Surgical strategy for squamous cell carcinoma of the external auditory canal: management of locally advanced cases with skull base involvement

xlomafota13 shared this article with you from Inoreader Surgical strategy for squamous cell carcinoma of the external auditory canal: management of locally advanced cases with skull base involvement Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/a-1733-2585 Objective Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4-subclassification. Methods Patients with SCC of the EAC who underwent curative treatment from 2002-2021 were retrospectively reviewed at our hospital. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS) were analyzed. To clarify the surgical indication for advanced stage, we proposed the T4-subclassification. Results In 46 patients, the tumors were in T1 stage in 8 patients, T2 in 10, T3 in 5, and T4 in 23. The 5-year DSS with T1, T2, T3, and T4 tumors were 100%, 85.7%, 100%, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS (p = 0.23 and p = 0.13). Patients with far advanced stage (T4b) tumors were significantly associated with shorter DSS than those with early stage (T1/T2) and advanced stage (T3/T4a) tumors (p = 0.007 and p = 0.03). Conclusion The present study focused on patients with SCC of the EAC at a University hospital over a period of 20-years, especially with skull base involvement, and a T4-subclassification was proposed. Complete tumor resection in an en bloc fashion could help to achieve a good survival rate even in patients with locally advanced tumors. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Artemisinin resistance: an important emerging clinical problem in tropical medicine

xlomafota13 shared this article with you from Inoreader Artemisinin resistance: an important emerging clinical problem in tropical medicine Via International Journal of Physiology, Pathophysiology and Pharmacology Int J Physiol Pathophysiol Pharmacol. 2021 Dec 15;13(6):152-157. eCollection 2021. ABSTRACT Artemisinin is an important antimalarial drug which is originated and developed from Chinese traditional herbal regimen. At present, artemisinin is used as an antimalarial drug for treatment of drug resistant malarial infection. The effectiveness of artemisinin is clinically accepted. Hence, artemisinin is currently used as main drug for malaria treatment in many tropical countries. Artemisinin resistance is a new emerging clinical problem in tropical medicine. New mutation can result in artemisinin resistance and the resistance becomes important new emerging problem in clinical malariology. It is necessary to control of artemisinin use and searching for new effective drug against artemisinin resistant malaria. In this article, the authors summarizes on important updated information regarding artemisinin resistance. PMID:35103097 | PMC:PMC8784654 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of different setting configurations with a new developed telemedical interface of a parallel kinematic robotic system ‐ an experimental development study

xlomafota13 shared this article with you from Inoreader Evaluation of different setting configurations with a new developed telemedical interface of a parallel kinematic robotic system ‐ an experimental development study Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background For development of a minimally invasive intracorporal micromanipulator, a master-slave telemanipulation system was required. Methods Different input positions for a tablet-based input device with a heads-up centered screen were evaluated. Personal preference was assessed using a questionnaire. Then, the most ergonomic and intuitive position was compared to a surgical reference position based on laparoscopic sigmoid resection. Results After comparing a 45°, 75° (pitch) and 60°/20° (pitch/yaw) to a 60° reference position no significant differences in processing time and number of failures could be demonstrated. Study participants indicated the 60°/20° position as the most comfortable in the questionnaire. This was therefore compared with the laparoscopic reference position, both sitting and standing. Here, the laparoscopic sitting position was perceived to be the most ergonomic. Conclusions The developed input device offers a maximum of flexibility and individualization to reach ergonomic and intuitive conditions. General recommendations regarding an optimal setting cannot be given, based on our results. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of oral screen exercise on orofacial and pharyngeal activity: An exploratory study using videofluoroscopy and surface electromyography in healthy adults

