ὁ δὲ ἡγεμὼν ἔφη· τί γὰρ κακὸν ἐποίησεν; οἱ δὲ περισσῶς ἔκραζον λέγοντες· σταυρωθήτω

Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic review

xlomafota13 shared this article with you from Inoreader Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic 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. 2021 Apr 24. doi: 10.1007/s00405-021-06803-8. Online ahead of print. ABSTRACT PURPOSE: The aim of this systematic review was to evaluate the clinical application potential of the video head impulse test (vHIT) in diagnosing vestibular neuritis (VN). METHODS: An electronic search was conducted in the following databases: Embase, MEDLINE, ScienceDirect, Google scholar, and the Cochrane Database of Systematic Reviews. Clinical studies were included in which an evaluation was made using vHIT either alone or in combination with other tests or bedside algorithms. Evaluations that were carried out using unvalidated tools were excluded. Only studies of patients with VN (superior, inferior, or in toto) were included. Screening of titles, abstracts, full texts, and data extraction were undertaken independently by pairs of reviewers. Included studies were quality appraised using a modified version of the Newcastle -Ottawa scale. RESULTS: Results were reported according to the preferred reporting items for systematic reviews and meta-analyses. Our search yielded 1309 unique records, 21 of which remained after screening titles and abstracts. Sixteen studies were included, i.e., for a total of 933 patients including 474 patients with a diagnosis of VN. CONCLUSIONS: The diagnostic value of vHIT is high for VN, as it is a high-frequency measurement tool. vHIT is a useful complement or alternative to caloric and rotational tests as an indicator of lesions of vestibular canal functioning, especially at the time of onset. This tool can provide useful clues about the clinical progress of recovery from the lesion through the value of the vestibulo ocular reflex gain and the consequent evolution of the saccade pattern, which allows the patient to stabilize vision on the retina. PMID:33893851 | DOI:10.1007/s00405-021-06803-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computed tomographic angiography (CTA) diagnosis of a rare meandering right pulmonary vein (MRPV)

xlomafota13 shared this article with you from Inoreader Computed tomographic angiography (CTA) diagnosis of a rare meandering right pulmonary vein (MRPV) Via radiol anat Surg Radiol Anat. 2021 Apr 24. doi: 10.1007/s00276-021-02751-4. Online ahead of print. ABSTRACT Meandering right pulmonary vein (MRPV) is an exceedingly rare congenital pulmonary vascular variant with less than 20 reported cases. MPVR is a tortuous aberrant venous drainage of the right pulmonary upper lobe anastomosing with the right lower pulmonary vein instead of directly joining the left atrium. The variant is benign with an orthotopic venous drainage without any kind of shunting. The differential diagnosis mostly comprises the scimitar syndrome but also primary varix, arteriovenous malformations, and pulmonary sequestration. We report a case of MRPV fortuitously diagnosed in a 70-year-old patient. Multi-detector computed tomographic angiography (CTA) with MPR, MIP, and 3D reconstructions allowed the diagnosis obviating the need for invasive procedures. PMID:33893860 | DOI:10.1007/s00276-021-02751-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic discrepancy in second opinion reviews of primary epithelial neoplasms involving salivary gland: An 11‐year experience from a tertiary referral center focusing on useful pathologic approaches and potential clinical impacts

xlomafota13 shared this article with you from Inoreader Diagnostic discrepancy in second opinion reviews of primary epithelial neoplasms involving salivary gland: An 11‐year experience from a tertiary referral center focusing on useful pathologic approaches and potential clinical impacts Via Head & Neck Abstract Aims In the era of precision medicine, accurate pathologic diagnoses are crucial for appropriate management. Methods We herein described the histologic features and clinical impacts of 66 salivary gland epithelial neoplasms in which the diagnosis was altered after expert review. Results The most common revised diagnosis was that of salivary duct carcinoma (SDC, n = 12), adenoid cystic carcinoma (n = 12), and myoepithelial carcinoma (n = 10). The most common initial diagnosis was mucoepidermoid carcinoma (n = 19) with SDC being the most common revised diagnosis (7/19). Thirteen salivary gland carcinomas were initially diagnosed as benign entities, whereas five benign tumors were initially interpreted as carcinoma. The change in diagnosis was considered to be clinically significant in 65 (97%) cases. Conclusions Given their rarity, salivary gland neoplasms are prone to diagnostic inaccuracy and discrepancy. A constellation of histologic features and ancillary studies are useful in reaching the correct diagnosis, which can have significant clinical impacts. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CD15+ tumor infiltrating granulocytic cells can predict recurrence and their depletion is accompanied by good responses to S‐1 with oral cancer

