Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on 68Ga-FAPI-04 and 18F-FDG PET/CT

alexandrossfakianakis shared this article with you from Inoreader Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on 68Ga-FAPI-04 and 18F-FDG PET/CT Via Clinical Nuclear Medicine - Published Ahead-of-Print We report a case of tuberculosis peritonitis in a 26-year-old woman who presented with abdominal pain, fatigue, and weight loss for the last 4 months. Abdominal US and CT demonstrated intra-abdominal massive ascites, misty mesentery, and diffuse peritoneal thickening. In addition, 3 nodular lesions were detected in the right lung. 18F-FDG PET/CT showed hypermetabolism in lung nodules, mesenteric area, peritoneal thickening, and ascites. 68Ga-FAPI-04 (fibroblast activation protein–specific inhibitor) PET/CT imaging was also performed; high uptakes were detected in the same regions of 18F-FDG PET/CT. Tuberculosis diagnosis was made after histopathological examination of wedge resection of the right lung. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A multi-pollutant approach to estimating causal effects of air pollution mixtures on overall mortality in a large, prospective cohort.

alexandrossfakianakis shared this article with you from Inoreader A multi-pollutant approach to estimating causal effects of air pollution mixtures on overall mortality in a large, prospective cohort. Via Epidemiology - Published Ahead-of-Print Background: Several studies have confirmed associations between air pollution and overall mortality, but it is unclear to what extent these associations reflect causal relationships. Moreover, few studies to our knowledge have accounted for complex mixtures of air pollution. In this paper, we evaluate causal effects of a mixture of air pollutants on overall mortality in a large, prospective cohort of Dutch individuals. Methods: We evaluated 86,882 individuals from the LIFEWORK study, assessing overall mortality between 2013-2017 through national registry linkage. We predicted outdoor concentration of five air pollutants (PM2.5, PM10, NO2, PM2.5 absorbance, oxidative potential) with land-use regression. We used logistic regression and mixture modeling (weighted quantile sum and boosted regression tree models) to identify potential confounders, assess pollutants relevance in the mixture–outcome association, and investigate interactions and non-linearities. Based on these results, we built a multivariate generalized propensity score model to estimate causal effects of pollutant mixtures. Results: Regression model results were influenced by multicollinearity. Weighted quantile sum and boosted regression tree models indicated that all components contributed to a positive linear association with the outcome, with PM2.5 being the most relevant contributor. In the multivariate propensity score model, PM2.5 (OR=1.18, 95% CI:1.08,1.29) and PM10 (OR=1.02, 95% CI:0.91,1.14) were associated with increased odds of mortality per interquartile range increase. Conclusion: Using novel methods for causal inference and mixture modeling in a large prospective cohort, this study strengthened the causal interpretation of air pollution effects on overall mortality, emphasizing the primary role of PM2.5 within the pollutant mixture. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study

paythelady.61 shared this article with you from Inoreader Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To analyze and compare surgical and audiological outcomes of conventional approaches versus laser CO2 surgery in stapes surgery. Methods 333 patients who underwent stapes surgery were enrolled in the study; the patient population was divided into three groups: group 1: 170 patients treated with conventional stapedotomy with manual microdrill (average age 49.13 years); group 2: 119 patients treated with conventional stapedotomy with electrical microdrill (average age 51.06 years); group 3: 44 patients (average age 50.4 years) who underwent CO2 laser stapedotomy. Intra-operative, postoperative outcomes and audiological results were investigated. Results The average surgical time of laser CO2 surgery was longer than for other surgical procedures. No statistical differences emerged in post-operative abnormal taste sensation. There was also no difference in postoperative dizziness. Air-bone gap (ABG) went down from 29.7 ± 10 dB (group 1) and 27.32 ± 9.20 (group 2) to 10 ± 6.9 dB (group 1) and 10.7 ± 6.03 dB (group 2). In group 3 the preoperative ABG was lowered from 28.3 ± 10.1 to 11.8 ± 10.9, with a statistical difference in auditory recovery (p = 0.0001); The group of patients treated with laser CO2 showed a percentage of patients with an ABG closure of between 0 and 10 dB higher than in the group treated with manual microdrills (77.2% vs. 60%, respectively; p = 0.03). Conclusion Overall surgical results of CO2 laser and conventional stapedotomy are comparable without any significant difference; however, the group treated with CO2 laser appears to have a percentage of patients with an ABG closure 0–10 dB higher than the group treated using the conventional technique. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature

paythelady.61 shared this article with you from Inoreader Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background Endolymphatic sac tumour (ELST) is a rare low-grade locally aggressive neoplasm arising from the endolymphatic duct or sac. It presents mostly with vestibulo-cochlear symptoms either sporadically or as part of von Hippel–Lindau (VHL) syndrome. Micro-neurosurgical excision remains the cornerstone of therapy with the role of radiotherapy (RT) being controversial. This is a clinico-pathological analysis of consecutive ELST patients presenting to a single-institution in India. Methods Neuropathology database of a tertiary-care comprehensive cancer centre was searched electronically to identify consecutive patients with histopathological diagnosis of ELST registered at the institute over last one decade. Data regarding demographic profile, clinical presentation, histopathological features, treatment details and outcomes were retrieved from electronic medical records for this retrospective analysis. Results Electronic search identified seven unique patients with biopsy-proven ELST registered at the institute between 2009 and 2020. Median age of the study cohort was 39 years (range 24–65 years) with strong male predilection (5:2 ratio) and left-sided preponderance (71%). Most common presenting symptoms were hearing loss (86%) and earache (71%) on affected side followed by headache (43%). All patients underwent maximal safe resection at initial diagnosis and were followed-up closely with periodic surveillance imaging. Two patients underwent salvage RT using high-precision conformal techniques at recurrence/progression. Conclusion ELST is a rare low-grade locally aggressive neoplasm that arises generally as part of VHL syndrome or sometimes sporadically. Gross total resection provides the best chance of cure with RT being reserved for unresectable disease, large residue, medical inoperability, or as salvage therapy for recurrent/progressive tumor. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

