Subglottic Mass as Isolated Manifestation of Relapsing Polychondritis at Presentation

xlomafota13 shared this article with you from Inoreader Subglottic Mass as Isolated Manifestation of Relapsing Polychondritis at Presentation Via ear nose throat Ear Nose Throat J. 2021 Jun 3:1455613211016718. doi: 10.1177/01455613211016718. Online ahead of print. ABSTRACT Relapsing polychondritis (RP) is a rare systemic disease that is characterized by recurrent episodic inflammation of the cartilaginous structures of the body, resulting in their progressive destruction and subsequent replacement with fibrotic scar. We present a case of RP that initially manifested with subglottic involvement and we propose an innovative strategy fo r the treatment for laryngeal RP in phase of active inflammation. A multidisciplinary approach (rheumatologist, otolaryngologist, immunologist, internist, cardiologist, etc) and adequate follow-up are essential. The timeliness of the diagnosis is fundamental to contain the destructive effects on the cartilages involved. PMID:34082611 | DOI:10.1177/01455613211016718 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Tympanic membrane regeneration using platelet-rich fibrin: a systematic review and meta-analysis 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 Jun 4. doi: 10.1007/s00405-021-06915-1. Online ahead of print. ABSTRACT PURPOSE: Platelet-rich fibrin (PRF) results in satisfactory wound healing. This analysis focuses on assessing the effectiveness of PRF in the treatment of tympanic membrane (TM) perforations. MATERIALS AND METHODS: The literature was searched using PubMed, Embase, Cochrane Library and Web of Science databases from inception to February 28th, 2021. The following healing and hearing outcomes were measured: closure rate, pre-and postoperative auditory results, and incidence of postoperative infections. Data were pooled and expressed as the odds ratio (OR). RESULTS: Ten studies were eligible for qualitative review, and seven of them were included for the final quantitative comparison. The OR for the closure rate of acute perforations was 4.30 (95% CI 1.35-13.70, I2 = 0%), and the OR in the chronic subgroup was 5.42 (95% CI 2.57-11.43, I2 = 0%). The total OR value for the completed closure rate was 5.10 (95% CI 2.72-9.54, I2 = 0%), indicating that the utilization of PRF can enhance the closure of both acute and chronic perforations. The qualitative review did not find improved hearing results with the use of PRF. In addition to promoting closure, PRF can reduce the incidence of infections (OR = 0.14). The sensitivity analysis did not change the final results, and there was no publication bias in this analysis. CONCLUSION: PRF can increase the closure rate of acute perforations, enhance the survival rate of autografts in TM surgeries and reduce the incidence of infections. However, the literature indicates that PRF does not influence the hearing outcomes. This study shows that PRF is an effective agent for TM regeneration. PMID:34086080 | DOI:10.1007/s00405-021-06915-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Understanding Dizzy Patients a Cross-Sectional Analysis of Attitudes toward Diagnosis, Providers, and Treatment

xlomafota13 shared this article with you from Inoreader Understanding Dizzy Patients a Cross-Sectional Analysis of Attitudes toward Diagnosis, Providers, and Treatment Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jun 4:34894211022095. doi: 10.1177/00034894211022095. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate patients' attitudes regarding their dizziness, provider capabilities, and receptiveness toward treatment. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary care vestibular clinic. PATIENTS: Ages 18 years or older, fluent in English, and who presented with a chief complaint of dizziness or vertigo. INTERVENTION (S): N/A. MAIN OUTCOMES MEASURE(S): Non-validated questionnaire surveying patients' beliefs regarding the cause of their dizziness, likelihood of successful treatment, and openness to various treatment modalities. RESULTS: Patients were asked to complete an online non-validated survey regarding their dizziness prior to being evaluated in neurotology clinic. About 67 surveys were completed between January 2017 and September 2018. A majority of patients attributed their dizziness to their ears (n = 47, 70%), followed by the brain (n = 29, 43%). Most subjects chose "neither agree nor disagree" about whether their provider could identify the cause of their dizziness (27%). Most subjects also chose "neither agree nor disagree" that their dizziness would resolve with treatment (31%). These attitudes were not influenced by demographics, dizziness severity, anxiety, depression, or quality of life on multivariate ordinal regression modeling. CONCLUSIONS: Patients who experi ence dizziness have neutral attitudes with regards to believing that their provider will be able to identify the cause of their dizziness and whether their dizziness will resolve with treatment. These neutral attitudes are experienced by a plurality of patients and do not differ by demographic information, dizziness handicap, quality of life, depression, or anxiety. PMID:34085539 | DOI:10.1177/00034894211022095 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy and safety of polyethylene glycol dural sealant system in cranial and spinal neurosurgical procedures: Meta-analysis

