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Τρίτη 31 Αυγούστου 2021

Acute appendicitis secondary to desmoplastic melanoma metastasis in immune-checkpoint inhibitors era

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CircAGFG1 acts as a sponge of miR-4306 to stimulate esophageal cancer progression by modulating MAPRE2 expression

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Acta Histochem. 2021 Aug 27;123(7):151776. doi: 10.1016/j.acthis.2021.151776. Online ahead of print.

ABSTRACT

OBJECTIVE: This work aims to determine the role of circular RNA (circRNA) AGFG1 and related molecular mechanism in esophageal squamous cell carcinoma (ESCC) cells.

METHODS: CircAGFG1 expression in ESCC cell lines was probed with qRT-PCR. ESCC cells were transfected/cotransfected with si-circAGFG1, pcDNA3.1-circAGFG1, si-Microtubule Associated Protein RP/EB Fami ly Member 2 (MAPRE2), pcDNA3.1-circAGFG1 + miR-4306 mimic or pcDNA3.1-circAGFG1 + si-MAPRE2. The interactions between circAGFG1 and miR-4306 as well as miR-4306 and MAPRE2 were confirmed by dual-luciferase reporter assay. Cell proliferation, migration and invasion were detected by CCK-8, cell scratch and Transwell assays, respectively. Relative RNA expression levels of circAGFG1, miR-4306 and MAPRE2 in ESCC cells were measured by qRT-PCR. The protein level of MAPRE2 in ESCC cells was monitored by Western blot.

RESULTS: CircAGFG1 was observably upregulated in ESCC cell lines. Besides, circAGFG1 silencing hindered ESCC cell development in vitro, and these effects were enhanced by miR-4306 overexpression or MAPRE2 silencing. Mechanistic analysis evidenced that circAGFG1 might act as a competitive endogenous RNA of miR-4306 to relieve the repressive effect of miR-4306 on its target MAPRE2.

CONCLUSION: CircAGFG1 facilitates ESCC progression via the miR-4306/MAPRE2 axis, and i t may act as a possible biomarker for therapy and diagnosis in ESCC treatment.

PMID:34461454 | DOI:10.1016/j.acthis.2021.151776

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Can intensity modulation of the auditory response explain intensity-decrement mismatch negativity?

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Neurosci Lett. 2021 Aug 27:136199. doi: 10.1016/j.neulet.2021.136199. Online ahead of print.

ABSTRACT

Mismatch negativity (MMN) elicited by decrements in sound pressure level has been asserted as evidence for its dependence upon general deviance detection, while refuting the proposition that it is simply caused by modulating the intrinsic sensory response with different physical properties of sound. However, reports of intensity-decrement MMN are sparse compared with MMN to stimulus frequency or duration changes, and verifying the mechanisms that shape difference waveform morphology is essential for their responsible use as clinical biomarkers. In the present study, open-access EEG data from 40 healthy young adults recorded during an intensity-decrement oddball paradigm was analyzed to establish the effects of transitions between different level stimuli on the auditory evoked response. Standard stimuli were 80 dB and deviant stimuli were 70 d B. Event-related potentials were extracted from standards after standards (sS), deviants after standards (sD), and standards after deviants (dS). Mean amplitude across a recommended measurement window for MMN (125 to 225 ms) was calculated for each ERP waveform. This revealed statistically significant negative amplitude shift elicited by lower-intensity deviant stimuli, as expected, and an opposite direction, positive amplitude shift elicited by higher-intensity standard stimuli that followed lower-intensity deviants, relative to standard stimuli presented consecutively. These findings indicate that intensity-modulation of the auditory response influences cortical activity measured during the latency range of MMN. To what extent the hypothesized deviance detection mechanisms may also contribute is uncertain and remains to be elucidated.

PMID:34461160 | DOI:10.1016/j.neulet.2021.136199

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Robotic rectal resection preserves anorectal function: systematic review and meta‐analysis

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ABSTRACT

Background

Improving survival rates in rectal cancer patients has generated a growing interest in functional outcomes after total mesorectal excision (TME). The well-established low anterior resection syndrome (LARS) score assesses postoperative anorectal impairment after TME. Our meta-analysis is the first to compare bowel function after open, laparoscopic, transanal, and robotic TME.

