Serum immunoglobulin G4 has limited diagnostic value in immunoglobulin G4-related chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Serum immunoglobulin G4 has limited diagnostic value in immunoglobulin G4-related chronic rhinosinusitis 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 21. doi: 10.1007/s00405-021-07083-y. Online ahead of print. ABSTRACT PURPOSE: To investigate the profiles and factors influencing serum IgG4 levels and evaluate the diagnostic value of serum IgG4 in IgG4-related CRS. METHODS: This was a prospective study analyzing data from 288 hospitalized CRS patients who had undergone endoscopic sinus surgery from July 1, 2017 to August 31, 2018. Data were analyzed for correlations between elevated serum IgG4 concentrations (> 135 mg/dL) and clinical symptoms (nasal congestion, rhinorrhea, loss of smell, headache and/or facial pain), endoscopic presentation (Lund-Kennedy scores), allergic status (total and allergen-specific IgE), and pathological features (IgG4+ and IgG+ cells). RESULTS: Overall, 43/288 (14.9%) CRS patients had elevated serum IgG4 levels > 135 mg/dL. Comparison of the clinical parameters between patients with elevated and normal serum IgG4 levels demonstrated serum total IgE levels to be significantly different (P = 0.003) between the two groups; and significantly correlated with serum IgG4 level in CRS subjects (P = 0.000; r = 0.232), particularly CRS patients with nasal polyps (P = 0.000; r = 0.259). In contrast, the ratio of plasmocyte/inflammatory cells and IgG4+ cells/IgG+ plasmocytes, and IgG4+ plasma cells/HPF in sinus mucosa were not significantly different between the groups and no patient with elevated serum IgG4 demonstrated ratio of IgG4+ /IgG+ cells > 40% or > 10 IgG4+ plasma cells/HPF. CONCLUSION: Serum IgG4 concentration is not related to the clinical phenotype of CRS and is likely to be of limited value when used alone in the diagnosis of IgG4-related CRS. PMID:34673994 | DOI:10.1007/s00405-021-07083-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multiparametric analysis of voice following prolonged voice use and voice rest in teachers: evidence from discriminant analysis

xlomafota13 shared this article with you from Inoreader Multiparametric analysis of voice following prolonged voice use and voice rest in teachers: evidence from discriminant 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 Oct 22. doi: 10.1007/s00405-021-07144-2. Online ahead of print. ABSTRACT PURPOSE: Even though recent investigations have used multiparametric protocol, the set of robust parameters in determining the effects of vocal fatigue and voice rest in teachers is not clear. The first objective of the study was to document the impact of prolonged voice use and voice rest on the subjective and objective voice parameters among Indian secondary school teachers. The second objective was to determine the set voice parameters sensitive to vocal changes resulting from continuous voice use and voice rest. METHOD: The study included 15 male and 15 female secondary school teachers with a clinically normal voice and no history of voice disorders. Phonation samples were recorded in three different conditions, i.e., condition 1 (before voice use), condition 2 (following voice use), and condition 3 (following voice rest). The vocal Fatigue Index (version 2) was administered before the voice recordings in all three conditions. The objective parameters, namely fundamental frequency, range of fundamental frequency, jitter (%), shimmer (%), harmonic to noise ratio, and smoothened cepstral peak prominence, were extracted. RESULTS: Results revealed that fundamental frequency, jitter, shimmer, Harmonic to noise ratio, and smoothened cepstral peak prominence were significantly different across the three conditions. The discriminant analysis revealed that only three parameters classified 98.3% of samples accurately between the three conditions. CONCLUSION: Further research on the correlation between the other subjective and the objective parameters of voice after vocal fatigue would provide more penetrating and ample in-depth insights into the assessment and quantification of vocal fatigue. PMID:34686892 | DOI:10.1007/s00405-021-07144-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ramsay Hunt syndrome with multiple cranial neuropathy: a literature review