xlomafota13 shared this article with you from Inoreader Effects of oral screen exercise on orofacial and pharyngeal activity: An exploratory study using videofluoroscopy and surface electromyography in healthy adults Via swallowing exercises Clin Exp Dent Res. 2022 Feb 1. doi: 10.1002/cre2.538. Online ahead of print. ABSTRACT OBJECTIVE: The oral screen is a device commonly used for treatment of orofacial disorders. The objective of this exploratory study was to examine the effect of oral screen exercise on the muscle activity in the lips, submental complex, masseter muscle, and kinematic activity of the tongue base, soft palate, pharynx, and larynx in healthy adults. This was compared with the kinematic activity during a dry swallow. It was hypothesized that not only the lip musculature but also other structures in the oral and pharyngeal cavities are activated while using an oral screen device. METHOD: Ten healthy subjects used an oral screen during examination with videofluoroscopy and surface electromyography (EMG). Three different instructions for oral screen application and a dry swallow were examined. RESULTS: The lip muscles showed the highest activity during oral screen exercise. The other muscle groups were activated to a lesser degree. The pattern of activation differed between individuals. Compared with a dry swallow, the range of motion of the tongue base, posterior pharyngeal wall, and the larynx was significantly smaller during oral screen activation. No major differences were found between three different instructions. CONCLUSION: This study indicates that the lips and submental complex and, to a lesser degree, oral, pharyngeal, and laryngeal structures are activa ted with the oral screen, but the pattern of activation varied between individuals. In comparison to the activity during a dry swallow, range of motion during oral screen exercise is small. PMID:35106972 | DOI:10.1002/cre2.538 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An analysis of hematological, coagulation and biochemical markers in COVID-19 disease and their association with clinical severity and mortality: an Indian outlook

xlomafota13 shared this article with you from Inoreader An analysis of hematological, coagulation and biochemical markers in COVID-19 disease and their association with clinical severity and mortality: an Indian outlook Via American Journal of Blood Research Am J Blood Res. 2021 Dec 15;11(6):580-591. eCollection 2021. ABSTRACT BACKGROUND: The "cytokine storm" (CS) in COVID-19 leads to the worst stage of illness which can be controlled only with timely intervention. There is an urgent need to identify laboratory markers of disease progression for optimum allocation of resources in developing countries like India. METHODS: A cross-sectional study was conducted on 100 COVID-19 positive patients over two months. The cases were sub-classified based on disease severity into mild to moderate (n=61), severe (n=26) and very severe (n=13) and into survivors (n=85) and non-survivors (n=15) based on survivor status. These patients were tested for hematological parameters (total blood lymphocyte counts, NLR, PLR, platelet indices etc.), coagulation markers (D-dimer, fibrin degradation products (FDP), fibrinogen etc.) and biochemical markers (LDH, ferritin, IL-6, procalcitonin, hs-CRP). RESU LTS: Statistically significant differences were observed in hematological variables (ANC, NLR and ESR), coagulation parameters (D-dimer, FDP, fibrinogen and thrombin time) and biochemical markers (LDH, ferritin, IL-6, procalcitonin and hs-CRP) with regard to subcategories based of disease severity as well as survivor status. There was strong correlation between NLR, D-dimer, IL-6, procalcitonin and ferritin. IL-6 emerged as the single best marker of disease severity (AUC: 0.997, P=0.00), however procalcitonin, LDH, D-dimer, FDP and NLR could also predict severe disease with a good sensitivity and specificity. CONCLUSION: To conclude, study demonstrates a plethora of biomarkers which could be utilized to accurately identify the hyperinflammation and tissue damage reminiscent of cytokine storm in COVID-19 patients so that timely, safe, and effective therapies can be administered to prevent progression and potentially reduce mortality. PMID:35103112 | PMC:PMC8784646 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A review of neoplasms with MITF/MiT family translocations

xlomafota13 shared this article with you from Inoreader A review of neoplasms with MITF/MiT family translocations Via Cellular and Molecular Biology Histol Histopathol. 2022 Feb 2:18426. doi: 10.14670/HH-18-426. Online ahead of print. ABSTRACT Microphthalmia-associated transcription factor (MITF/MiT) family is a group of basic helix-loop-helix leucine zipper (bHLH-LZ) transcription factors including TFE3 (TFEA), TFEB, TFEC and MITF. The first renal neoplasms involving MITF family translocation were renal cell carcinomas with chromosome translocations involving ASPL-TFE3/t(X;17)(p11.23;q25) or MALAT1-TFEB/t(6;11)(p21.1;q12), and now it is known as MiT family translocation RCC in 2016 WHO classification. Translocations involving MITF family genes also are found in other tumor types, such as perivascular epithelioid cell neoplasm (PEComa), Alveolar soft part sarcoma (ASPS), epithelioid hemangioendothelioma, ossifying fibromyxoid tumor (OFMT), and clear cell tumor with melanocytic differentiation and ACTIN-MITF translocation. In this review, we summarize the features of different types of neoplasms with MITF family translocations. PMID:35107169 | DOI:10.14670/HH-18-426 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sonographische Diagnostik tonsillärer Abszesse: Eigene Erfahrungen und eine systematische Übersicht

