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Κυριακή 15 Αυγούστου 2021

The power and potential of BIOMAP to elucidate host‐microbiome interplay in skin inflammatory diseases

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Abstract

The two most common chronic inflammatory skin diseases are atopic dermatitis (AD) and psoriasis. The underpinnings of the remarkable degree of clinical heterogeneity of AD and psoriasis are poorly understood and, as a consequence, disease onset and progression are unpredictable and the optimal type and time-point for intervention are as yet unknown. The BIOMAP project is the first IMI (Innovative Medicines Initiative) project dedicated to investigating the causes and mechanisms of AD and psoriasis and to identify potential biomarkers responsible for the variation in disease outcome. The consortium includes 7 large pharmaceutical companies and 25 non-industry partners including academia. Since there is mounting evidence supporting an important role for microbial exposures and our microbiota as factors mediating immune polarization and AD and psoriasis pathogenesis, an entire work package is dedicated to the investigation of skin and gut microbiome linked to AD or psoriasis. The lar ge collaborative BIOMAP project will enable the integration of patient cohorts, data and knowledge in unprecedented proportions. The project has a unique opportunity with a potential to bridge and fill the gaps between current problems and solutions. This review highlights the power and potential of BIOMAP project in the investigation of microbe-host interplay in AD and psoriasis.

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Combination of the endoscopic septonasal flap technique and bioabsorbable steroid-eluting stents for repair of congenital choanal atresia in neonates and infants: a retrospective study

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Multiple surgical approaches have been proposed to repair the congenital choanal atresia. However, there remains no general consensus about the optimal surgical technique. This study aimed to describe and eval...
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Radioactive iodine does not improve overall survival for patients with aggressive variants of papillary thyroid carcinoma less than 2 cm

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Surgery. 2021 Aug 10:S0039-6060(21)00571-7. doi: 10.1016/j.surg.2021.05.054. Online ahead of print.

ABSTRACT

BACKGROUND: Tall cell and diffuse sclerosing variants of papillary thyroid cancer are associated with aggressive features. Radioactive iodine after total thyroidectomy is poorly studied.

METHODS: Patients ≥18 years in the National Cancer Data Base from 2004 to 2016 with classic papillary thyroid cancer, tall cell, or diffuse sclerosing 1 mm to 40 mm were identified. Logistic regression identified factors associated with aggressive features. Overall survival was assessed using Kaplan-Meier method and log-rank tests, after propensity score matching for clinicopathological and treatment variables.

RESULTS: A total of 155,940 classic papillary thyroid cancer patients, 4,011 tall cell, and 507 diffuse sclerosing were identified. Tall cell patients represented an increasing proportion of the study population during the analysis period, whereas diffuse sclerosing and classic papillary thyroid cancer patients showed a statistically significant decline. Extrathyroidal extension and nodal involvement were more prevalent among tall cell and diffuse sclerosing patients when compared to those diagnosed with classic papillary thyroid cancer (P < .01). Adjuvant radioactive iodine was less frequently used in patients with classic papillary thyroid cancer when compared to tall cell and diffuse sclerosing patients (42.6% vs 62.4%, 59.0%; P < .001, re spectively). Aggressive variants receiving total thyroidectomy versus total thyroidectomy + radioactive iodine propensity score matched across clinicopathologic variables were analyzed. There was no difference in overall survival between the 2 treatment groups for tumors <2 cm (01-1.0 cm, 92.2% vs 84.8%; P = .98); (1.0-2.0 cm, 72.7% vs 88.1%; P = .82). However, overall survival was improved for total thyroidectomy + radioactive iodine propensity score matched patients with tumor sizes 21 to 40 mm versus total thyroidectomy (83.4% vs 70.0%, P = .004).

CONCLUSION: For aggressive tumor variants ≤2 cm treated with total thyroidectomy, there is no overall survival advantage provided by the addition of adjuvant radioactive iodine.

PMID:34384604 | DOI:10.1016/j.surg.2021.05.054

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Seasonal expression and distribution of kisspeptin1 (kiss1) in the ovary and testis of freshwater catfish, Clarias batrachus: A putative role in steroidogenesis

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Via histochem

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Acta Histochem. 2021 Aug 9;123(6):151766. doi: 10.1016/j.acthis.2021.151766. Online ahead of print.