Methods

All studies reporting functional outcomes after rectal cancer surgery (LARS score) were included, and results were compared with a consecutive series of robotic TME (n=48).

Results

Thirty-two publications were identified, including 5 565 patients. Anorectal function recovered significantly better within one year after robotic TME (3.8 [95%CI -9.709–17.309]) versus laparoscopic TME (26.4 [95%CI 19.524–33.286]), p=0.006), open TME (26.0 [95%CI 24.338–29.702], p=0.002), and transanal TME (27.9 [95%CI 22.127–33.669], p=0.003).

Conclusions

Robotic TME enables better recovery of anorectal function compared to other techniques. Further prospective, high-quality studies are needed to confirm the benefits of robotic surgery.

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Reading and comprehension: phoniatric assessment in students with reading difficulties

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Braz J Otorhinolaryngol. 2021 Jul 21:S1808-8694(21)00125-7. doi: 10.1016/j.bjorl.2021.05.014. Online ahead of print.

ABSTRACT

INTRODUCTION: Reading is a highly refined skill that encompasses two main components: decoding graphic symbols and understanding the written message. These aspects generally develop together, but reading comprehension is a much more complex process, sustained not only by the identification of written words and vocabulary but also by language systems, such as syntax and general knowledge. Although there is a well-established technique for performing the phoniatric assessment, there is no common use of tests that assess reading comprehension or the association of this information with other assessment data.

OBJECTIVE: The objective of this study is, in the context of the phoniatric consultation, to evaluate the reading and retelling in children with relevant reading difficulties and to correlate the decoding and comprehension problems with the alterations observed in auditory and visual perceptual tests, pointing out the evidence that best contributed to the differential diagnosis of these subjects.

METHODS: Starting from a population of 301 children enrolled in the 4th and 5th grades of elementary school, 13 children with evident reading and writing difficulties were evaluated regarding the reading and retelling tasks and separated into groups according to the problem of decoding, fluency, and comprehension. Reading performance was correlated with the performance in visual and auditory perceptual tests and based on the similarity analysis, the tests considered to be the most relevant in the diagnosis process of these children were identified.

RESULT: The results suggest that the tasks: naming of figures, repetition of numbers in reverse order, figure copying, syllabic synthesis, phonemic synthesis, rhyme, and phonemic manipulation altogether contribute to diagnosis and mul tidisciplinary intervention aspects.

CONCLUSION: Some tasks are more relevant to the diagnostic process of children with complaints of learning difficulties in reading.

PMID:34462203 | DOI:10.1016/j.bjorl.2021.05.014

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Transmastoid exposure of the labyrinthine segment of the facial nerve: an anatomical study

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Braz J Otorhinolaryngol. 2021 Aug 11:S1808-8694(21)00136-1. doi: 10.1016/j.bjorl.2021.07.002. Online ahead of print.

ABSTRACT

INTRODUCTION: Compression of the labyrinthine segment of the facial nerve by edema has been considered as an important pathology in the majority of the cases of idiopathic facial nerve paralysis. Hence, it is suggested that total decompression of the facial nerve should also include the labyrinthine segment by a middle fossa approach. However, the middle fossa approach requires craniotomy and temporal lobe retraction, which increases the morbidity. The labyrinthine segment of the facial nerve can also be reached through mastoidectomy. However, many ear surgeons are not familiar with this approach due to the lack of anatomical data on this surgical area.

OBJECTIVE: To study the anatomical limitations of decompression of the labyrinthine segment via transmastoid approach.

METHODS: Complete mastoidectom y was performed in six adult cadavers heads. Dissection was extended in the zygomatic root and posterior bony wall of the external auditory canal to visualize the incudomallear joint completely. The bone between tympanic segment, lateral and superior semicircular canal's ampullas and middle fossa dural plate was removed. Fine dissection was carried out over tympanic segment of the facial nerve in an anterosuperomedial direction the labyrinthine segment was reached.