xlomafota13 shared this article with you from Inoreader CD15+ tumor infiltrating granulocytic cells can predict recurrence and their depletion is accompanied by good responses to S‐1 with oral cancer Via Head & Neck Abstract Background It has been reported in oral squamous cell carcinoma (OSCC) that myeloid‐derived suppressor cells infiltrate tumor tissues. This study examined whether S‐1 chemotherapy changes immune cell populations in the tumor microenvironment. Methods We examined 71 patients with of OSCC, including 51 patients who received preoperative S‐1 chemotherapy. Immunohistochemistry for PD‐L1, CD8, forkhead box protein 3 (FOXP3), and CD15 was performed using biopsy and resected specimens. Results The numbers of CD8+, FOXP3+, and CD15+ cells in resected specimens were significantly decreased by S‐1 chemotherapy. The reduction of the proportion of CD15+ cells significantly differed between responders and nonresponders. Most responders were distributed into the group with low PD‐L1 expression and a low density of CD8+ cells before chemotherapy. Furthermore, many patients with recurrence exhibited a high density of CD15+ cells in biopsy specimens. Conclusion Preoperative S‐1 chemotherapy can potentially improve prognosis by reducing CD15+ cells in the tumor microenvironment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High‐risk early‐stage oral tongue squamous cell carcinoma, when free margins are not enough: Critical review

xlomafota13 shared this article with you from Inoreader High‐risk early‐stage oral tongue squamous cell carcinoma, when free margins are not enough: Critical review Via Head & Neck Abstract Oral tongue squamous cell carcinoma (OTSCC) is a quite peculiar disease from an anatomical and biological standpoint. An increasing amount of literature highlights the existence of a small subset of T1‐T2N0 OTSCC, properly resected on a margin‐dependent basis, which conversely proved higher than expected rates of loco‐regional/distant failure and disease‐specific mortality. These specific high‐risk tumors might not have a margin‐dependent disease and could possibly benefit from a more aggressive upfront loco‐regional treatment, especially addressing the so‐called T‐N tract. Widespread adoption of a histopathological risk model would allow early recognition of these high‐risk diseases and, consequently, intensification of the traditional treatment strategies in that specific niche. We reviewed the available knowledge trying to shed light on the potential determinants of the dismal prognosis of these high‐risk OTSCC, with special reference to the role of overlo oked T‐N tract involvement and possible alternatives in terms of elective neck management and risk stratification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparative analysis of human bone marrow mesenchymal stem cells, articular cartilage derived chondroprogenitors and chondrocytes to determine cell superiority for cartilage regeneration

xlomafota13 shared this article with you from Inoreader Comparative analysis of human bone marrow mesenchymal stem cells, articular cartilage derived chondroprogenitors and chondrocytes to determine cell superiority for cartilage regeneration Via histochem Acta Histochem. 2021 Apr 21;123(4):151713. doi: 10.1016/j.acthis.2021.151713. Online ahead of print. ABSTRACT INTRODUCTION: Chondroprogenitors, a promising therapeutic modality in cell-based therapy, are routinely isolated from articular cartilage by fibronectin differential adhesion assay. However, there is paucity of information regarding their biological profile and the lack of a marker that can reliably distinguish them from cultured chondrocytes due to possible dediffer entiation. Since chondroprogenitors have been classified as mesenchymal stem cells(MSCs), the aim of our study was to compare bone marrow-MSCs, chondroprogenitors and chondrocytes, and assess superiority for cartilage repair. An additional objective was to also compare CD49b as a differentiating marker for isolating chondroprogenitors as a recent report demonstrated significantly high expression in the surfaceome of migratory articular chondroprogenitors. METHODS: Bone marrow aspirate and articular cartilage was obtained from three osteoarthritic knee joints. Study arms included a) bone marrow-MSCs, b) chondroprogenitors, c) cultured chondrocytes, d) chondrocytes cultured with additional growth factors and e) CD49b + sorted chondroprogenitors. Assessment parameters included population doubling, surface expression for positive, negative MSC markers and potential markers of chondrogenesis (CD29, CD49e, CD49b, CD166 and CD146), RT-PCR for markers of chondrogenesis and hypertrophy and trilineage differentiation. RESULTS AND CONCLUSION: Chondroprogenitors exhibited efficient chondrogenesis (SOX-9 and COL2A1) and significantly lower tendency for hypertrophy (RUNX2), which was also reflected in trilineage differentiation where progenitors displayed minimal calcified matrix, efficient glycosaminoglycan deposition and high collagen type II uptake. CD49b did not serve as a marker for isolation as sorted chondroprogenitors performed significantly poorer when compared to fibronectin assay derived cells. Emphasis on preclinical studies utilizing progenitors of higher purity is the future direction. PMID:33894479 | DOI:10.1016/j.acthis.2021.151713 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosing necrotizing external otitis on CT and MRI: assessment of pattern of extension