xlomafota13 shared this article with you from Inoreader Ramsay Hunt syndrome with multiple cranial neuropathy: a literature review 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 23. doi: 10.1007/s00405-021-07136-2. Online ahead of print. ABSTRACT BACKGROUND: Ramsay Hunt Syndrome (RHS) is a neurotological disorder involving the reactivation of the varicella-zoster virus (VZV) in the geniculate ganglion of the facial nerve (Sweeney and Gilden in J Neurol Neurosurg Psychiatry 71:149-154, 2001). The characteristic presentation involves ipsilateral lower motor neuron type facial paresis, auricular pain with or without hearing impairment, and vesicular lesions of the external auditory canal and outer ear. Involvement of the facial and vestibulocochlear nerve is typical in RHS, whilst multiple cranial neuropathies are rare and associated with poorer prognosis and systemic complications (Arya et al. in Am J Case Rep 19:68-71, 2017; Shinha and Krishna in IDCases 2:47-48, 2015; Shim et al. in Acta Otolaryngol 131:210-215, 2011; Coleman et al. in J Voice 26:e27-e28, 2012; Morelli et al . in Neurol Sci 29:497-498, 2008;). Likely mechanisms involved in the pathogenesis of cranial polyneuropathy include direct peri-neural and trans-axonal spread of viral inflammation between contiguous cranial nerves and haematogenous dissemination between nerves with shared blood supply. Impairments in speech, swallowing, hearing, and oculo-protection can contribute to morbidity and requires a multidisciplinary approach to patient care. METHODS: We present a rare case of RHS with multiple cranial neuropathies followed by a comprehensive review of current literature with regard to the pathophysiology, diagnostic workup, and the management strategies employed in these patients. CONCLUSION: RHSs with multiple cranial neuropathies are important to recognise as they are associated with significant morbidity and poor prognosis. A multidisciplinary approach to patient management is required to address the several complications that can arise from cranial nerve deficits, especia lly in regard to speech and swallow. PMID:34687339 | DOI:10.1007/s00405-021-07136-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cribriform adenocarcinoma of the tongue and minor salivary glands: a systematic review of an uncommon clinicopathological entity

xlomafota13 shared this article with you from Inoreader Cribriform adenocarcinoma of the tongue and minor salivary glands: a systematic review of an uncommon clinicopathological entity 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 23. doi: 10.1007/s00405-021-07140-6. Online ahead of print. ABSTRACT INTRODUCTION: Cribriform adenocarcinoma of the tongue and minor salivary glands (CATMSG) is a rare neoplasm, accounting for less than 1% of salivary gland tumors. In the past it has been considered a possible variant of polymorphous low-grade adenocarcinoma (PLGA), while nowadays it is accepted as a provisional entity in the WHO classification. The aim of this paper is to systematically review the existing literature about CATMSG with a particular attention to differential diagnosis and prognostic factors. METHODS: This study was performed in accordance with the PRISMA checklist. A comprehensive search in PubMed, Cochrane, and Google Scholar databases was carried out in June 2021, in partnership with a medical librarian, without time restriction. Search items include the following keywords: "cribriform adenocarcinoma of the to ngue" OR "cribriform adenocarcinoma of the tongue and minor salivary glands." RESULTS: A total of 56 patients were evaluated. Patient age across the studies ranged from 13 to 85 years (mean 59.6 year). The most common site of involvement was the tongue (58.9%), followed by palate (19.6%), tonsil (7.1%), buccal (3.6%) and reticular mucosa (3.6%), lip (3.6%), retromolar pad (1.7%), and floor of the mouth (1.7%). Lymph node involvement at the diagnosis was very common (58.9%), while there was no evidence of patients diagnosed with metastatic disease. The most common surgical approach was surgical excision (17, 30.3%); neck dissection was performed in 16 patients (28%). Radiotherapy was the most common adjuvant treatment reported (46.4%); only one patient underwent adjuvant chemotherapy (1.7%). Five patients experienced a recurrence (8.8%). CONCLUSION: To our knowledge, only 56 five cases of CATMSG have been previously described. The results of this review seem to confirm th e low frequency of relapses and distant metastases, but we observed that almost 60% of cases presented with cervical lymph node involvement. In our opinion, CATMSG should be considered as a distinct tumor entity from PLGA. PMID:34687340 | DOI:10.1007/s00405-021-07140-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Denosumab-related osteonecrosis of the external auditory canal-benefit of the early surgical management

