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Πέμπτη 22 Οκτωβρίου 2020

Treatment of basal cell carcinomas and basaloid follicular hamartomas in basal cell nevus syndrome children and adolescents.

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Treatment of basal cell carcinomas and basaloid follicular hamartomas in basal cell nevus syndrome children and adolescents.

J Dermatolog Treat. 2020 Oct 21;:1-6

Authors: Verkouteren BJA, Mosterd K

PMID: 33081541 [PubMed - as supplied by publisher]

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Antihistamines-refractory chronic pruritus in psoriatic patients undergoing biologics: Aprepitant Vs Antihistamine double dosage, a real-world data.

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Antihistamines-refractory chronic pruritus in psoriatic patients undergoing biologics: Aprepitant Vs Antihistamine double dosage, a real-world data.

J Dermatolog Treat. 2020 Oct 21;:1-15

Authors: Damiani G, Kridin K, Pacifico A, Malagoli P, Dm Pigatto P, Finelli R, Taccone FS, Peluso L, Conic RRZ, Bragazzi NL, Dermatologists Italian Network Y, Fiore M

Abstract
BACKGROUND: Psoriasis-related pruritus-(PRP) in patients under systemic treatment is challenging. The risk to switch anti-psoriatic drug and to lose response to previous therapy is high, thus dermatologists prefer to add an anti-pruritic agent.
OBJECTIVES: To evaluate the effect of anti-histamines and aprepitant in treating PPR of psoriatic patients undergoing systemic anti-psoriatic therapies.
METHODS: A pilot observational open-label study was performed on responsive psoriatic patients with PPR under treatment. Initial therapy included oral rupatadine (10 mg/day for 30 days).In case of Epworth Sleepiness Scale(ESS) was above 14, patients were switched to aprepitant(80mg/day for 7 days),otherwise rupatadine dosage was increased(20 mg/day for 7 days).Clinical evaluation was performed at the baseline(T0) and after 7 days(T7).
RESULTS: We enrolled 40 patients with PPR, 20 in each group. Age, gender, Psoriatic arthritis(PsA) and the itch-VAS, were matched. At T7, aprepitant displayed higher improvements than rupatadine (itch-VAS= 4[3-5] vs 8.5[8-9], p< 0.01, DLQI= 14[13-16] vs. 18[16-21], p < 0.01 and ESS= 5[4-7] vs 15[14-16], p < 0.01). Doubling the rupatadine dosage from 10mg to 20mg/day only slightly improve itch (itch-VAS 9[8-10] vs 9[8-9], p = 0.03), conversely no modifications in the quality of life (DLQI 18[17-20] vs 18[17-21], p = 0.73) and increased sleepiness (ESS 10[9-11] vs 15[14-16], <0.01).
CONCLUSIONS: Aprepitant may be a valid alternative in PPR patients with ESS >14 under antihistamines.

PMID: 33084462 [PubMed - as supplied by publisher]

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Effect of Lactobacillus brevis CD2 containing lozenges and plaque pH and cariogenic bacteria in diabetic children: a randomised clinical trial.

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Effect of Lactobacillus brevis CD2 containing lozenges and plaque pH and cariogenic bacteria in diabetic children: a randomised clinical trial.

Clin Oral Investig. 2020 Oct 21;:

Authors: Lai S, Lingström P, Cagetti MG, Cocco F, Meloni G, Arrica MA, Campus G

Abstract
OBJECTIVE: The short-term effect (60 days) of Lactobacillus brevis CD2 lozenges vs placebo on variables related to caries and gingivitis in type 1 diabetic children was evaluated.
MATERIAL AND METHODS: Eight diabetics (4-14 years old) were assigned to two groups (n = 34 subjects each), probiotic lozenges and placebo. Stimulated saliva for microbiological analysis and plaque pH were assessed at baseline (t0), 30 days (t1), 60 days (t2) and in the follow-up period (90 days from baseline, t3). Gingival status was assessed at t0, t2 and t3. Two-way ANOVA assessed differences between groups.
RESULTS: In the probiotic group, Streptococcus mutans bacterial density mean scores dropped from 3.11 ± 1.13 at baseline to 1.82 ± 0.72 (t2) and to 2.06 ± 0.56 (t3), while in the placebo group, the scores were 3.09 ± 0.8 (t0), 2.82 ± 0.47 (t2) and 3.11 ± 0.43 (t3) (p < 0.01). Lowest and maximum pH fall increased in the probiotic group, from 5.37 ± 0.41 at baseline to 5.49 ± 0.24 at t3 (p < 0.01) and from 1.20 ± 0.46 to 0.98 ± 0.29 (p = 0.02). Bleeding score decreased significantly in both groups, showing a statistically significant lower bleeding score at t2 in the probiotic group (25.6%, 95% CI 21.5-32.7 vs 29.5%, 95% CI 25.2-34.9, p = 0.02).
CONCLUSIONS: Lactobacillus brevis CD2 has shown to improve caries-related risk factors and gingival health in diabetic children.
CLINICAL RELEVANCE: Lactobacillus brevis CD2 might contribute to improved oral health in type 1 diabetic children.

PMID: 33083852 [PubMed - as supplied by publisher]

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Frequency-lowering processing to improve speech-in-noise intelligibility in patients with age-related hearing loss.

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Frequency-lowering processing to improve speech-in-noise intelligibility in patients with age-related hearing loss.

Eur Arch Otorhinolaryngol. 2020 Oct 20;:

Authors: Bruno R, Freni F, Portelli D, Alberti G, Gazia F, Meduri A, Galletti F, Galletti B

Abstract
OBJECTIVE: Modern hearing aids use various signal-processing strategies to improve speech intelligibility. In this manuscript, we studied the linear frequency transposition (LFT), a frequency-lowering algorithm, in patients with age-related hearing loss. Frequency-lowering algorithms transpose high-frequency sounds to a lower-frequency band. The study aimed to assess whether LFT could be used as a tool to improve speech intelligibility in patients with a better high-frequency preservation.
METHODS: The study population consisted of 77 patients (age average 74.8 ± 12.4) wearing hearing aids with an open or tulip coupling system with age-related hearing loss. The unaided air conduction pure tone average (PTA) at 500, 1000, 2000 Hz was 43.5 ± 14.3 dB; the unaided word recognition score (WRS) average was 53.7 ± 12.5%. We compared WRS in all patients with the hearing aid turned on, in "quiet" and using a "pink" and "babble" masking noise. Three hearing aid settings were tested in each acoustic conditions: no transposition (NT), high transposition (HT), and low transposition (LT). "High" and "low" refer to the "start frequency"; all sounds above the start frequency are transposed in a lower-frequency band. When the start frequency was suggested by the fitting software, we called the condition "high transposition"; when the start frequency was set at the lowest possible value provided by the fitting software, we called the condition "low trans position". The quality of the voice was also assessed asking the patient to give a score from 1 to 10, where 10 was the maximum listening comfort [quality of voice score (QVS)].
RESULTS: Collected data were compared for each condition (NT, HT, LT, in quiet, pink noise and babble noise) and no statistically significant differences were found in WRS and QVS (quiet WRS p = 0.07, pink noise WRS p = 0.18, babble noise WRS p = 0.11, QVS p = 0.91). We selected 33 patients with a better WRS in babble noise using transposition (high and low). In this group, the age was significantly lower than patients who did not use transposition (p = 0.01).
CONCLUSION: Linear frequency transposition is not useful to improve speech-in-noise intelligibility in patients with age-related hearing loss. Despite that no statistically significant differences were found, younger people could get advantages from the LFT when babble noise disturbs the listening of speech. The use of FL algorithm as a way to improve speech intelligibility in noisy environments should be always considered.

PMID: 33083865 [PubMed - as supplied by publisher]

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Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening.

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Anatomy of inferior end of palatopharyngeus: its contribution to upper esophageal sphincter opening.

