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Τετάρτη 13 Φεβρουαρίου 2019

The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis

Objectives/Hypothesis

Wide variation in postinjury functional recovery is a hallmark of unilateral vocal fold paralysis (UVFP), ranging from zero to full recovery. The present study examined the impact of cricothyroid (CT) muscle involvement on recovery using quantitative laryngeal electromyography (LEMG) of the thyroarytenoid–lateral cricoarytenoid (TA‐LCA) muscle complex at multiple times postinjury.

Study Design

Prospective cohort study in a medical center.

Methods

Eighty‐one patients with UVFP (37 males and 44 females) received an initial assessment of quantitative LEMG, stroboscope, acoustic voice analysis and 36‐Item Short Form Survey quality‐of‐life questionnaire at 3 to 6 months after UVFP onset and a follow‐up assessment at 12 months after UVFP onset.

Results

The initial and follow‐up assessments were performed at 4.3 ± 1.9 and 12.5 ± 1.3 months after UVFP onset, respectively. The peak turn frequency of the TA‐LCA muscle complex on the lesion side was improved at the follow‐up (470 ± 294 Hz) compared with the initial assessment (300 ± 204 Hz) (P < .001). Patients were also divided into two groups with (n = 27) and without (n = 54) CT involvement, respectively. TA‐LCA muscle complex turn frequency improved in patients without CT involvement (from 277 ± 198 to 511 ± 301 Hz; P < .001), but not in those with CT involvement (from 345 ± 211 to 386 ± 265 Hz; P = .46). Seventy‐one of all patients received early intervention with intracordal hyaluronate injection, showing similar therapeutic effects in those with and without CT involvement.

Conclusions

Acute UVFP with combined TA‐LCA muscle complex and CT muscle involvement has a poor prognosis, with poorer recovery of TA‐LCA muscle complex recruitment. Early interventions should be considered in patients with UVFP with CT involvement.

Level of Evidence

2 Laryngoscope, 2019



http://bit.ly/2DCKTq1

Validating peritonsillar abscess drainage rates using the Pediatric hospital information system data

Objectives

To evaluate the accuracy of the Children's Hospital Association's Pediatric Health Information System (PHIS) registry data in determining surgical drainage rates as compared to a chart review on the same cohort of children with diagnosis of peritonsillar abscess.

Study Design

Retrospective analysis.

Methods

Our analysis included 200 children, ages 2 to 17 years, treated for a peritonsillar abscess from 2011 to 2016. The primary outcome was to determine the sensitivity, specificity, predictive values, receiver operating characteristics (ROC), and likelihood ratios of surgical drainage rates comparing the PHIS database to manual chart review of the same patients.

Results

One hundred and fifteen (58%) children underwent drainage by chart review, whereas 87 (44%) had a drainage procedure by PHIS data. Age was a significant predictor of abscess drainage by chart review (age coefficient = 0.10; standard error = 0.04; 2 = 5.8; P = 0.02; odds ratio = 1.1; 95% confidence interval [CI] = 1.01–1.19). When using the chart review as the reference value for surgical drainage, the PHIS data had a sensitivity of 76% and 100% specificity. The positive and negative predictive values were 100% and 75%, respectively. The ROC area was 0.88 (95% CI, 84 to 92). Cases that lacked a clear procedure note composed the false negative cases in the PHIS.

Conclusion

At our institution, the PHIS Administrative data was adequate at predicting surgical drainage of the peritonsillar abscess when compared to chart review.

Level of Evidence

4. Laryngoscope, 2019



http://bit.ly/2SvvZMw

Regarding “patient‐reported versus physiologic swallowing outcomes in patients with head and neck cancer after chemoradiation”



http://bit.ly/2DBdzQm

In response to letter to the editor regarding: “Patient‐reported versus physiologic swallowing outcomes in patients with head and neck cancer after chemoradiation”



http://bit.ly/2SzWy38

Endocrinology's best articles of 2018 : Adipose tissue in control of metabolism by Liping Luo and Meilian Liu. Microvesicles and exosomes: new players in metabolic and cardiovascular disease by Charlotte Lawson et al. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities by Mark E Cleasby, Pauline M Jamieson and Philip J Atherton. , Current understanding of metformin effect on the control of hyperglycemia in diabetes by Hongying An and Ling He. , Plasma steroid-binding proteins: primary gatekeepers of steroid hormone action by Geoffrey L Hammond. , Thyroid hormones induce browning of white fat by Noelia Martínez-Sánchez et al. , Sodium butyrate activates NRF2 to ameliorate diabetic nephropathy possibly via inhibition of HDAC by Wenpeng Dong et al. , Leptin stimulates bone formation in ob/ob mice at doses having minimal impact on energy metabolism Kenneth A Philbrick et al. , IGFBP-4 regulates adult skeletal growth in a sex-specific manner b

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Medical Trichology : Trigeminal trophic syndrome simulating pityriasis amiantacea,Nerve sheath myxoma of scalp,Woolly hair nevus type 2,Trichodynia silenced effectively with propranolol,Serum interleukin-15 is a marker of alopecia areata severity,Tubular hair casts in trichoscopy of hair and scalp disorders,Research on the balance of thiol-disulfide in blood serum in women with telogen effluvium,Light microscopic morphology of hair from scalp, eyebrow, axilla, and pubic regions