xlomafota13 shared this article with you from Inoreader Sonographische Diagnostik tonsillärer Abszesse: Eigene Erfahrungen und eine systematische Übersicht Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1744-6305 Hintergrund Die transkutane Sonografie ist seit einigen Jahrzehnten ein fester Bestandteil der bildgebenden Diagnostik im Kopf-Hals-Bereich. Insbesondere in der Darstellung von Abszessen der Fossa tonsillaris ist die Sonografie eine schnelle, sichere und kostengünstige diagnostische Methode. Diese Arbeit soll einen Überblick über die derzeit publizierten Studien in Bezug auf die diagnostische Wertigkeit geben. Material und Methoden Systematische Literaturrecherche in folgenden Online-Datenbanken: PubMed und MEDLINE nach den Suchbegriffen transcutaneous ultrasound, tonsillar abscess, peritonsillar abscess, intratonsillar abscess, peritonsillar cellulitis und parapharyngeal abscess. Bewertung der wissenschaftlichen Relevanz der Arbeiten nach festgelegten Kriterien. Ergebnisse Die Publikationen wurden in Bezug auf die klinische Anwendung, die klinische Befunderhebung und die diagnostische Genauigkeit analysiert. Die Sensitivität und Spezifität werden je nach Studie und Patientenkollektiv zwischen 67 % und 100 % bzw. 50 % und 93 % angegeben. Schlussfolgerungen In Zusammenschau der aktuell publizierten Ergebnisse verspricht die transkutane Sonografie ein großes Potenzial, die Diagnostik des Peritonsillarabszesses zu verbessern, und ermöglicht eine gute Abgrenzbarkeit zur peritonsillären Zellulitis. Dies ist für das klinische Management von Patienten mit Abszessverdacht von entscheidender Bedeutung. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |& nbsp; Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal schwannoma: A case report and literature review

xlomafota13 shared this article with you from Inoreader Laryngeal schwannoma: A case report and literature review Via ear nose throat Ear Nose Throat J. 2022 Jan 29:1455613221075225. doi: 10.1177/01455613221075225. Online ahead of print. ABSTRACT Laryngeal schwannomas are rare benign neurogenic tumors of the larynx. They cannot be detected in the early stages because disease onset is asymptomatic. This case of laryngeal schwannoma provided a reference for clinical diagnosis and treatment strategy. A 24-year-old man presented with a 3-year history of hoarseness and sore throat for 6 months. Laryngoscopy and computed tomography showed submucosal bulging of the right ventricular fold in the right paraglottic space. The patient underwent tracheotomy first, followed by laryngotomy. The edema of the laryngeal mucosa was significantly alleviated, with normal movement of the bilateral vocal cords on the 10th day after surgery. The tracheal tube was removed at the time of discharge. The hoarseness had disappeared at the end of the first month after surgery. The effective treatment of laryngeal schwannoma involves complete resection with surgery while protecting the integrity of the larynx and restoring laryngeal function. The indication for surgery should be strictly controlled to avoid damage to the mucosa and structures of the larynx. PMID:35098768 | DOI:10.1177/01455613221075225 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complications Encountered with ETV in Infants with Congenital Hydrocephalus

