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Κυριακή 26 Δεκεμβρίου 2021

Intracorporeal Cortical Telemetry as a Step to Automatic Closed-Loop EEG-Based CI Fitting: A Proof of Concept

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Audiol Res. 2021 Dec 13;11(4):691-705. doi: 10.3390/audiolres11040062.

ABSTRACT

Electrically evoked auditory potentials have been used to predict auditory thresholds in patients with a cochlear implant (CI). However, with exception of electrically evoked compound action potentials (eCAP), conventional extracorporeal EEG recording devices are still needed. Until now, built-in (intracorporeal) back-telemetry options are limited to eCAPs. Intracorporeal recording of auditory responses beyond the cochlea is still lacking. This study describes the feasibility of obtaining longer latency cortical responses by concatenating interleaved short recording time windows used for eCAP recordings. Extracochlear reference electrodes were dedicated to record cortical responses, while intracochlear electrodes were used for stimulation, enabling intracorporeal telemetry (i.e., without an EEG device) to assess higher cortical processing in CI recipients. Simulta neous extra- and intra-corporeal recordings showed that it is feasible to obtain intracorporeal slow vertex potentials with a CI similar to those obtained by conventional extracorporeal EEG recordings. Our data demonstrate a proof of concept of closed-loop intracorporeal auditory cortical response telemetry (ICT) with a cochlear implant device. This research breaks new ground for next generation CI devices to assess higher cortical neural processing based on acute or continuous EEG telemetry to enable individualized automatic and/or adaptive CI fitting with only a CI.

PMID:34940020 | DOI:10.3390/audiolres11040062< /p>

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Regulation of nuclear medicine services: Perception of the problems and challenges in Colombia for the approach to cancer

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Biomedica. 2021 Dec 15;41(4):692-705. doi: 10.7705/biomedica.6123.

ABSTRACT

Introduction: Colombia has modified the nuclear medicine norms that impact the administration of radioactive iodine therapy in the treatment of thyroid cancer. Objective: To identify the areas of agreement regarding the issue, as well as the current and emergent requirements associated with the normative for the operation of nuclear medicine services that have an impact on the care of patients with thyroid cancer in Colombia. Materials and methods: We conducted a two-round Delphi study for each expert, clinical, and regulatory group. The first round explored views on the implications of the regulations that apply to nuclear medicine. The second round rated the statements from the first round by their relevance. Results: The issues regarding nuclear medicine services were related to the normative clarity and the lack of synergy and coherence among inspection, surveillance, and control bodies. The demands on the waste management system require a high economic investment that can influence the service offer and have an impact on the integral control of thyroid cancer. Unification of the auditors' criteria, delimitation of the acting agent functions, technical assistance to the services to comply with the normative, and the oversight of the inspection, surveillance, and control bodies by the regulatory entities are among the current and future needs. Conclusions: Our findings suggest th at nuclear medicine services are going through a time of multiple institutional, regulatory, and economic challenges that put at risk the development and maintenance of nuclear medicine in cancer care.

PMID:34936254 | DOI:10.7705/biomedica.6123

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Machine learning can identify patients at risk of hyperparathyroidism without known calcium and intact parathyroid hormone

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Abstract

Background

To prove the concept of diagnosing primary hyperparathyroidism (pHPT) without calcium and parathyroid hormone (PTH) values and identifying potential risk factors for pHPT.

Methods

Data were extracted from the clinical data warehouse (CDW) at the University of Arkansas for Medical Sciences (UAMS) Epic EHR (2014–2019).

Results

1737 patients with over 185 000 rows of clinical data were provided in a relational structure and processed/flattened to facilitate modeling. Phenotype elements were identified for pHPT without advance knowledge of calcium and PTH levels. The area under the curve (AUC) for the prediction of pHPT using our model was 0.86 with sensitivity and specificity of 0.8953 and 0.6686, respectively, using a 0.45 probability threshold.

Conclusion

Primary hyperparathyroidism was predicted from a dataset excluding calcium and PTH data with 86% accuracy. This approach needs to be validated/refined on larger samples of data and plans are in place to do this with other regional/national datasets.

