PTH in situ measurement in patients with hyperparathyroidism: single-centre experience of 179 patients

xlomafota13 shared this article with you from Inoreader PTH in situ measurement in patients with hyperparathyroidism: single-centre experience of 179 patients Via oto-rhino-laryngologie Eur J Endocrinol. 2022 Feb 1:EJE-21-1249. doi: 10.1530/EJE-21-1249. Online ahead of print. ABSTRACT CONTEXT: The measurement of PTH in situ (PTHis) by fine-needle aspiration (FNA) is proposed as a tool to preoperatively help localize parathyroid glands detected on ultrasound. However, the accuracy of PTHis is highly variable according to the few available studies. We aimed to develop and validate the PTHis procedure. We assessed the performance of PTHis in a large series of patients with hyperparathyroidism. PATIENTS: The technique setup consisted of PTHis measurement in thyroid samples from patients with thyroid nodules and patients with high circulating PTH levels (tertiary hyperparathyroidism). Consecutive patients were recruited and submitted to ultrasound-guided FNA-PTHis determination. RESULTS: During the method setup, we obtained undetectable PTHis levels in all non-parathyroid tissues after sample dilutions. PTHis was high er in patients with hyperparathyroidism (n=145, 1817±3739 ng/L, range <4.6-31,140) than in those with thyroid or undetermined cervical lesions (n=34, <4.6 ng/mL,p<0.0001). When evaluating PTHis performance in histologically proven samples (158 lesions from 121 patients), PTHis was detectable in 85/97 parathyroid lesions (87%, range 22-31,140 ng/L) and undetectable in all non-parathyroid lesions (n=61,p<0.0001). The specificity and positive predictive value were 100%, and the sensitivity was 87.6%. False-negative lesions (n=12) were smaller (9.4±5.9 mm) and more often consisted of hyperplasias (75%) than true-positive lesions (16.1±8.4 mm and 33%, p=0.009 and p=0.0089, respectively). The method was safe and well tolerated. Four educational cases are also provided. CONCLUSIONS: PTHis determination is a safe and well-tolerated procedure that enhances the specificity of ultrasound-detected lesions. If accurately set up, it confirms the parathyroid origin of uncharac terized cervical lesions. PMID:35167489 | DOI:10.1530/EJE-21-1249 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aggressive paediatric camptodactyly: The evolution of a proposed treatment algorithm

xlomafota13 shared this article with you from Inoreader Aggressive paediatric camptodactyly: The evolution of a proposed treatment algorithm Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 22:S1748-6815(22)00034-1. doi: 10.1016/j.bjps.2022.01.020. Online ahead of print. ABSTRACT INTRODUCTION: It is a long-established teaching to avoid operating on camptodactyly unless there is a failure of non-operative treatment, such as serial splinting and hand therapy, and there is an established proximal interphalangeal joint (PIPJ) contracture of 60°; a recent systematic review reflects this continuing approach, with some papers advocating intervention with a lesser degree of contracture. AIM: To evaluate whether early flexor digitorum superficialis (FDS) release, followed by gentle passive manipulation (GPM), will correct severe 'congenital' camptodactyly, if undertaken at an earlier age than usual, thus avoiding the more aggressive surgical approach required in the established adolescent cases. METHOD: The surgical technique and treatment algorithm are described. A multi-centre case series is presented; data analysis included patient demographics, syndromic association, side/digit affected, ages at onset, progression, referral and at surgery, operation details, pre- and post-operative contracture and range of motion. RESULTS: There were 12 patients (3 males, 9 females) who underwent 15 operations for 24 involved digits. Patients had surgery by 3 months (median) post-referral, and there was a significant improvement in median (range) PIPJ contracture (90°(30°-90°) vs. 0°(0°-45°); p<0.001) and range of motion (0°(0°-60°) vs. 90°(50°-95°); p<0.001), at a median post-operative follow-up of 2.5 years. According to the Siegert grade, 87.5% of digits had excellent/good post-operative outcomes and 12.5% had fair outcomes. CONCLUSION: This paper specifically addresses the problem of aggressive and progressive camptodactyly in the young child. By this, we mean patients who have failed non-operative treatment and have PIPJ contractures ≥60°, and those whose contractures have increased by 30° within 1 year. All cases responded to early FDS release and GPM, hence correcting the PIPJ contracture. However, cases with multiple digital involvement, whether syndromic or not, and failed previous surgery or the older child, required additional procedures to restore a dynamic dorsal apparatus and active extension. PMID:35153164 | DOI:10.1016/j.bjps.2022.01.020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of abnormal vestibular responses in children with sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader Prevalence of abnormal vestibular responses in children with sensorineural hearing loss 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. 2022 Feb 14. doi: 10.1007/s00405-021-07241-2. Online ahead of print. ABSTRACT PURPOSE: Dysfunction of the vestibular organs has a great deal of influence on children's balance. Children with sensorineural hearing loss (SNHL) may often have accompanying abnormal vestibular responses. Video head impulse test (vHIT) combined with a test battery of cervical and ocular vestibular evoked myogenic potentials (cVEMPs, oVEMPs) make it possible to determine the prevalence of abnormal vestibular response in any of the five paired vestibular organs amongst children with SNHL. METHOD: Prospective cross-sectional study including children aged 3-17 years with uni- or bilateral SNHL (bone-conduction (BC) pure tone average (PTA4) above 20 dB). Assessments included vHIT, cVEMP, and oVEMP. Descriptive data were analyzed. T-tests were performed to detect any correlation between the degree of SNHL and abnormal ve stibular responses. RESULTS: 42 children (27 males), a total of 63 ears with SNHL, mean BC PTA4 SNHL of 42.3 dB (32.0; 58.4 IR) were included. 28.6% had at least one ear with abnormal vestibular response. 97.6% (41/42) completed one and 75.0% (27/36) completed all vestibular examinations. Ears with two pathological examinations had significantly more severe SNHL than ears with one pathological or normal vestibular examinations (p = 0.008, p = 0.005). CONCLUSION: All test methods used with this study were easy, fast, and comfortable for children (as young as 3 years of age) to undergo. Even a moderate SNHL might be associated with abnormal vestibular response. Structural damage to the organs is the most likely cause of vestibular deficit. Consensus on criteria defining pathological examinations with both vHIT and VEMPs are required for more accurate comparison with previous studies. PMID:35156132 | DOI:10.1007/s00405-021-07241-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function