RESULTS: All the mastoids were well pneumatized. Distances between the labyrinthine segment and middle fossa dura, and between the labyrinthine segment and superior semicircular canal, were 2.5 and 4.5 mm on average, respectively. In addition, distances between the middle fossa dura and dome of the lateral semicircular canal, and between the middle fossa dura and tympanic segment were 4.6 mm and 4.3 mm on average, respectively.

CONCLUSION: It is possible to expose the labyrinthine segment of the facial nerve t hrough mastoidectomy by dissecting the bone in the area between the tympanic segment of the facial nerve, middle fossa dural plate and ampullary ends of the lateral and superior semicircular canals.

PMID:34462204 | DOI:10.1016/j.bjorl.2021.07.002

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A challenging TSH/GH co-secreting pituitary adenoma with concomitant thyroid cancer; a case report and literature review

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BMC Endocr Disord. 2021 Aug 30;21(1):177. doi: 10.1186/s12902-021-00839-x.

ABSTRACT

BACKGROUND: Thyroid stimulating hormone (TSH) secreting pituitary adenoma (TSHoma) with coexisting thyroid cancer is extremely rare, and proper treatment of both diseases may pose a unique clinical challenge. When TSHoma has plurihormonality, particularly involving the co-secretion of growth hormone (GH), management can be more complicated. Herein, we present a difficult-to-manage case of papillary thyroid cancer with an incurable TSH/GH-secreting pituitary adenoma.

CASE PRESENTATION: A 59-year-old man was referred to our hospital due to memory impairment and inappropriate TSH level. Sella magnetic resonance imaging revealed a huge pituitary mass extending to the suprasellar area. Clinical diagnosis of TSH/GH co-secreting pituitary adenoma was made based on elevated free T4, total T3, serum α-subunit, insulin-like growth factor-1 levels and non-suppressible GH levels after oral glucose loading. Rectal cancer and multifocal papillary thyroid microcarcinoma (PTMC) were diagnosed during initial screening for internal malignancy; lower anterior resection was performed and close observation was planned for PTMC. Long-acting octreotide therapy was commenced, which resulted in a dramatic reduction in TSHoma size and facilitated control of hormonal excess. Total thyroidectomy and radioactive iodine (RAI) therapy were needed during follow up due to the growth of PTMC. After the surgery, the pituitary adenoma represented resistance to somatostatin analogue therapy and the tumor size gradually increased despite the addition of dopamine agonist therapy. Furthermore, TSH suppressive therapy with levothyroxine was impossible and an adequate TSH level for RAI therapy was unmountable. Late debulking pituitary surgery was ineffective, and the patient gradually deteriorated and lost to follow up.

CONCLUSION: We report the first aggravated case of TSH/GH co-secreting pituitary tumor after total thyroidectomy for concomitant multifocal PTMC. Deferring of thyroid surgery until the TSHoma is well controlled may be the optimal therapeutic strategy in patients with TSHoma and coexistent thyroid cancer; ablative thyroid surgery may result in catastrophic pituitary tumor growth.

PMID:34461869 | DOI:10.1186/s12902-021-00839-x

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Identification of Two Different Phenotypes of Patients with Amiodarone-Induced Thyrotoxicosis and Positive Thyrotropin Receptor Antibody Tests

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Validity and Reliability of the French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS)

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Ear Nose Throat J. 2021 Aug 31:1455613211032004. doi: 10.1177/01455613211032004. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop a French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (Fr-sQOD) to assess the quality of life impairments of patients with olfactory dysfunction (OD).

METHODS: Patients with OD and controls were enrolled from 2 academic centers. Individuals completed the Fr-sQOD, an OD visual analog scale severity, and th e French version of the sinonasal outcome tool-22 (SNOT-22). Cronbach α was used to measure the internal consistency of Fr-sQOD. The reliability and the external validity of Fr-sQOD were assessed through a test-retest approach and by correlating Fr-sQOD with SNOT-22 scores, respectively. The external validity was assessed by correlation analysis between Fr-sQOD and the result of an assessment of the severity of OD on a visual analog scale.