xlomafota13 shared this article with you from Inoreader Denosumab-related osteonecrosis of the external auditory canal-benefit of the early surgical management Via ear nose throat Ear Nose Throat J. 2021 Oct 21:1455613211053389. doi: 10.1177/01455613211053389. Online ahead of print. ABSTRACT Background: Antiresorptive drugs are widely used to reduce bone mineral loss in patients with osteoporosis and to prevent skeletal-related events in patients with metastatic cancers and multiple myeloma (MM). Both the bisphosphonates (BP) and denosumab typically used in this indication were shown to be effective and relatively safe. Obviously, this medicatio n could have some adverse effects; one of them is osteonecrosis of the external auditory canal. Only sporadic cases of external auditory canal osteonecrosis have been published yet. Here, we provide a case of denosumab-related osteonecrosis of the external auditory canal successfully treated surgically in the early stage of the disease.Case report: A 68-year-old patient with breast cancer underwent comprehensive oncological treatment, including denosumab administration. She was diagnosed with osteonecroses in the jaw and ear canal. The necrotic bones in both regions were resected with primary wound closure. Both affected sites healed well with no signs of necrosis recurrence.Conclusions: Osteonecrosis of the external auditory canal is a rare but probably underdiagnosed complication of antiresorptive medication. It has a negative impact on patient quality of life if left untreated. Early surgical treatment appears to be effective. The authors highlight several similarit ies with medication-related osteonecrosis of the jaw. Therefore, an analogous disease staging and treatment rationale is suggested. PMID:34672841 | DOI:10.1177/01455613211053389 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic and Prognostic Value of Fibrinogen, Fibrinogen Degradation Products, and Lymphocyte/Monocyte Ratio in Patients With Laryngeal Squamous Cell Carcinoma

xlomafota13 shared this article with you from Inoreader Diagnostic and Prognostic Value of Fibrinogen, Fibrinogen Degradation Products, and Lymphocyte/Monocyte Ratio in Patients With Laryngeal Squamous Cell Carcinoma Via ear nose throat Ear Nose Throat J. 2021 Oct 21:1455613211048970. doi: 10.1177/01455613211048970. Online ahead of print. ABSTRACT OBJECTIVES: Laryngeal squamous cell carcinoma (LSCC) is a common squamous cell carcinoma of the head and neck with no reliable diagnostic biomarkers. However, recent studies have shown that inflammation plays an essential role in tumor development, and several inflammation-based biomarkers have been shown to have prognostic value. This study aimed to investigate t he auxiliary value of fibrinogen (FIB), fibrinogen degradation products (FDP), and lymphocyte/monocyte ratio (LMR) in LSCC diagnosis and prognosis. METHODS: Clinical data from 218 patients recently diagnosed with LSCC and 207 diagnosed with benign laryngeal lesions (BLLs) were retrospectively reviewed. Potential diagnostic biomarkers were evaluated using univariate and multivariate analyses; receiver operating characteristic (ROC) curve analysis was used to identify cut-off values and diagnostic efficiency. Least absolute shrinkage and selection operator (LASSO) Logistic regression analysis was used to screen for independent risk factors to construct a diagnostic nomogram. The chi-squared test and Kaplan-Meier method were performed to investigate the correlation of clinicopathological characteristics and 3-year overall survival (OS) with FIB, FDP, and LMR in patients with LSCC. RESULTS: FIB, FDP, and LMR levels were significantly different between the LSCC and BLL groups (P < .001), and all were independent risk factors for LSCC. The area under the ROC curve of the diagnostic nomogram was .894. Additionally, FIB, FDP, and LMR were correlated with some invasive clinicopathological features, and LMR ≥4.29 was associated with reduced OS (P = .038). CONCLUSION: FIB, FDP, and LMR demonstrated potential as biomarkers for the diagnosis and prognosis of LSCC; however, further studies are needed to confirm their efficacy. PMID:34672822 | DOI:10.1177/01455613211048970 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fish Gelatin-Based Absorbable Dural Sealant with Anti-inflammatory Properties