xlomafota13 shared this article with you from Inoreader Diagnosing necrotizing external otitis on CT and MRI: assessment of pattern of extension 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. 2021 Apr 25. doi: 10.1007/s00405-021-06809-2. Online ahead of print. ABSTRACT BACKGROUND AND PURPOSE: Necrotizing external otitis (NEO) is a serious complication of external otitis. NEO can be classified according to-anterior, medial, posterior, intracranial, and contralateral-extension patterns. Currently there is no consensus on the optimal imaging modality for the identification of disease extension. This study compares NEO extension patterns on MR and CT to evaluate diagnostic comparability. METHODS: Patients who received a CT and MR within a 3-month interval were retrospectively examined. Involvement of subsites and subsequent spreading patterns were assessed on both modalities by a radiologist in training and by a senior head and neck radiologist. The prevalence of extension patterns on CT and MR were calculated and compared. RESULTS: All 21 included NEO cases showed an anterior extension pa ttern on CT and MR. Contrary to MR, medial extension was not recognized on CT in two out of six patients, and intracranial extension in five out of eight patients. The posterior extension pattern was not recognized on MR. Overall, single anterior extension pattern (62%) is more prevalent than multiple extension patterns (38%). CONCLUSION: All anterior NEO extension pattern were identified on CT as well as MR. However, the medial and intracranial spreading patterns as seen on MR could only be identified on CT in a small number of patients. The posterior spreading pattern can be overlooked on MR. Thus, CT and MR are complimentary for the initial diagnosis and work-up of NEO as to correctly delineate disease extent through the skull base. PMID:33895893 | DOI:10.1007/s00405-021-06809-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Protocols and assessment procedures in fiberoptic endoscopic evaluation of swallowing: an updated systematic review

xlomafota13 shared this article with you from Inoreader Protocols and assessment procedures in fiberoptic endoscopic evaluation of swallowing: an updated systematic review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Apr 2:S1808-8694(21)00061-6. doi: 10.1016/j.bjorl.2021.03.002. Online ahead of print. ABSTRACT INTRODUCTION: Neurological alterations can generate swallowing disorders and fiberoptic endoscopic evaluation of swallowing is one of the tests performed for its diagnosis, as well as assistance in dysphagia management. OBJECTIVE: To identify and describe a fiberoptic endoscopic evaluation of swallowing standardized protocol for the neurological adult population and its stages. METHODS: Systematic review registered on the PROSPERO platform (CRD42018069428), carried out on the websites: MEDLINE, Cochrane Library and Scielo; published between 2009 and 2020. Randomized clinical trials, cross-sectional, and longitudinal studies were included. Two independent judges evaluated the study design and extracted the data from the selected studies. Doubts regarding inclusion or not of the studies were evaluated b y a third judge. Scientific articles included were those with adult neurological remained patients with outcomes: (1) diagnosis of swallowing disorder (2) change in sensitivity in laryngeal region (3) penetration of food offered (4) aspiration of food offered. RESULTS: 3724 articles were initially selected, after personalized search for patients with neurological alterations 101 studies remained. In the end, 21 qualitative studies from 2009 to 2020 remained in the systematic review and they were described in detail and compared. Seven articles used protocols of the institutions in which the research took place and four mentioned using the same protocol. The reliable reproducibility of the protocols is feasible only in three of the articles, even presenting different protocols. CONCLUSIONS: There is no standard or validated protocol to assess the swallowing function of adults with neurological diseases. PMID:33895102 | DOI:10.1016/j.bjorl.2021.03.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aesthetic utility of addition of nipple-areola recentralization to rotation flap according to nipple tumor distance for patients with lower-outer or upper-inner located breast cancers