COMMENTARY 

Autistic-undisciplined thinking in the practice of medical trichologyp. 1
Ralph Michel Trueb, Hudson Dutra, Maria Fernanda Reis Gavazzoni Dias
DOI:10.4103/ijt.ijt_79_18  
Medical trichology is the branch of dermatology that deals with the scientific study of the hair and scalp in health and disease. As any discipline, the practice of medical trichology is not immune to malpractice, either deliberately or carelessly. In his publication "Autistic Undisciplined Thinking in Medicine and How to Overcome It," Swiss psychiatrist Eugen Bleuler describes yet another form of malpractice in medicine reflecting autistic-undisciplined thinking. Autism is not limited to psychopathology, but inherent to the thinking of man throughout history in his drive for knowledge, with thousands of theories lacking any basis in reality. Bleuler recognized the drive character of autistic thinking and how it leads to conclusions that are unshakable because they are determined by, and fulfill, emotional needs, rather than rational argumentation. Even with correct questions, the complexity and incalculability of some problems are often so great that it cannot do justice to realistic thinking and the boundaries between inadequately substantiated hypothesis and autistic sham explanation disappear. Statistics, careful research design, and the attempt to impose stringent methods on our thinking are to be commended. The habituation of the public to useless medicine, to misconceptions, is not hygiene, but negligent endangerment. It has created an industry that largely lives on the autistic thinking of patients and doctors and because it is prosperous, makes propaganda among lay people as well as among doctors that necessarily leads to abuses. This article aims at exposing the most prevalent among abuses in trichological practice due to autistic-undisciplined thinking, specifically: iron supplementation, antiandrogenic treatment, and individualized cell-based therapy in female androgenetic alopecia, treatment of folliculitis decalvans with retinoids, and the value of nutritional therapies.
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ORIGINAL ARTICLESTop

