Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis

xlomafota13 shared this article with you from Inoreader Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis Via Clinical Otolaryngology Abstract •Changes in the microvascular network of the nasal mucosa may be accompanied by changes in olfaction. •Contact endoscopic changes in the microvascular network of the nasal mucosa may be used as a marker of sinonasal sarcoidosis. •A modified version of the Negoro's classification, in use for the tongue mucosa, may be used for the classification of contact endoscopic microvascular patterns of the nasal mucosa in patients with sarcoidosis •The validation of the use of the vascular patterns of nasal mucosa on contact endoscopy as a marker of nasal disease activity is a major future research challenge •Contact endoscopy emerges as a promising technique for on-site diagnosis of early, advanced or late inflammatory mucosal spots or generalized mucosal affection in sarcoidosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures

xlomafota13 shared this article with you from Inoreader Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures Via Clinical Otolaryngology Abstract Objectives In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit's complication rates. Design Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Patients were assessed pre-operatively for pre-existing oral, temporomandibular, dental, pharyngeal or laryngeal pathology, interincisor distance and qualitative gross limitations to neck extension and forward head posture. Intraoperatively, the laryngoscopic view was graded by anaesthetic and surgical teams, and complications were recorded on patient interview in recovery. Setting Tertiary adult airway service for predominantly benign pathology. Results Adequate surgical views were obtained in 149/150 procedures. BMI had a weak positive correlation with a more difficult view (r=0.22, p=0.008;) but did not correlate with a statistically significant increase in any complication. There was a weak negative correlation between age and interincisor gap (r=-0.20, p=0.014), and wider mouth opening correlated very weakly with a lower incidence of sore throat (r=-0.19, p=0.023). Gross macroglossia showed a significant moderate positive correlation with tongue symptoms (r=0.45, p=1.611x10-8). Conclusion In the context of an experienced airway unit with a high caseload of predominantly benign pathology, SL is very effective and safe with low associated morbidity and no mortality. The most common complication of SL is temporary sore throat and there remain recognised risks of temporary tongue and dental symptoms. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma

xlomafota13 shared this article with you from Inoreader Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma Via radioactive iodine Radiol Imaging Cancer. 2021 Sep;3(5):e219020. doi: 10.1148/rycan.2021219020. NO ABSTRACT PMID:34533374 | DOI:10.1148/ryca n.2021219020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma Via Head & Neck Abstract Background Enhancer RNAs (eRNAs) play an important role in carcinogenesis. The landscape of eRNAs in head and neck squamous cell carcinoma (HNSCC) remains largely unknown. Methods The eRNA expression matrix was obtained from the enhancer RNA in the cancer database. Functional enrichment analyses were performed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG). Prognostic eRNAs were identified using Cox regression analysis, and a prognostic prediction model was constructed based on coefficients. Results KEGG analysis showed that eRNA-related transcription factors were mainly enriched in herpes simplex virus 1 (HSV1) infection. The zinc finger (ZNF) family may play an essential role in HNSCC. ENSR00000188847, ENSR00000250663, ENSR00000313345, ENSR00000317887, and ENSR00000336429 were identified. The prediction model was robust. Conclusions We constructed a robust 5-eRNA prognostic prediction model, and these eRNAs are potential biomarkers for HNSCC prognosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection

xlomafota13 shared this article with you from Inoreader Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection Via leak of cerebrospinal fluid Br J Neurosurg. 2021 Sep 28:1-6. doi: 10.1080/02688697.2021.1981240. Online ahead of print. ABSTRACT BACKGROUND: Cerebrospinal fluid (CSF) leak through petrosal air cells is a known complication after drilling the posterior wall of the internal acoustic canal (IAC) for resection of vestibular schwannoma (VS). Whereas mild pneumocephalus is common after retrosigmoid craniotomy, tension pneumocephalus has been rarely documented. OBJECTIVE: To testify a case of fatal tension pneumocephalus after VS resection in a patient with ventriculo-peritoneal (VP) shunt and to propose possible recommendations to limit the risk of this dramatic complication. METHODS: A case of fatal tension pneumocephalus after VS resection in presence of hidden CSF fistula is illustrated with pre- and post-operative images. RESULTS: In the uneventful situation of concomitant post-operative CSF fistula in presence of VP shunt, tension pneumocephalus may occ ur. The negative pressure created by the shunt system and the presence of osteo-dural defect allow the air to enter and, at the same time, prevent the outflow. CONCLUSION: After VS resection, tension pneumocephalus can occur as a consequence of CSF fistula from petrosal air cells in the presence of functioning VP shunt. Precautions as pre-operative increase to 'virtual-off' the pressure of the valve, subsequences CT scans after surgery and sealing of the petrous air cells are recommended to avoid such as fatal complication. PMID:34579610 | DOI:10.1080/02688697.2021.1981240 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review