paythelady.61 shared this article with you from Inoreader High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia

paythelady.61 shared this article with you from Inoreader Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To review functional and subjective benefit after implantation of an active transcutaneous bone conduction device (BCD) in patients with congenital microtia with atresia or stenosis of the external auditory canal. Methods Retrospective chart analysis and questionnaire on the subjective impression of hearing ( Speech, Spatial and Qualities of Hearing Scale (SSQ-B) of patients treated between 2012 and 2015. ResultsResults 18 patients (24 ears) with conductive or mixed hearing loss in unilateral (n = 10) or bilateral (n = 8) atresia were implanted with a BCD. No major complications occurred after implantation. Preoperative unaided air conduction pure tone average at 0.5, 1, 2 and 4 kHz (PTA 4 ) was 69.2 ± 11.7 dB, while postoperative aided PTA 4 was 33.4 ± 6.3 dB, resulting in a mean functional hearing gain of 35.9 +/- 15.6 dB. Preoperatively, the mean monosyllabic word recognition score was 22.9 % ± 22.3 %, which increased to 87.1 % +/- 15.1 % in the aided condition. The Oldenburger Sentence Test at S0N0 revealed a decrease in signal-to-noise-ratio from − 0.58 ± 4.40 dB in the unaided to − 5.67 ± 3.21 dB in the postoperative aided condition for all patients investigated. 15 of 18 patients had a subjective benefit showing a positive SSQ-B score (mean 1.7). Conclusion The implantation of an active bone conduction device brings along subjective and functional benefit for patients with conductive or combined hearing loss. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

paythelady.61 shared this article with you from Inoreader Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS. Methods Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale. Results The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%). Conclusion Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers

paythelady.61 shared this article with you from Inoreader Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background To evaluate the utility of positron-emission tomography (FDG PET) in initial staging and management of head and neck cancers. Methods This is a retrospective study of 99 treatment naïve head and neck cancer patients treated between January 2017 and December 2020 at a tertiary teaching centre. Change in initial staging and management was noted based on PET scan compared to cross-sectional imaging (CT and MRI). Results There were 73 (73.7%) males and 26 (26.2%) females with male-to-female ratio of 2.8:1.Overall, change in management was seen in 36/99 (36.4%) patients due to PET scan. With regards to initial staging, T, N and M stage was changed in 14/99 (14.1%), 19/99 (19.1%) and 3/99 (3%) patients, respectively. These changes were significantly higher in patients with unknown primary (63.3%, p value −0.001) and N3 (41%, p −0.045) nodal disease. Conclusion PET-CT plays an important role in appropriate initial staging and subsequent treatment planning of head and neck cancers. Advances in knowledge Initial staging PETCT changes management in 36.4% cases. Accuracy of various different imaging modalities have been compared. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of deep convolutional neural network models for mandibular fracture detection in panoramic radiographs

paythelady.61 shared this article with you from Inoreader Assessment of deep convolutional neural network models for mandibular fracture detection in panoramic radiographs Via International Journal of Oral and Maxillofacial Surgery The aim of this study was to develop automated models for the identification and detection of mandibular fractures in panoramic radiographs using convolutional neural network (CNN) algorithms. A total of 1710 panoramic radiograph images from the years 2016 to 2020, including 855 images containing mandibular fractures, were obtained retrospectively from the regional trauma centre. CNN-based classification models, DenseNet-169 and ResNet-50, were fabricated to identify fractures in the radiographic images. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects

paythelady.61 shared this article with you from Inoreader Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects Via Latest Results for Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Abstract Purpose The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them. Methods Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9 skeletal patterns. Each subject was assigned a skeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9 groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group. Results No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9 skeletal patterns. However, class III growers had a significantly earlier onset of prepubertal growth (10.25 ± 1.56 years) when compared to that of class II high angle cases (11.11 ± 1.67 years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups. Conclusion A map was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report

paythelady.61 shared this article with you from Inoreader Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report Via SAGE Publications Inc: Annals of Otology, Rhinology & Laryngology: Table of Contents Annals of Otology, Rhinology &Laryngology, Ahead of Print. Objectives:To report a case of a morbidly obese 17-year-old boy who presented 4 days post-tonsillectomy with acute deep venous thromboses and a massive pulmonary embolism. To describe a protocol and decision-making tree for providing anticoagulation in the immediate post-tonsillectomy period.Methods:A chart review and review of the literature.Results:The patient ultimately did well and had no bleeding from the tonsil beds or further thromboembolic complications. A review of the literature revealed no available data regarding the safety of anticoagulation in the immediate post-tonsillectomy period.Conclusions:We propose that if anticoagulation is needed within 14 days of tonsillectomy, submaximal anticoagulation with a reversible and titratable anticoagulant may be optimal. A multidisciplinary team approach is needed for these complex cases. Future reporting and investigation of anticoagulation post-tonsillec tomy is needed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.