Eur Arch Otorhinolaryngol. 2020 Oct 20;:

Authors: Fukino K, Tsutsumi M, Nimura A, Miwa K, Ono T, Akita K

Abstract
PURPOSE: The palatopharyngeus is one of the longitudinal pharyngeal muscles which contributes to swallowing. It is reported that the palatopharyngeus has muscle bundles in various directions and with attachment sites, and each muscle bundle has a specific function. Although previous reports suggest that the palatopharyngeus is partly interlaced with some parts of the inferior constrictor, the precise relationship remains unclear. The purpose of this study was to examine the precise manner of the connection between the palatopharyngeus and inferior constrictor, and to examine the histological characteristics of this connection.
METHODS: We examined 15 halves of nine heads from Japanese cadavers (average age: 76.1 years); 12 halves, macroscopically, and three halves, histologically.
RESULTS: Our observation suggests that the palatopharyngeus spreads radially on the inner aspect of the pharyngeal wall. The most inferior portion of the palatopharyngeus extended to the inner surface of the cricopharyngeal part of the inferior constrictor. Histological analysis showed that the inferior end of the palatopharyngeus continued into the dense connective tissue located at the level of the cricoid cartilage. The dense connective tissue not only covered the inner surface of the inferior constrictor but also entered its muscle bundles and enveloped them.
CONCLUSION: Therefore, the palatopharyngeus interlaced the cricopharyngeal part of the inferior constrictor through the dense connective tissues. The findings of this study show that the palatopharyngeus may act on the upper esophageal sphincter directly and help in its opening with the aid of the pulling forces in the superolateral direction.

PMID: 33083866 [PubMed - as supplied by publisher]

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Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology.

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Intraoral ultrasonography in the assessment of DOI in oral cavity squamous cell carcinoma: a comparison with magnetic resonance and histopathology.

Eur Arch Otorhinolaryngol. 2020 Oct 21;:

Authors: Filauro M, Missale F, Marchi F, Iandelli A, Carobbio ALC, Mazzola F, Parrinello G, Barabino E, Cittadini G, Farina D, Piazza C, Peretti G

Abstract
OBJECTIVE: The first-line therapeutic approach for oral cavity squamous cell carcinoma (OCSCC) is complete surgical resection. Preoperative assessment of depth of invasion (cDOI) is crucial to plan the surgery. Magnetic resonance (MR) and intraoral ultrasonography (IOUS) have been shown to be useful tools for assessment of DOI. The present analysis investigates the accuracy of MR and IOUS in evaluating DOI in OCSCC compared to histological evaluation (pDOI).
MATERIALS AND METHODS: Forty-nine previously untreated patients with cT1-T3 OCSCC were reviewed. Nine patients were staged with MR alone, 10 with IOUS alone, and 30 with both MR and IOUS.
RESULTS: Mean difference between cDOIMR and pDOI values of 0.2 mm (95% CI - 1.0-1.3 mm) and between cDOIIOUS and pDOI of 0.3 mm (95% CI - 1.0-1.6 mm). Spearman R between cDOIMR and pDOI was R = 0.83 and between cDOIIOUS and pDOI was R = 0.76. Both radiological techniques showed high performance for the correct identification, with the optimum cut-off of 5 mm, of patients with a pDOI ≥ 4 mm and amenable to a neck dissection, with an AUC of 0.92 and 0.82 for MR and IOUS, respectively.
CONCLUSION: Both examinations were valid approaches for preoperative determination of DOI in OCSCC, although with different cost-effectiveness profiles and indications.

PMID: 33084951 [PubMed - as supplied by publisher]

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High-speed videolaryngoscopy in early glottic carcinoma patients following transoral CO2 LASER cordectomy.

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High-speed videolaryngoscopy in early glottic carcinoma patients following transoral CO2 LASER cordectomy.