xlomafota13 shared this article with you from Inoreader Fish Gelatin-Based Absorbable Dural Sealant with Anti-inflammatory Properties Via leak of cerebrospinal fluid ACS Biomater Sci Eng. 2021 Oct 11;7(10):4991-4998. doi: 10.1021/acsbiomaterials.1c00734. Epub 2021 Oct 1. ABSTRACT Cerebrospinal fluid (CSF) leakage from the dura mater during craniotomy is a common complication, which is associated with infection, meningitis, pneumocephalus, and delayed wound healing. In the present study, we developed an absorbable fish gelatin-based anti-inflammatory sealant for dura mater sealing to prevent CSF leakage. Gelatin derived from Alaska pollock (ApGltn) was modified with α-linolenic acid (ALA), an omega-3 fatty acid that exhibits anti-inflammatory properties, and cross-linked with a poly(ethylene glycol)-based cross-linker to develop ALA-ApGltn sealant (ALA-Seal). ALA-Seal demonstrated a higher storage modulus and tangent delta (tan δ) compared with those of the original ApGltn sealant (Org-Seal). The swelling ratio of ALA-Seal was markedly lower than that of DuraSeal, a commercially available dural sealant. Ex vivo burst strength measurements using porcine dura mater indicated that there was no significant difference between DuraSeal and ALA-Seal, despite ALA-Seal having an order of magnitude lower storage modulus. The anti-inflammatory properties of ALA-Seal, evaluated using brain microglial cells, were considerably higher than those of DuraSeal and Org-Seal, with a minimal adverse effect on cell viability. Therefore, compared to DuraSeal, ALA-Seal is a potential dural sealant with a lower swelling ratio, similar burst strength, and higher anti-inflammatory properties, which may prevent CSF leakage. PMID:34596382 | DOI:10.1021/acsbiomaterials.1c00734 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel Dural-Splitting Operative Technique for Excision of Ventrally Located Spinal Meningiomas

xlomafota13 shared this article with you from Inoreader Novel Dural-Splitting Operative Technique for Excision of Ventrally Located Spinal Meningiomas Via leak of cerebrospinal fluid World Neurosurg. 2021 Sep 30;157:48-53. doi: 10.1016/j.wneu.2021.09.101. Online ahead of print. ABSTRACT OBJECTIVE: Spinal meningiomas are one of the frequently seen intradural extramedullary spinal tumors. They are almost always World Health Organization grade I, and a complete removal of the tumor can be curative. However, ventrally located spinal meningioma removal can be challenging due to the position in front of the spinal cord through a narrow corridor provided by routine dorsal approaches. Incomplete excision of the relatively inaccessible dural attachment can consequently lead to recurrence. We describe a safe and reproducible technique used to achieve Simpson grade I removal of ventrally located spinal meningioma. METHODS: Since the spinal dura can be easily divided into inner and outer layers and the tumor usually spares the outer layer, we developed a simple technique to achieve total resection of the tumor and involved dura while leaving the outer dural layer intact. RESULTS: An advantage of this procedure is that it exploits an interdural approach to allow early devascularization of the tumor without cord manipulation and provides access to the ventral dura to achieve Simpson grade I excision. Another advantage is complete dural closure to minimize postoperative cerebrospinal fluid leak or ventral cord herniation without the need for dural substitutes. CONCLUSION: Its novel interdural approach can be used for all ages and all spinal meningiomas. PMID:34601172 | DOI:10.1016/j.wneu.2021.09.101 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Filamin-A expression in laryngeal squamous cell carcinoma and its clinical significance

