40% with moderate trauma. The difference in prevalence between the groups was significant (P = .018). During the first 4 weeks after the trauma, it was observed 20, 3, 0, and 1 BPPV onsets, respectively. No BPPV cases were seen for the remainder of the 3-month follow-up.

Conclusion

The risk of developing BPPV after minimal-to-moderate head trauma is considerable and related to trauma severity. Most cases occur within few days after the trauma, but any BPPV occurring within the first 2 weeks after head trauma are likely due to the traumatic event.

Level of Evidence

3 Laryngoscope, 2021

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Stratifying the Risk of Cardiovascular Disease in Obstructive Sleep Apnea Using Machine Learning

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Objectives/Hypothesis

Obstructive sleep apnea (OSA) is associated with higher risk of morbidity and mortality related to cardiovascular disease (CVD). Due to overlapping clinical risk factors, identifying high-risk patients with OSA who are likely to develop CVD remains challenging. We aimed to identify baseline clinical factors associated with the future development of CVD in patients with OSA.

Study Design

Retrospective analysis of prospectively collected data.

Methods

We performed a retrospective analysis of 967 adults aged 45 to 84 years and enrolled in the Multi-Ethnic Study of Atherosclerosis. Six machine learning models were created using baseline clinical factors initially identified by stepwise variable selection. The performance of these models for the prediction of additional risk of CVD in OSA was calculated. Additionally, these models were evaluated for interpretability using locally interpretable model-agnostic explanations.

Results

Of the 967 adults without baseline OSA or CVD, 116 were diagnosed with OSA and CVD and 851 with OSA alone 10 years after enrollment. The best performing models included random forest (sensitivity 84%, specificity 99%, balanced accuracy 91%) and bootstrap aggregation (sensitivity 84%, specificity 100%, balanced accuracy 92%). The strongest predictors of OSA and CVD versus OSA alone were fasting glucose >91 mg/dL, diastolic pressure >73 mm Hg, and age >59 years.

Conclusion

In the selected study population of adults without OSA or CVD at baseline, the strongest predictors of CVD in patients with OSA include fasting glucose, diastolic pressure, and age. These results may shape a strategy for cardiovascular risk stratification in patients with OSA and early intervention to mitigate CVD-related morbidity.

Level of Evidence

3 Laryngoscope, 2021

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Efficacy of Superior Laryngeal Nerve Block for the Treatment of Neurogenic Cough: a Retrospective Review

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Abstract

Chronic cough may be multifactorial. A subset of patients may have a neurogenic cough, secondary to irritation of the superior laryngeal nerve. Superior laryngeal nerve blocks may be an efficacious treatment for neurogenic cough. Neuromodulating medications may be used in the treatment of chronic cough, but may have side effects. There are no reported serious adverse effects from superior laryngeal nerve blocks. Prospective, placebo-controlled studies are needed to confirm the efficacy of superior laryngeal nerve blocks for the treatment of chronic cough.

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