Eur Arch Otorhinolaryngol. 2020 Oct 21;:

Authors: Gandhi S, Bhatta S, Ganesuni D, Ghanpur AD, Saindani SJ

Abstract
PURPOSE: To compare high-speed videolaryngoscopy (HSV) findings, like open quotient (OQ), vocal fold vibratory onset delay (VFVOD), amplitude symmetry index (ASI) and phase symmetry index (PSI), after 6 months of cordectomy with that after 1 year, and to compare later with the control group.
METHODS: Retrospective analysis of HSV recordings of 33 patients of early glottic carcinoma after cordectomy was performed after 6 months and 1 year of cordectomy with the help of videokymogram and digital kymogram. The control group of ten individuals was selected from patients who came to hospital with complaints other than larynx. The comparison was done for different types of cordectomy separately.
RESULTS: The mean of OQ, VFVOD, ASI and PSI was found to be significantly higher after 6-month follow-up than after 1-year follow-up, the later was in turn found to be significantly higher than that of the control group, for type II and III cordectomy. The mean of OQ, VFVOD, ASI and PSI for other types of cordectomy also showed similar results, but the significance was not calculated due to less sample size.
CONCLUSION: There was significant improvement in OQ, VFVOD, PSI and ASI following CO2 LASER cordectomy after 1 year of follow-up, making it a good management option for early glottic carcinoma. The ability of the HSV to measure variations in the vocal cord vibration, following cordectomy, was well established by this study.

PMID: 33084952 [PubMed - as supplied by publisher]

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Intermittent intracranial condylar dislocation with minimal functional sequelae.

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Intermittent intracranial condylar dislocation with minimal functional sequelae.

Int J Oral Maxillofac Surg. 2020 Oct 17;:

Authors: Zumbrunn Wojczyńska A, Schuknecht B, Ettlin DA

Abstract
Degenerative changes of the temporomandibular joint (TMJ) present with a broad spectrum of morphological alterations. However, erosions leading to a glenoid fossa defect and condylar impingement of the temporal lobe are a rare finding. A 77-year-old female patient presented with limited mouth opening and pre-auricular pain during mastication on the left side. She denied any neurological dysfunction. Her medical history included poliomyelitis, multiple cancers, and osteonecrosis of the left tibial plateau. Computed tomography revealed advanced degeneration of both TMJs. On the left side, a glenoid fossa fragment was elevated towards the left middle cranial fossa. Real-time dynamic magnetic resonance imaging (MRI) showed repetitive intracranial condylar dislocation during mouth closure. She declined surgery and received instructions for self-management. At the 12-month follow-up, she reported resolution of the pain and normal masticatory function. A control MRI showed a stable radiographic appearance. This report illustrates that intermittent dislocation of the mandibular condyle into the middle cranial fossa can be successfully managed conservatively. The self-limiting nature of the TMJ degenerative joint disease, patient preference, and the patient's general health status require consideration when advising patients on the therapeutic strategy.

PMID: 33082066 [PubMed - as supplied by publisher]

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A case of rhinocerebral mucormycosis with brain abscess drained by endoscopic endonasal skull base surgery.

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A case of rhinocerebral mucormycosis with brain abscess drained by endoscopic endonasal skull base surgery.

Med Mycol Case Rep. 2020 Dec;30:22-25

Authors: Uraguchi K, Kozakura K, Oka S, Higaki T, Makihara S, Imai T, Doi A, Ohta T, Kariya S, Nishizaki K

Abstract
A 70-year-old Japanese man undergoing remission induction therapy for acute monocytic leukemia (AML-M5b) developed fever and headache, and was started on antibiotics and liposomal amphotericin B (L-AMB). There was no improvement, and computed tomography and contrast-enhanced magnetic resonance imaging revealed acute rhinosinusitis and brain abscess. Successful endoscopic endonasal surgery was performed at this point, providing drainage for the rhinosinusitis and abscess. Histopathological findings showed the mucormycosis.

PMID: 33083212 [PubMed]

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Sniffin' Sticks to Measure Olfactory Function and Recovery Following Bilateral Superior Turbinate Resection as Part of Endoscopic Transsphenoidal Approach.

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Sniffin' Sticks to Measure Olfactory Function and Recovery Following Bilateral Superior Turbinate Resection as Part of Endoscopic Transsphenoidal Approach.