xlomafota13 shared this article with you from Inoreader Filamin-A expression in laryngeal squamous cell carcinoma and its clinical significance Via Cellular and Molecular Biology Histol Histopathol. 2021 Oct 22:18383. doi: 10.14670/HH-18-383. Online ahead of print. ABSTRACT BACKGROUND: Laryngeal squamous cell carcinomas (LSCCs) are tumours with a high incidence of treatment failure and recurrence. Recent strategies to improve the five-year survival rate and to decrease the rates of recurrence and metastases did not improve outcomes significantly. Research efforts in recent years have started focusing on discovering biomarkers of prognosis and management in LSCCs. Filamin-A reportedly has been associated with metastatic disease in a recent study. Analysis of this protein's expression in LSCCs is lacking in the literature. MATERIALS AND METHODS: This study analysed the expression of filamin-A, using immunohistochemistry, in a tissue microarray of 80 cases of laryngeal squamous cell cancers. Clinical-pathological parameters were analysed according to filamin-A expression in the tissue microarray. Furthermore , a review of possible mechanisms of this protein in cancer, in general, was presented, along with a review of the protein's expression in other head and neck tumours. RESULTS: A significant majority of laryngeal squamous cell cancers exhibited positive expression of filamin-A protein. All the filamin-A positive tumours expressed it in their cytoplasm. Significant correlation between filamin-A expression and grade, stage, lymph node status and metastases were found. CONCLUSION: The above may suggest an important role for filamin-A in LSCCs. Overall, filamin-A expression in laryngeal cancer is in line with evidence seen in other head and neck cancers. Further studies are in order to pinpoint the exact role of this protein in LSCCs, and its possible utilization in the management of these difficult-to-treat tumours. PMID:34677823 | DOI:10.14670/HH-18-383 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The surgical management of hidradenitis suppurativa in the United Kingdom: a national survey of care pathways informing the THESEUS study

xlomafota13 shared this article with you from Inoreader The surgical management of hidradenitis suppurativa in the United Kingdom: a national survey of care pathways informing the THESEUS study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00422-8. doi: 10.1016/j.bjps.2021.08.038. Online ahead of print. ABSTRACT BACKGROUND: The evidence-base underpinning treatment efficacy and effectiveness for hidradenitis suppurativa (HS) is limited, as has been highlighted in the wide-ranging research priorities established by a James Lind Alliance priority-setting partnership (PSP). Understanding the landscape of surgical practice is a key step towards tackling undesired variation in care and resolving treatment uncertainties. This survey of current surgical practice aimed to describe care pathways involving surgeons for the management of HS and surgical approaches to management. METHODS: In the development of the prospective cohort Treatment of Hidradenitis Suppurativa Evaluation Study (THESEUS), a bespoke electronic surgeon survey was conducted to describe variation in care pathways and surgical preferences in the manag ement of HS. This was disseminated to a pre-defined denominator list of surgeons using local collaborators through the reconstructive surgery trials network (RSTN). RESULTS: Key results were small numbers of surgeons working in formal multidisciplinary teams (MDTs) (8/198, 4%), heterogeneity of first-line intervention, low rates of guideline endorsed treatments (laser and deroofing in particular), variation in wound closure methods and follow-up length, and that over half of respondents do not use well-validated outcome instruments to determine treatment success/failure (110/198, 56%). CONCLUSIONS: This survey demonstrated variation in care, which is likely to be undesirable. Surgeons treating HS patients might consider developing MDTs or referring patients to those with an interest in HS and considering routine outcome measurement. Such steps might reduce variation, increase standardisation of care and improve access to specific treatments. PMID:34674976 | DOI:10.1016/j.bjps.2021.08.038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

It may be time for a world-wide study to assess patient and parent perception of outcomes following autologous reconstruction, porous polyethylene and osseointegrated implants

xlomafota13 shared this article with you from Inoreader It may be time for a world-wide study to assess patient and parent perception of outcomes following autologous reconstruction, porous polyethylene and osseointegrated implants Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 8:S1748-6815(21)00450-2. doi: 10.1016/j.bjps.2021.09.009. Online ahead of print. NO ABSTRACT PMID:34674973 | DOI:10.1016/j.bjps.2021.09.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.