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A Systematic Review of Robotic Surgery: From Supervised Paradigms To Fully Autonomous Robotic Approaches

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Abstract

Background

From traditional open surgery to laparoscopic surgery and robot-assisted surgery (RAS), advances in robotics, machine learning, and imaging are pushing the surgical approach to-wards better clinical outcomes. Pre-clinical and clinical evidence suggests that automation may standardise techniques, increase efficiency, and reduce clinical complications.

Methods

A PRISMA-guided search was conducted across PubMed and OVID.

Results

Of the 89 screened articles, 51 met the inclusion criteria, with 10 included in the final review. Automatic data segmentation, trajectory planning, intra-operative registration, trajectory drilling, and soft tissue robotic surgery were discussed.

Conclusion

Although automated surgical systems remain conceptual, several research groups have developed supervised autonomous robotic surgical systems with increasing consideration for ethico-legal issues for automation. Automation paves the way for precision surgery and improved safety and opens new possibilities for deploying more robust artificial intelligence models, better imaging modalities and robotics to improve clinical outcomes.

This article is protected by copyright. All rights reserved.

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Τετάρτη 22 Δεκεμβρίου 2021

Case Reports in Otolaryngology


Arteriovenous Malformation in the Auricle in a 59-Year-Old Woman
, Junhui Jeong
Volume 2021 (2021), Article ID 7438571, 3 pages
A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base, Kohei Matsuo, Satoshi Tanaka, Masayuki Sakata, Hiroki Takeda, Akihiro Nagata, Masashi Mori, Rie Ito, Yoshifumi Yamamoto, Kiyonobu Ueno, and Atsuhiko Uno
Volume 2021 (2021), Article ID 7500273, 4 pages
Deep Neck Infection: Atypical Presentation of Papillary Thyroid Cancer, Apichana Mahattanapreut, Rangsima Aroonroch, Chalermchai Chintrakarn, and Chutintorn Sriphrapradang
Volume 2021 (2021), Article ID 1479201, 4 pages
Alobar Holoprosencephaly with Cebocephaly in a Neonate Born to an HIV-Positive Mother in Eastern Uganda, Franck Katembo Sikakulya, Sonye Magugu Kiyaka, Robert Masereka, and Robinson Ssebuufu
Volume 2021 (2021), Article ID 7282283, 4 pages
ALK-Positive Anaplastic Large Cell Lymphoma: A Diagnostic Dilemma for the Otolaryngologist in a Resource Poor Setting, Nicholas Figaro, Rickhi Ramoutar, Rodolfo Arozarena, Dawn Meyers, and Solaiman Juman
Volume 2021 (2021), Article ID 3756742, 6 pages
INI1-Intact Sinonasal Carcinoma with Rhabdoid Features, Erin Mulry, Danielle M. Blake, Poornima Hegde, and Todd E. Falcone
Volume 2021 (2021), Article ID 6075130, 3 pages
Bilateral Recurrent Laryngeal Nerve Palsy following Total Thyroidectomy in Triple A Syndrome, an Unexpected but Critical Complication, Mathieu Chamberland, Marc-Antoine Poulin, and Danielle Beaudoin
Volume 2021 (2021), Article ID 1315117, 3 pages
Importance of Imaging in Congenital Unilateral Vocal Fold Paralysis: A Case of Neck Neuroblastoma Presenting with Unilateral Vocal Fold Paralysis, W. X. Yeo, C. Y. Chan, and K. K. H. Tan
Volume 2021 (2021), Article ID 7368567, 4 pages
A Rare Complication of Fine-Needle Aspiration of Neck Structures, Yazeed M. Qadadha, Nainika Nanda, Chad Ennis, and Timothy McCulloch
Volume 2021 (2021), Article ID 8944119, 5 pages
Delayed-Onset Neuropathic Pain after Septoplasty, Foteini-Stefania Koumpa, Mark Ferguson, and Hesham Saleh
Volume 2021 (2021), Article ID 9966318, 4 pages

Docosahexaenoic acid supplementation alleviates behavioral memory impairment caused via repeated administration of sevoflurane in aged rats

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Exp Ther Med. 2022 Jan;23(1):46. doi: 10.3892/etm.2021.10968. Epub 2021 Nov 15.