Ann Otol Rhinol Laryngol. 2020 Oct 21;:3489420965621

Authors: Gong SW, Ahmadi S, Blackburn SL, Ulin L, Citardi MJ, Luong A, Yao WC

Abstract
BACKGROUND: Extended endoscopic transsphenoidal (EET) approaches can include complete resection of both superior turbinate (ST) for wider exposure. Moreover, ST resection has been associated with postoperative olfactory impairment.
OBJECTIVE: We sought to determine the impact of bilateral ST resection on olfaction during a transsphenoidal approach.
METHOD: A prospective observational study was conducted on 29 patients undergoing endoscopic skull base surgery sparing the olfactory tracts at a tertiary academic center. Olfactory function was measured with Sniffin' Sticks at the preoperative visit, 2-weeks and 6 to 8 weeks postoperatively. All components: odor threshold (OT), odor discrimination (OD), odor identification (OI) and composite scores (TDI = OT+OD+OI) were evaluated.
RESULT: Study was completed in 15 patients with 14 excluded due to a variety of reasons. At 2 weeks, a significant decrease was noted in composite scores (32.3 ± 5.4 vs. 23.8 ± 5.8, P < .05) and OT (7.7 vs. 3.2, P < .05). There was a significant increase in olfactory scores between post-op weeks 2 and 6 to 8 weeks in TDI (23.8 vs. 31.4, P < .05) as well as in OT (3.2 vs. 7.6, P < .05), OD (9.4 vs. 11.1, P < .05), and OI (11.1 vs. 12.7, P < .05). No significant difference was found between TDI (32.3 ± 5.4 vs. 31.4 ± 5.1), OT (7.7 vs. 7.6), OD (11.4 vs. 11.1) and OI (13.2 vs. 12.7) from preoperative and 6-8 weeks postoperative visits.
CONCLUSION: Patients undergoing bilateral ST resection during EET procedures experience transient hyposmia postoperatively. However, the olfactory function normalizes to preoperative levels at 6 to 8 weeks. The resection of the bilateral superior turbinate does not appear to decrease olfactory function.

PMID: 33084356 [PubMed - as supplied by publisher]

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Decrease in Respiratory Related Hospitalizations in Tracheostomy-Dependent Children Who Tolerate Passy-Muir Valve Use.

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Decrease in Respiratory Related Hospitalizations in Tracheostomy-Dependent Children Who Tolerate Passy-Muir Valve Use.

Ann Otol Rhinol Laryngol. 2020 Oct 21;:3489420966612

Authors: Li L, Wikner E, Behzadpour H, Perez G, Mudd P

Abstract
OBJECTIVE: To assess the effect of Passy-Muir® Valve (PMV) tolerance on respiratory illness and respiratory related hospital admissions in tracheostomy-dependent children.
METHODS: Retrospective cohort study of 262 patients who underwent tracheostomy placement between 2012 and 2018 at a tertiary free-standing children's hospital. Outcome measures studied were number of reported upper respiratory infections and respiratory related hospitalizations per year (RRH/year).
RESULTS: About 135 (51.5%) tracheostomy-dependent children underwent PMV trials, and 106 (78.5%) of these children were able to tolerate PMV for at least 1 hour daily. When comparing children who tolerated PMV versus those who did not, the latter group had significantly higher rates of subglottic stenosis but no significant differences in RRH/year or average age. In those children who tolerated PMV and achieved routine use of PMV > 1 hour/day, an average of 1.14 RRH/year occurred prior to PMV tolerance, as compared with 0.57 RRH/year after PMV tolerance (P = .003). Multivariate analysis shows that in patients <2 years, there is a significant decrease in RRH/year after PMV tolerance is attained (1.53 vs 0.76, P = .001), independent of indication for tracheostomy.
CONCLUSION: In tracheostomy-dependent children who tolerate PMV use routinely >1 hour/day there are decreased rates of respiratory related hospitalizations (RRH). Children <2 years of age have the most impact of RRH, with rates that are significantly lower with routine use of the PMV.

PMID: 33084350 [PubMed - as supplied by publisher]

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