Light microscopic morphology of indigenous Ghanaian African hair from scalp, eyebrow, axilla, and pubic regionsp. 8
Yusra Kalmoni, Frederick Kwaku Addai, Saviour Kweku Adjenti, Kevin Kofi Adutwum-Ofosu, John Ahenkorah, Bismarck Afedo Hottor, Richard Michael Blay
DOI:10.4103/ijt.ijt_70_18  
Context: Relatively scanty literature on autochthonic African Negroid hair morphology provokes research interest for anthropological, forensic, and cosmetic purposes. Aims: This study aimed to contribute basic morphological information on Ghanaian African hairs. Settings and Design: The study was done in selected second-cycle schools in Accra, Ghana, using convenient sampling. Subjects and Methods: Hairs were obtained by pluck method, from 30 males and 30 females aged 15–20 years. Ghanaian African autochthony was established if individuals had two generations of indigenous Ghanaian parentage. Scalp, eyebrow, axilla, and pubic hairs were image captured using a digital light microscope eyepiece connected to a computer. Diameters of hair strands were measured; types of the medulla and the form and shape of the hair roots were studied. Statistical Analysis Used: ANOVA test (SPSS Version 17.0) was used to compare the means of quantitative hair features among the sexes and the four regions of the body studied. Results: Pubic hair shaft was thickest (respective male and female diameters were 100.21 μm, 88.40 μm) and eyebrow hair was thinnest (53.97 and 46.69-μm diameters in males and females, respectively). Axillary and scalp hairs were the closest in diameters with 76.21 and 72.02 μm, respectively, in males and 73.07 and 71.15 μm, respectively, in females. Continuous type medulla was predominant in all hairs, with a trend of percentage occurrence in descending order from the pubic, axilla, eyebrow, and scalp in both sexes. Conclusions: Bodily regional differences in diameter of hair shaft and medullary presence were affirmed.
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Tubular hair casts in trichoscopy of hair and scalp disordersp. 14
Mahesh Mathur, Prakash Acharya, Alina Karki, Jyoti Shah, Nisha Kc
DOI:10.4103/ijt.ijt_77_18  
Introduction: Hair casts have been reported in a variety of hair and scalp disorders. Trichoscopy allows a quick and noninvasive method for the evaluation of hair and scalp disorders in high magnification. However, the study of hair casts seen in trichoscopy is lacking. Objective: The main objective is to study the occurrence and patterns of tubular hair cast (THC) in different hair and scalp disorders. Patients and Methods: The patients with hair and scalp disorders presenting at the dermatology department of our hospital were evaluated using trichoscopy. Cases of primary parakeratotic disorders and behavioral disorders were excluded. After a detailed history and evaluation of the hair and scalp, histopathology, light microscopic examination, potassium hydroxide examination, and fungal culture were done when necessary. Results: THC was seen in total 21 cases of seven different hair and scalp disorders. Of these, the majority of cases were of discoid lupus erythematosus (DLE) (5/21) and maximum frequency of THCs within a disorder was seen in cases of pemphigus foliaceus (PF) (50%). Proximal casts occurred in 90.47% of cases. Single cast involving two shafts was seen in a case of PF, and two casts within a single shaft were seen in two cases of DLE and one case of alopecia areata. Conclusions: THCs in trichoscopy can be seen in various hair and scalp disorders and their study may help during the diagnosis of those disorders when combined with other trichoscopic features.
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Research on the balance of thiol-disulfide in blood serum in women with telogen effluviump. 20
Ayşe Akbas, Fadime Kılınç, Sertaç Sener, Akta Akınş, Cemile Bıçer, Orhan Şen
DOI:10.4103/ijt.ijt_78_17  
Backgrounds: Telogen effluvium (TE) is the most common reason for hair loss in humans. Although the exact etiopathogenesis of TE has not been revealed clearly and completely, multifactorial etiologies are to be blamed. In recent years, since oxidative stress (OS) has been shown to play an important role in the etiopathogenesis of so many diseases, the effects of OS on several skin diseases are researched and analyzed. Thiols are antioxidant components that include sulfur group, and the balance of thiol-disulfide has an important role in the formation and prevention of OS. This balance is destroyed in many diseases and its effect on TE is not clearly understood yet. Objectives: In this study, we aimed to search the thiol–disulfide balance that could reveal OS in patients with TE. Materials and Methods: Fifty-two patients with TE and control group of 46 persons were included in the study. Native thiol, disulfide, and total thiol levels were evaluated by a new, automatic spectrophotometric method. Disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol rates were calculated. Results: There was no statistical difference between TE patients and control group in terms of native thiol, disulfide, and total thiol levels. Thiol–disulfide balance was fixed and not affected in TE patients.
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Serum interleukin-15 is a marker of alopecia areata severityp. 26
Adel Ali Ebrahim, Rehab Mohammed Salem, Asmaa Adel El Fallah, Esraa Taha Younis
DOI:10.4103/ijt.ijt_80_18  
Background: Interleukin-15 (IL-15) is a cytokine that is involved in many inflammatory and autoimmune diseases. Although alopecia areata (AA) is an autoimmune disease, serum levels of IL-15 have not been studied well in AA patients. Aim of the Work: We aims at evaluating the serum levels of IL-15 in active AA. Subject and Methods:This case-control study included 40 AA patients and 40 apparently healthy matched controls. Written informed consents were obtained from all the participants. The scalp was examined to assess sites, number, and size of alopecia patches, and the severity of AA lesions was assessed using the Severity of Alopecia Tool score (SALT score) which determine the percentage of hair loss in the scalp. The body was carefully examined to detect any alopecia patches in any hairy area. Nail examination was carried out to detect any nail involvement. Serum IL-15 levels were measured using an ELISA kits. Results: Serum levels of IL-15 in patients were significantly higher than those in the control group (P < 0.001). Serum levels in alopecia totalis were significantly higher than those with one or two patches, and serum levels in patients with both scalp and body involvement were significantly elevated than the levels of patients with either scalp or body involvement. There was a statistically significant positive correlation between SALT score and serum levels of IL-15 (P < 0.001). Conclusion: Serum IL-15 may be a marker of AA severity.
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CASE REPORTSTop

Trigeminal trophic syndrome simulating pityriasis amiantaceap. 31
Luisa Groba Bandeira, Maria Cláudia Alves Luce, Bruno De Castro E Souza, Priscila Kakizaki, Neusa Yuriko Sakai Valente
DOI:10.4103/ijt.ijt_16_18  
We report a case of trigeminal trophic syndrome (TTS) on the scalp of a 69-year-old woman. Initially, the diagnosis of pityriasis amiantacea was considered. The review of pathological antecedents and knowledge of TTS were fundamental for the diagnosis of this illness. We performed a brief review on TTS and differential diagnoses.
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Nerve sheath myxoma of scalp: A rare site of presentationp. 34
Shakti Kumar Yadav, Sompal Singh, Namrata Sarin, Roshina Naeem, Sonam Kumar Pruthi
DOI:10.4103/ijt.ijt_45_18  
Nerve sheath myxoma, a superficial myxoid tumor, was first described in 1969 by Harkin and Reed. Tumor has cytological and histological resemblance with neurothekeoma, another cutaneous myxoid lesion. Nerve sheath myxoma affects individuals of all age groups and equal predilection for both genders with most favored sites being the fingers and knee. Here, we present a case report of nerve sheath myxoma of the scalp, diagnosed and confirmed with histopathology and immunohistochemistry.
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Woolly hair nevus type 2: Rare entityp. 38
Farhana Tahseen Taj, Shraddha Kologi
DOI:10.4103/ijt.ijt_28_18  
Woolly hair nevus is a rare non hereditary disorder of scalp characterized by curling and kinking of hair. It can present in childhood or adolescent age. Dermoscopy is a useful noninvasive technique to help in the diagnosis of wolly hair nevus. We report a case of woolly hair nevus associated with linear epidermal nevus.
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LETTER TO EDITORTop

Trichodynia silenced effectively with propranololp. 41
Piotr Brzezinski, Vijay Zawar, Anca Chiriac
DOI:10.4103/ijt.ijt_8_19  
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