ABSTRACT

Elderly patients often need repeated surgical intervention, so it is important to determine the impact of repeated exposure to anesthetics on learning and memory. Docosahexaenoic acid (DHA) is considered to be an essential nutrient for maintaining brain health. The aim of the present study was to explore the potential effects of DHA on memory impairment induced by repeated sevoflurane anesthesia in aged rats. A total of 54 Sprague Dawley aged rats (18 months) were randomly divided into the following six groups: i) Control group; ii) sevoflurane group (Sev, 2.5% for 5 min); iii) DHA group (3 g/kg); iv) Sev + DHA (0.3 g/kg) group; v) Sev + DHA (1 g/kg) group; and vi) Sev + DHA (3 g/kg) group. Morris water maze experiment was performed to evaluate the learning and memory ability of the rats following treatment. H&E staining was used to observe any histological changes. Superoxide dismutase, malondialdehyde and glutathione peroxidase levels were detected using ELISA. Immunohistochemistry and western blotting were used to determine nuclear factor erythroid-2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) protein expression levels. Following repeated sevoflurane anesthesia, rats exhibited a prolonged escape latency. The number of times rats crossed the platform and the time spent in the target quadrant were also significantly reduced by repeated sevoflurane anesthesia. However, rats treated with Sev + DHA exhibited a reduced escape latency, whilst the number of times they crossed the platform and the time spent in the target quadrant increased compared with Sev treatment alone. Histopathological examination revealed that DHA treatment ameliorated the disordered neuron arrangement, deep staining of the neuronal nucleus pyknosis and cell edema observed in the brain tissue induced by repeated sevoflurane anesthesia. Furthermo re, the protein expression levels of Nrf2 and HO-1 were demonstrated to be significantly increased in rats treated with DHA and exposed to repeated sevoflurane anesthesia compared with those in untreated rats that underwent repeated sevoflurane anesthesia. In conclusion, the present study revealed that DHA exerted protective effects against impairments in learning and memory induced by repeated sevoflurane anesthesia in aged rats, which may be associated with the Nrf2/HO-1 signaling pathway.

PMID:34934425 | PMC:PMC8652387 | DOI:10.3892/etm.2021.10968

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Protective effects of syringic acid on inflammation, apoptosis and intestinal barrier function in Caco-2 cells following oxygen-glucose deprivation/reoxygenation-induced injury

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Exp Ther Med. 2022 Jan;23(1):66. doi: 10.3892/etm.2021.10989. Epub 2021 Nov 23.

ABSTRACT

Syringic acid (SA) is an abundant phenolic acid compound that has been demonstrated to yield therapeutic benefits in myocardial and renal ischemia/reperfusion (I/R). However, the role of SA in intestinal I/R injury is unclear. Thus, the present study aimed to investigate the protective effect of SA against intestinal I/R injury. Caco-2 cells were incubated with different doses of SA before oxygen-glucose deprivation/reoxygenation (OGD/R) induction. The viability of Caco-2 cells, the activity of lactate dehydrogenase (LDH), the production of pro-inflammatory cytokines and the levels of reactive oxygen species, superoxide dismutase and malondialdehyde were measured. Apoptosis was evaluated using a TUNEL assay and western blotting. Transepithelial electrical resistance and western blotting were performed to evaluate intestinal barrier function in Caco -2 cells. The present study revealed that pretreatment with SA significantly increased cell viability and reduced LDH release in Caco-2 cells subjected to OGD/R treatment. In addition, SA suppressed OGD/R-induced inflammatory responses by reducing pro-inflammatory cytokine levels. Furthermore, the levels of oxidative stress and apoptosis were ameliorated by SA. SA also alleviated the intestinal barrier disruption exhibited by Caco-2 cells after OGD/R injury. Overall, the present study revealed that SA may potentially protect Caco-2 cells from OGD/R injury, and that this effect may be attributed to its anti-inflammatory and anti-apoptotic activities, as well as its ability to protect the function of the intestinal barrier.

PMID:34 934437 | PMC:PMC8649867 | DOI:10.3892/etm.2021.10989

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