xlomafota13 shared this article with you from Inoreader Aesthetic utility of addition of nipple-areola recentralization to rotation flap according to nipple tumor distance for patients with lower-outer or upper-inner located breast cancers Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 31:S1748-6815(21)00141-8. doi: 10.1016/j.bjps.2021.03.051. Online ahead of print. ABSTRACT We aimed to validate the cosmetic utility of addition of nipple-areola recentralization (NAR) to rotation flap according to nipple tumor distance (NTD) as a volume displacement technique after breast conserving surgery (BCS) for lower-outer and upper-inner breast cancers. Twenty breast cancer patients who had been treated with rotation flap with (Group 1; n = 6) or without (Group 2; n = 14) NAR after BCS for lower-outer or upper-inner located tumors, and those who had undergone BCS without oncoplastic surgical technique for tumors in the same area (Control group; n = 43), were retrospectively investigated. Cosmetic outcome was evaluated using Harvard scale and/or BCCT.core. As a result, the ratio of patients categorized as excellent/good was 83% in Group 1 and 93% in Group 2, respectively, and there was no significant difference between them (P = 0.521). In addition, Group 1 + 2 showed a significantly higher ratio of patients classified as excellent/good than the control group (90% vs. 56%; P = 0.009). After adjustment of clinical background parameters using propensity score matching analysis between Group 1 + 2 and the control group, 12 pairs with similar background factors were matched. Among them, Group 1 + 2 showed a higher ratio of patients categorized as excellent/good than the control group (92% vs. 42%; P = 0.034). In conclusion, addition of NAR to rotation technique according to NTD may enable us to perform a volume displacement after BCS for lower-outer or upper-inner located tumors irrespective of NTD without sacrificing postoperative breast appearance. PMID:33895091 | DOI:10.1016/j.bjps.2021.03.051 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Seeing White: Management of TIVA during autologous breast reconstruction

xlomafota13 shared this article with you from Inoreader Seeing White: Management of TIVA during autologous breast reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 1:S1748-6815(21)00138-8. doi: 10.1016/j.bjps.2021.03.048. Online ahead of print. ABSTRACT Total IntraVenous Anaesthesia is frequently the anaesthetic of choice for enhanced recovery after surgery pathways during breast reconstruction free flap surgery. This relies upon the continuous intravenous infusion of propofol. We describe our experience of two patients where augmentation of a venously congested DIEP flap with a cephalic vein transposition procedure, risked interruption of the intravenous delivery of anaesthesia to the patient. We also share our steps taken to mitigate this risk going forward. PMID:33895092 | DOI:10.1016/j.bjps.2021.03.048 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pemphigus Vulgaris and Bullous Pemphigoid of the Upper Aerodigestive Tract: A Review Article and Novel Approaches to Management

xlomafota13 shared this article with you from Inoreader Pemphigus Vulgaris and Bullous Pemphigoid of the Upper Aerodigestive Tract: A Review Article and Novel Approaches to Management Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Background: Autoimmune bullous diseases are rare conditions characterized by blistering of the skin and mucous membranes. The 2 commonest forms are pemphigus vulgaris and bullous pemphigoid. The oral cavity or oropharynx may be the initial site of presentation or often the only site involved. Summary: These conditions are often misdiagnosed or overlooked leading to poorer patient outcomes. Due to the chronic nature of these conditions and the systemic effects of treatment, there is a significant associated morbidity and mortality. As such, an understanding of the fundamentals of autoimmune bullous diseases is vital to those working in otolaryngology. The mainstay of management in both conditions is topical and systemic corticosteroids. There is also a role for immunomodulating and non-steroidal anti-inflammatory drugs as adjunct or alternative therapies. Surgical intervention may be required to protect the airway. Often multimodality treatment is required involving multidisciplinary input from otolaryngologists, oral surgeons, dermatologists, and rheumatologists. This review article will highlight the aetiology, pathology, clinical features, investigations, and management of both pemphigus vulgaris and bullous pemphigoid including recent advances in management. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.