ABSTRACT

The central role of kisspeptin (kiss) in mammalian reproduction is well established; however, its intra-gonadal role is poorly addressed. Moreover, studies investigating intra-gonadal role of kiss in fish reproduction are scanty, contradictory and inconclusive. The expression of kiss1 mRNA has been detected in the fish brain, and functionally attributed to the regulat ion of reproduction, feeding and behavior. The kiss1 mRNA has also been demonstrated in tissues other than the brain in some studies, but its cellular distribution and role at the tissue level have not been adequately addressed in fish. Therefore, an attempt was made in the present study to localize kiss1 in gonadal cells of the freshwater catfish, Clarias batrachus. This study reports the presence of kiss1 in the theca cells and granulosa cells of the ovarian oocytes and interstitial cells in the testis of the catfish. The role of kiss1 in the ovary and testis of the catfish was also investigated using kiss1 receptor (kiss1r) antagonist (p234). The p234 treatment decreased the production of 17β-estradiol in ovary and testosterone in the testis by lowering the activities of 3β-hydroxysteroid dehydrogenase and 17β-hydroxysteroid dehydrogenase under both, in vivo as well as in vitro conditions. The p234 treatment also arrested the progression of oogenesis, as evident from the low n umber of advancing/advanced oocytes in the treated ovary in comparison to the control ovary. It also reduced the area and perimeter of the seminiferous tubules in the treated catfish testis. Thus, our findings suggest that kiss is involved in the regulation of gonadal steroidogenesis, independent of known endocrine/ autocrine/ paracine regulators, and thereby it accelerates gametogenic processes in the freshwater catfish.

PMID:34384940 | DOI:10.1016/j.acthis.2021.151766

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Impact of Biologic Therapies on Surgery for Chronic Rhinosinusitis With Nasal Polyposis

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Ear Nose Throat J. 2021 Aug 12:1455613211034722. doi: 10.1177/01455613211034722. Online ahead of print.

NO ABSTRACT

PMID:34384031 | DOI:10.1177/01455613211034722

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Paraganglioma of the Thyroid Gland: A Case Report and a Review of the Literature

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Ear Nose Throat J. 2021 Aug 12:1455613211034595. doi: 10.1177/01455613211034595. Online ahead of print.

ABSTRACT

Paragangliomas of the thyroid gland are rare and usually they originate from the inferior laryngeal paraganglia. In this case report, we describe the case of a 78-year-old woman who presented with an incidental finding of thyroid nodule dislocating the trachea. After a systemic and radiological evaluation, right lobo-isthmectomy was performed, and the definitive d iagnosis of paraganglioma was reached. Diagnosis of these thyroidal lesions could be difficult due to their rarity, to their specific radiological aspects and the need of employing specific histological staining techniques. Once the definitive diagnosis is reached, patients should undergo a systemic and genetic evaluation. Surgery is the gold standard treatment; radiotherapy should be considered when aggressive behavior is suspected. Regular long-lasting follow-up should be proposed to these patients considering the unpredictable behavior of these lesions.

PMID:34384034 | DOI:10.1177/01455613211034595

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Endoscopic-Assisted Fronto-Orbital Distraction Osteogenesis: Initial Patient Report

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J Craniofac Surg. 2021 Aug 13. doi: 10.1097/SCS.0000000000008082. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this manuscript is to introduce a novel endoscopic-assisted approach for creation of osteotomies and distractor hardware placement for unicoronal craniosynostosis.

METHODS: Only three small incisions are performed, one at the anterior fontanelle, pterional region, and upper lateral blepharoplasty location. Unicoronal strip craniectomy and osteotomies in temporal bone, nasofrontal junction, lateral orbital rim, sphenoid wing, orbital roof, and contralateral frontal bone are performed through these incisions with the assistance of a 30° 5-mm endoscope. One linear cranial distractor is inserted through the pterional incision and fixated across the unicoronal suturectomy.

RESULTS: Endoscopic-assisted fronto-orbital distraction osteogenesis has been performed on 3 patients with unicoronal craniosynostosis. Media n age at surgery was 5.4 months (95%CI 5.0-6.1). Median operative duration was 98 minutes (95%CI 91-112), and estimated blood loss was 25 mL (95%CI 15-150). Median length of distraction achieved was 25.7 mm (95%CI 21.9-28.0), based on lateral skull x-rays obtained on the last day of activation. Distractors were removed 2.3 months postoperatively (95%CI 2.1-3.1), and operative duration of distractor removal was 20 minutes (95%CI 19-29). There was 1 complication, a transient cerebrospinal fluid leak thought to have been caused by a pinpoint injury to the dura at the nasofrontal junction, which was managed expectantly and resolved spontaneously by the fourth postoperative day.

CONCLUSIONS: Endoscopic-assisted fronto-orbital distraction osteogenesis is a promising treatment modality for children with unicoronal craniosynostosis combining the benefits of distraction osteogenesis with a minimally invasive approach. Additional experience and follow-up are needed to determine its util ity, safety, and longevity.

PMID:34387268 | DOI:10.1097/SCS.0000000000008082

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A systematic review and meta-analysis of iliocapsularis muscle: an important landmark in orthopedic surgery

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Surg Radiol Anat. 2021 Aug 12. doi: 10.1007/s00276-021-02815-5. Online ahead of print.