xlomafota13 shared this article with you from Inoreader Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review Via radioactive iodine J Clin Med. 2021 Sep 15;10(18):4150. doi: 10.3390/jcm10184150. ABSTRACT Multidisciplinary team (MDT) meetings are the mainstay of the decision-making process for patients presenting with complex clinical problems such as papillary thyroid carcinoma (PTC). Adherence to guidelines by MDTs has been extensively investigated; however, scarce evidence exists on MDT performance and variability where guidelines are less prescriptive. We evaluated the consistency of MDT management recommend ations for T1 and T2 PTC patients and explored key variables that may influence therapeutic decision making. A retrospective review of the prospective database of all T1 and T2 PTC patients discussed by the MDT was conducted between January 2016 and May 2021. Univariate analysis (with Bonferroni correction significance calculated at p < 0.006) was performed to establish clinical variables linked to completion thyroidectomy and Radioactive iodine (RAI) recommendations. Of 468 patients presented at thyroid MDT, 144 pT1 PTC and 118 pT2 PTC met the selection criteria. Only 18% (n = 12) of pT1 PTC patients initially managed with hemithyroidectomy were recommended completion thyroidectomy. Mean tumour diameter was the only variable differing between groups (p = 0.003). pT2 patients were recommended completion thyroidectomy in 66% (n = 16) of instances. No measured variable explained the difference in recommendation. pT1 patients initially managed with total thyroidectomy were not recommended RAI in 71% (n = 55) of cases with T1a status (p = 0.001) and diameter (p = 0.001) as statistically different variables. For pT2 patients, 60% (n = 41) were recommended RAI post-total thyroidectomy, with no differences observed among groups. The majority of MDT recommendations were concordant for patients with similar measurable characteristics. Discordant recommendations for a small group of patients were not explained by measured variables and may have been accounted for by individual patient factors. Further research into the MDT decision-making process is warranted. PMID:34575260 | DOI:10.3390/jcm10184150 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inpatient Sinus Surgery Patient Morbidity and Outcomes: A National Analysis

xlomafota13 shared this article with you from Inoreader Inpatient Sinus Surgery Patient Morbidity and Outcomes: A National Analysis Via The Laryngoscope Objectives/Hypothesis To investigate the morbidity and mortality of patients undergoing endoscopic sinus surgery (ESS) in the inpatient setting. Study Design Retrospective database review. Methods The Nationwide Inpatient Sample was queried for all ESS between 2008 and 2014. Using All Patients Refined Diagnosis Related Groups (APR-DRG) codes, cases with APR-DRG codes under Major Diagnostic Category 3 (Diseases and Disorders of the Ear, Nose, Mouth, and Throat) were designated as patients with primary otolaryngology diagnoses undergoing ESS (ORL), and all other codes were designated as patients with non-otolaryngology pathologies as their primary reason for admission but undergoing ESS (non-ORL). A univariate analysis and a logistic regression were used to compare patient demographics, comorbidities, disease severity, and mortality. Results There were 8,305 ORL patients and 6,342 non-ORL patients. ORL patients were more likely to be elective admissions (61.3% vs. 48.5%, P < .001), have a deviated nasal septum (17.9% vs. 12.3%, P < .001), nasal polyps (15.8% vs. 5.0%, P < .001), obstructive sleep apnea (10.7% vs. 5.2%, P < .001), and pulmonary disease (15.9% vs. 10.5%, P < .001). Non-ORL patients had a higher likelihood of in-hospital mortality (odds ratio [OR] 6.22, 95% confidence interval [CI] 3.29–11.78, P < .001), length of stay in the highest quartile (OR 2.43, 95% CI 2.16–2.74, P < .001), and a higher proportion had APR-DRG subclasses indicating extreme severity of illness (19.3% vs. 4.3%, P < .001) or extreme risk of mortality (12.5% vs. 2.0%, P < .001). Conclusion Patients undergoing ESS in the inpatient setting have a higher than expected mortality rate which can be associated with a non-otolaryngology pathology as the primary reason for their admission. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Micronutrients on Thyroid Parameters