xlomafota13 shared this article with you from Inoreader Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function Via ear nose throat Ear Nose Throat J. 2022 Feb 14:1455613221077601. doi: 10.1177/01455613221077601. Online ahead of print. NO ABSTRACT PMID:35152782 | DOI:10.1177/01455613221077601 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope

xlomafota13 shared this article with you from Inoreader Message: Bow hunter syndrome (BHS) is an uncommon cause of vertebrobasilar insufficiency that results from occlusion or injury to the vertebral artery (VA) during neck rotation. The cause is often a bony abnormality that may compress the VA compromising distal flow or lead to vessel wall injury resulting in thromboembolism. Thyroid Cartilage Compression Causing Bow Hunter's Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 12:34894221077477. doi: 10.1177/00034894221077477. Online ahead of print. ABSTRACT OBJECTIVES AND METHODS: We report a unique case of Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope despite previous decompressive surgery at vertebral levels C5-C6. RESULTS: Re-evaluation with computed tomography-scan during provocation of dizziness by neck rotation revealed compression of the right VA at level C6 from against the ipsilateral posterior border and superior cornu of the thyroid cartilage. Laryngoplasty resulted in complete resolution of symptoms. CONCLUSION: This extremely rare cause of Bow's Hunter's syndrome should be considered, especially in refractory cases after neurosurgical decompression, and surgical management is straightforward and successful. PMID:35152775 | DOI:10.1177/00034894221077477 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Cartilage Compression Causing Bow Hunter's Syndrome

xlomafota13 shared this article with you from Inoreader Thyroid Cartilage Compression Causing Bow Hunter's Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 12:34894221077477. doi: 10.1177/00034894221077477. Online ahead of print. ABSTRACT OBJECTIVES AND METHODS: We report a unique case of Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope despite previous decompressive surgery at vertebral levels C5-C6. RESULTS: Re-evaluation with computed tomography-scan during provocation of dizziness by neck rotation revealed compression of the right VA at level C6 from against the ipsilateral posterior border and superior cornu of the thyroid cartilage. Laryngoplasty resulted in complete resolution of symptoms. CONCLUSION: This extremely rare cause of Bow's Hunter's syndrome should be considered, especially in refractory cases after neurosurgical decompression, and surgical management is straightforward and successful. PMID:35152775 | DOI:10.1177/00034894221077477 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Serratus Anterior-Rib Composite Flap as a Novel Approach for Tracheal Reconstruction

xlomafota13 shared this article with you from Inoreader Serratus Anterior-Rib Composite Flap as a Novel Approach for Tracheal Reconstruction Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 13:34894211067608. doi: 10.1177/00034894211067608. Online ahead of print. ABSTRACT OBJECTIVE: To report a novel case of tracheal reconstruction using a serratus anterior-rib composite flap. METHODS: Case report and literature review. RESULTS: A 46-year-old male with a 4 cm anterior tracheal wall defect underwent reconstruction with a serratus anterior-rib composite flap. The patient experienced excellent results regarding phonati on, swallowing, and cosmesis. CONCLUSION: The serratus anterior-rib composite flap appears to be a suitable candidate for tracheal reconstruction and merits further analysis in this context. The flap's intrinsic incorporation of a perfused rib segment allows for reliable reconstruction of the neotrachea and maintenance of proximal dynamic airway support. PMID:35156399 | DOI:10.1177/00034894211067608 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.