ABSTRACT

PURPOSE: Iliocapsularis (IC) is a small muscle overlying the capsule of the hip joint. Although recent attention is being given to this muscle by orthopedic surgeons who encounter it during the anterior approach to total hip arthroplasty, little is known about its anatomical features. The aim of this study was to review the anatomy of IC, and describe its' origin, insertion, blood supply, innervation, muscle fiber characteristics and size. The function, clinical relevance and comparative anatomy of IC were also appraised.

METHODS: Using Evidence-Based Anatomy methodology, electronic databases were searched with the terms "iliocapsularis", "iliacus minor", "iliotrochantericus", and "ilioinfratrochantericus" to identify eligible studies.

RESULTS: Six studies (n = 287 lower limbs) examining the anatomy of IC were included. The pooled prevalence (PP) of the IC was 98.7% (95% CI 96.5-100.0). It arises from the inferior facet of the anterior inferior iliac spine (AIIS) and attaches inferior to the lesser trochanter. Attached to the anteromedial capsule along its entire length, IC has the largest capsular contribution of any of the hip muscles (73.8 ± 27.3 × 16.1 ± 4.4 mm). Thus, it is an important landmark in anterior surgical approaches to the hip joint.

CONCLUSION: The anatomy of IC is becoming more relevant with the increasing use of anteri or approaches to hip surgery. With attachments to the AIIS, the lesser trochanter as well as the length of the capsule, this muscle is an important landmark in total hip arthroplasty.

LEVEL OF EVIDENCE: Level V.

PMID:34386828 | DOI:10.1007/s00276-021-02815-5

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Association of Perioperative Complications with Vitamin D Levels in Major Head and Neck Surgery

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Objectives/Hypothesis

To investigate the association of vitamin D level and perioperative complications in patients undergoing major head and neck surgery.

Study Design

Retrospective Cohort Study.

Methods

A retrospective chart review was performed for all patients undergoing reconstructive head and neck surgery between December 2017 and December 2019. Data regarding patient demographics, serum 25-hydroxyvitamin D (calcidiol) level, hospital course, prior radiation, and fistula formation were collected. Patients were categorized by serum calcidiol level as deficient (<20 ng/mL) or sufficient (≧20 ng/mL) and outcomes were compared between groups.

Results

Fifty-seven patients were included in the analysis. Average age at time of surgery was 62.6 ± 10.6 years. Patients with vitamin D levels <20 ng/mL were considered deficient and ≧20 ng/mL were considered sufficient. Individuals in the deficient group (n = 29) had a mean serum calcidiol level of 13.95 ± 3.95 ng/mL, whereas those in the sufficient group (n = 28) had a mean calcidiol level of 28.53 ± 5.73 ng/mL. The rate of fistula was 41.4% in the deficient group, whereas patients in the sufficient group had a rate of fistula of 14.3% (P = .038). On multivariate analysis, higher serum calcidiol level above 20 ng/mL was associated with a lower likelihood of developing fistulae with an odds ratio 0.830 (95% confidence interval: 0.718–0.960, P = .012).

Conclusion

Vitamin D deficiency may play a role in development of fistula after major head and neck surgery.

Level of Evidence

4 Laryngoscope, 2021

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Canadian consensus statement on the management of radioactive iodine-resistant differentiated thyroid cancer

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Oral Oncol. 2021 Aug 10;121:105477. doi: 10.1016/j.oraloncology.2021.105477. Online ahead of print.

ABSTRACT

Radioactive iodine-resistant differentiated thyroid cancer (RAIRTC) is an aggressive form of thyroid cancer that is uncommon and heterogeneous in its clinical behavior. With the emergence of more effective systemic therapy, the need for guidance in decision-making was recognized and a consensus committee of national experts was assembled. The consensus committee consisted of 13 clinicians involved in treating RAIRTC from across Canada and included endocrinologists, nuclear medicine physicians, surgeons, and radiation and medical oncologists. Domains of interest were identified by consensus, and evidence gathered using systematic reviews. Consensus recommendations for the diagnosis and management of RAIRTC were developed. It was recognized that the rarity of RAIRTC in practice and heterogeneous patterns of thyroid cancer care could limit access to effective therapy for some RAIRTC patients. This document offers guidance to manage RAIRTC patients in a multidisciplinary manner.

PMID:34388408 | DOI:10.1016/j.oraloncology.2021.105477

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Voice Changes Without Laryngeal Nerve Alterations After Thyroidectomy: The Need For Prospective Trials - A Review Study

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Thyroidectomy is a commonly performed surgical procedure that is offered for different thyroid pathologies. The most frequent complication after total thyroidectomy is transient or permanent hypoparathyroidism followed by transient or permanent recurrent laryngeal nerve palsy. Patients may experience voice impairment despite intact laryngeal nerve function. These patients are of special interest because they experience subjective symptoms which are difficult to measure and therefore to treat.
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