xlomafota13 shared this article with you from Inoreader Complications Encountered with ETV in Infants with Congenital Hydrocephalus Via leak of cerebrospinal fluid Neurol India. 2021 Nov-Dec;69(Supplement):S520-S525. doi: 10.4103/0028-3886.332252. ABSTRACT BACKGROUND: Hydrocephalus is an abnormal excessive accumulation of cerebrospinal fluid (CSF) in the cavity and spaces of the brain. Endoscopic third ventriculostomy (ETV) has been an established treatment modality for congenital hydrocephalus. However, in very young infants, the results are challenging. In our study, we have evaluated whether ETV really offers an acceptable complication-free postoperative course. OBJECTIVE: To study the complication and mortality rate in infants having congenital hydrocephalus treated with ETV. MATERIALS AND METHODS: This is a single-center prospective study conducted at the Department of Neurosurgery, K. G. M. U, Lucknow, from January 2019 to February 2020. We studied 40 infants presenting with clinical and radiological features suggestive of congenital hydrocephalus. Follow-up was done at the first, thir d, and sixth months after discharge. RESULTS: Nineteen infants (47.5%) required a second CSF diversion procedure at 6 months of follow-up. The failure rate was significantly higher in infants less than 3 months of age (P value of 0.04). The ETV site bulge was the most frequent complication encountered in the postoperative period, occurring in 20% of the cases. Eventually, all these infants required a ventriculoperitoneal shunt; 15% developed clinical features consistent with the diagnosis of post-ETV meningitis. The ETV site CSF leak occurred in 10% of the patients. Subdural hygroma developed in 7.5% of the patients; 17.5% of the patients contributed to mortality with a mean time of expiry of 22 days post-procedure. All these deaths had multifactorial causes and could not be said as a complication or failure of ETV. CONCLUSION: We do not recommend ETV for infants less than 3 months because of a high failure rate. The ETV site bulge was the most reliable and earliest mark er of failure and a second CSF diversion surgery should be immediately considered. PMID:35103011 | DOI:10.4103/0028-3886.332252 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Symptomatic Lingual Thyroglossal Duct Cyst in Children: A Laryngomalacia Phenotype

xlomafota13 shared this article with you from Inoreader Symptomatic Lingual Thyroglossal Duct Cyst in Children: A Laryngomalacia Phenotype Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 31:34894221075082. doi: 10.1177/00034894221075082. Online ahead of print. ABSTRACT OBJECTIVES: Patients with lingual thyroglossal duct cyst (TGDC) can present as symptomatic with obstructive airway and feeding difficulties. METHODS: We present 3 cases of symptomatic lingual TGDC. RESULTS: All 3 patients were diagnosed with laryngomalacia and underwent further concurrent or delayed airway intervention, in addition to cyst removal . CONCLUSIONS: We reason that there is a phenotype of laryngomalacia in the symptomatic lingual thyroglossal duct cyst patients who present with symptoms due to disruption in laryngeal anatomy rather than the cyst itself causing obstructive symptoms. Distinguishing this phenotype, especially in comparison to other pathologies such as vallecular cysts, may better allow for planning of concurrent or delayed airway procedures and overall counseling of parents. PMID:35100842 | DOI:10.1177/00034894221075082 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sino-nasal hemangiopericytoma: a case series and systematic literature review

xlomafota13 shared this article with you from Inoreader Sino-nasal hemangiopericytoma: a case series and systematic literature review 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 1. doi: 10.1007/s00405-021-07239-w. Online ahead of print. ABSTRACT BACKGROUND: Hemangiopericytoma is a rare tumor of the sino-nasal tract. Its clinical behavior is controversial. Whereas some describe an indolent course, others consider it to be an aggressive lesion with a tendency toward rapid local recurrence. Here, we describe our experience in the management of sino-nasal hemangiopericytoma (SN-HPC), comparing our experience with the current literature, and evaluating signs and tools to improve diagnosis and treatment. METHODS: All cases of SN-HPC between 2010 and 2020 were extracted and reviewed from our institutional electronic medical records. SN-HPC cases from PubMed and EMBASE between 2010 and 2020 were analyzed in a systematic literature review using the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. Data regarding demographics, presentation, d iagnosis, treatment, and outcome were collected. RESULTS: We identified four cases of SN-HPC in the nasal cavity in our institution and an additional 53 cases in previous reports. The mean age at the time of diagnosis was 59 years, with a 1.2:1 male to female ratio. SN-HPC mostly appears unilaterally, arising in the ethmoid sinus (42.1%). The most common presenting symptoms were epistaxis (47.3) and nasal obstruction (47.3%). Both computed tomography (CT) and magnetic resonance imaging (MRI) were required for diagnosis and for tailoring the treatment plan. Endoscopic surgical excision was used in 85.9% of the patients, and in 15.7%, an additional preoperative embolization was performed, which was associated with septal necrosis in one patient (2.6%). The recurrence rate was 7%. CONCLUSION: Although previous reports attribute an aggressive tumoral behavior to SN-HPC, our experience and the literature review support a more indolent course with low recurrence rates followin g complete endoscopic resection. Preoperative embolization can be useful in certain cases, but due to potential complications, it should not be routinely indicated. PMID:35103868 | DOI:10.1007/s00405-021-07239-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.