RESULTS: Eighty patients completed the evaluations. The internal consistency was adequate (Cronbach α .96), and the test-retest reliability was high in the entire cohort (rs = 0.877, P < .001). The correlation between Fr-sQOD total scores and the severity of OD was moderate but significant (rs = -0.431; P = .001) supporting an acceptable external validity. Patients with OD had a significantly higher score of Fr-sQOD than healthy individuals (P < .001), indicating a high internal validity.

CONCLUSION: The Fr-sQOD is a reliable and valid self-administered tool in the evaluation of the impact of OD on quality of life of French-speaking patients.

PMID:34463149 | DOI:10.1177/01455613211032004

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A Preliminary Report on the Correlation Between Nasal Function and the Different Phases of the Nasal Cycle

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Ear Nose Throat J. 2021 Aug 31:1455613211041788. doi: 10.1177/01455613211041788. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore whether the different phases of the nasal cycle have a significant effect on nasal temperature, the nasal mucosal clearance rate, and levels of nasal nitric oxide (nNO) and to investigate the correlation between these nasal conditions.

METHODS: The study participants were divided into 2 groups: the control group and the rhinitis group. The participants' nasal temperature, cilia clearance rate, and nNO levels were measured during different phases of the nasal cycle (the congestion phase and decongestion phase) in the control group and before and after undergoing inferior turbinate ablation in the rhinitis group.

RESULTS: The temperature of the nasal cavity in the control group was significantly higher in the congestion phase than in the decongestion phase (P = .0025), while in the rhinitis group, the temperature of the nasal cavity decreased significantly after inferior turbinate ablation (P = .001). In the control group, the nasal mucosa clearance time was significantly shorter in the congestion phase than in the decongestion phase (P = .001), and in the rhinitis group, the clearance time of the nasal mucosa was significantly shortened after the operation (P = .0025). In the control group, the levels of nNO were significantly higher in the congestion phase than in the decongestion phase (P = .025), while in the rhinitis group, nNO levels decreased significantly after the operation (P = .005).

CONCLUSION: The function of the nasal cavity changes in different phases of the nasal cycle. Therefore, when evaluating the impact of various factors on nasal function, factors associated with the nasal cycle should also be considered. Inferior turbinate plasma ablation can improve the ciliary function of the nasal mucosa, reduce the temperature of the nasal cavity, and reduce nNO levels.

PMID:34463151 | DOI:10.1177/01455613211041788

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Depression in the pediatric otolaryngology clinic setting

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Abstract

Objectives

For most pediatric specialty clinics, mental health is not the primary presenting complaint yet can portend unrecognized morbidity. We describe rates and risk factors of depression and suicidal ideation in adolescents seen at a pediatric specialty clinic and examine changes during COVID-19.

Methods

Outpatient pediatric otolaryngology clinic encounters of patients ages 12-19 at a tertiary academic medical center were identified from October 2018 to July 2020. Demographic characteristics, ICD-10 primary diagnosis, Patient Health Questionnaire (PHQ)-2 score, and PHQ-9 score (if administered) were obtained. Multivariable regression examined risk factors for PHQ-9 administration, PHQ-9 scores ≥10, and suicidal ideation. Patient characteristics and PHQ scores were compared before and after March 23, 2020 (California COVID-19 Stay-at-Home order).

Results

3,609 encounters with PHQ-2 data were identified. Of these, 223 (6.2%) scored ≥3 and underwent PHQ-9 assessment. 121 (3.4% of 3,609) scored ≥10 on the PHQ-9 and 53 (1.5%) endorsed suicidal ideation. Factors associated with PHQ-9 administration were female gender (OR 1.58, p=0.001), obesity (OR 1.48, p=0.043), and Neck Mass/Neoplasm/Cancer diagnosis (OR 1.99, p=0.013). Female gender was also associated with suicidality (OR 2.47, p=0.008). Comparison pre-COVID-19 vs. during COVID-19 showed no differences in depression or suicidality. However subgroup analysis revealed some significant findings.

Conclusions

We demonstrate substantial prevalence of positive depression screening and suicidal ideation among adolescent pediatric otolaryngology clinic encounters. Depression rates were similar pre-COVID-19 and during COVID-19, yet barriers to screening during this time were substantial. Pediatric specialty providers must remain vigilant for mental health issues in their patients.

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