xlomafota13 shared this article with you from Inoreader Effect of Micronutrients on Thyroid Parameters Via Journal of Thyroid Research Micronutrients are involved in various vital cellular metabolic processes including thyroid hormone metabolism. This study aimed to investigate the correlation between serum levels of micronutrients and their effects on thyroid parameters. The correlation of serum levels of micronutrients and thyroid markers was studied in a group of 387 healthy individuals tested for thyroid markers (T4, T3, FT4, FT3, TSH, anti-TPO, RT3, and anti-Tg) and their micronutrient profile at Vibrant America Clinical Laboratory. The subjects were rationalized into three groups (deficient, normal, or excess levels of micronutrients), and the levels of their thyroid markers were compared. According to our results, deficiency of vitamin B2, B12, and B9 and Vit-D25[OH] () significantly affected thyroid functioning. Other el emental micronutrients such as calcium, copper, choline, iron, and zinc () have a significant correlation with serum levels of free T3. Amino acids asparagine (r = 0.1765, ) and serine (r = 0.1186, ) were found to have a strong positive correlation with TSH. Valine, leucine, and arginine () also exhibited a significant positive correlation with serum levels of T4 and FT4. No other significant correlations were observed with other micronutrients. Our study suggests strong evidence for the association of the levels of micronutrients with thyroid markers with a special note on the effect of serum levels of certain amino acids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hemoglobin Absorption Spectral Imaging (H.A.S.I.): a novel optical staining technique for microlaryngoscopy

xlomafota13 shared this article with you from Inoreader Hemoglobin Absorption Spectral Imaging (H.A.S.I.): a novel optical staining technique for microlaryngoscopy 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 Sep 28. doi: 10.1007/s00405-021-07090-z. Online ahead of print. ABSTRACT PURPOSE: Optical image enhancement techniques are widely used in endoscopy to improve the visualization of blood vessels for diagnostic and therapeutic purposes. These techniques are monitor-based and therefore not available for direct microscopy. In this study, a novel optical microscope filter, Hemoglobin absorption spectral imaging (H.A.S.I.) was tested for use in microlaryngoscopy. METHODS: A novel dichroic filter was designed to improve contrast in small blood vessels by highlighting transmission in the spectrum range of hemoglobin absorption maxima. A surgical microscope equipped with the novel H.A.S.I. filter was installed in one operating room in our institution. 68 consecutive patients referred to our ENT department for endoscopy were examined using white light and the novel H.A.S.I. filter during microlaryngoscopy. S urgeons described the blood vessels of the vocal cords using a classification chart and assessed for suspected malignancy using both white light and H.A.S.I. RESULTS: 77 consecutive microlaryngoscopies were performed on 68 patients. 142 vocal cords were visualized in microlaryngoscopy and the blood vessels classified according to the chart. With white light, 152 blood vessel characteristics were documented and 157 with H.A.S.I. Notably, pathologies like benign horizontal blood vessel changes, leukoplakia, and vertical blood vessel changes like dots and loops were seen more frequently with H.A.S.I. Finally, seven lesions were treated by transoral laser microsurgery (TLM) with H.A.S.I. to test the practicability of the method for microlaryngoscopic laser surgery. CONCLUSION: This is the first study describing H.A.S.I. as an optical staining method for microlaryngoscopy. In our experience, the method was practical and improved the evaluation of vocal cord blood vessels. In some cases, the use of H.A.S.I. led to a change in diagnosis and treatment. Also, H.A.S.I. was found to be helpful in microlaryngeal laser surgery for demarcating resection margins. This is, to our knowledge, the first optical staining method integrated into a surgical microscope and can be conveniently used during microlaryngeal laser surgery and does not require further equipment. PMID:34581854 | DOI:10.1007/s00405-021-07090-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.