xlomafota13 shared this article with you from Inoreader Efficacy and safety of polyethylene glycol dural sealant system in cranial and spinal neurosurgical procedures: Meta-analysis Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Apr 26;12:182. doi: 10.25259/SNI_132_2021. eCollection 2021. ABSTRACT BACKGROUND: We aimed to assess the efficacy of polyethylene glycol (PEG) dura sealant to achieve watertight closure, prevention of cerebrospinal fluid (CSF) leak and to investigate its possible side effects. METHODS: We searched Medline (through PubMed), Scopus, and the Cochrane Library through December 2019. We included articles demonstrating cranial or spinal procedures with the use of PEG material as a dural sealant. Data on intraoperative watertight closure, CSF leak, and surgical complications were extracted and pooled in a meta-analysis model using RevMan version 5.3 and OpenMeta (Analyst). RESULTS: Pooling the controlled trials showed that PEG resulted in significantly more intraoperative watertight closures than standard care (risk ratio [RR] = 1.44, 95% confidence interval [CI] [1.24, 1.66]). However, the combined effect estimate d id not reveal any significant difference between both groups in terms of CSF leaks, the incidence of surgical site infections, and neurological deficits (P = 0.7, 0.45, and 0.92, respectively). On the other hand, pooling both controlled and noncontrolled trials showed significance in terms of leak and neurological complications (RR = 0.0238, 95% CI [0.0102, 0.0373] and RR = 0.035, 95% CI [0.018, 0.052]). Regarding intraoperative watertight closure, the overall effect estimate showed no significant results (RR=0.994, 95% CI [0.986, 1.002]). CONCLUSION: Dura seal material is an acceptable adjuvant for dural closure when the integrity of the dura is questionable. However, marketing it as a factor for the prevention of surgical site infection is not scientifically proved. We suggest that, for neurosurgeons, using the dural sealants are highly recommended for duraplasty, skull base approaches, and in keyhole approaches. PMID:34084610 | PMC:PMC8168650 | DOI:10.25259/SNI_132_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two cases of supratentorial lobar intracranial hemorrhage following lumbar decompression and stabilization

xlomafota13 shared this article with you from Inoreader Two cases of supratentorial lobar intracranial hemorrhage following lumbar decompression and stabilization Via leak of cerebrospinal fluid Surg Neurol Int. 2021 May 10;12:221. doi: 10.25259/SNI_271_2021. eCollection 2021. ABSTRACT BACKGROUND: Lumbar spine surgery with or without intraoperative dural tear (DT) may contribute to postoperative subdural hematomas and/or cerebellar intracranial hemorrhages (ICHs). Here, we present two patients, one with and one without an intraoperative DT occurring during lumbar surgery, both of whom developed acute postoperative supratentorial ICHs. CASE DESCRIPTION: Two patients developed supratentorial lobar ICH following lumbar decompressions and fusion. The first patient, without an intraoperative DT, developed multiple ICHs involving the left cerebellum and left temporal lobe. The second patient, following an L4-5 decompression/instrumented fusion involving a DT, postoperatively developed a large right frontal ICH. CONCLUSION: Here, two patients undergoing lumbar spine surgery with/without DT subsequently developed significant ICH. PMID:34084648 | PMC:PMC8168694 | DOI:10.25259/SNI_271_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dural leakage due to ipsilateral needle placement for spinal level localization in unilateral decompression surgery: A case report

xlomafota13 shared this article with you from Inoreader Dural leakage due to ipsilateral needle placement for spinal level localization in unilateral decompression surgery: A case report Via leak of cerebrospinal fluid Surg Neurol Int. 2021 May 3;12:205. doi: 10.25259/SNI_245_2021. eCollection 2021. ABSTRACT BACKGROUND: A spinal dural defect caused by needle placement for spinal level localization is an uncommon complication of cerebrospinal fluid leak with the potential for the development of intracranial hypertension. CASE DESCRIPTION: Our 48-year-old patient underwent unilateral fenestration and sequestrectomy for intractable L5 radiculopathy due to disc herniation at the level L4-5 on the right side. The spinal level was identified with fluoroscopy after placement of a 24-gauge Sprotte spinal needle on the right side. Intraoperatively, a sub-millimeter spinal dural defect was visualized on the ipsilateral side. CONCLUSION: Caution is needed when needle placement is used to localize the spinal level for unilateral surgery. PMID:34084632 | PMC:PMC8168678 | DOI:10.25259/SNI_245_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extra-axial haemorrhage in a patient with Alport syndrome after epidural anaesthesia

xlomafota13 shared this article with you from Inoreader Extra-axial haemorrhage in a patient with Alport syndrome after epidural anaesthesia Via leak of cerebrospinal fluid BMJ Case Rep. 2021 Jun 3;14(6):e242160. doi: 10.1136/bcr-2021-242160. ABSTRACT Extra-axial haemorrhage following epidural anaesthesia is extremely rare. We present the case of an 18-year-old G1P0 woman with Alport syndrome who had a ventouse delivery for failure to progress that was complicated by a postpartum tonic-clonic seizure. Clinically, and confirmed radiologically, the patient was found to have experienced an extra-axial haemorrhage (extradural and subdural haemorrhage) secondary to a cerebrospinal fluid leak caused by a dural puncture during epidural anaesthesia. Differentiating between postdural puncture headache, subdural haemorrhage and extradural haemorrhage can be extremely challenging, but it is important to consider these rare conditions when evaluating patients presenting with postpartum headache and seizure. PMID:34083183 | DOI:10.1136/bcr-2021-242160 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spinal cord injury repair using mesenchymal stem cells derived from bone marrow in mice: A stereological study

xlomafota13 shared this article with you from Inoreader Spinal cord injury repair using mesenchymal stem cells derived from bone marrow in mice: A stereological study Via histochem Acta Histochem. 2021 May 31:151720. doi: 10.1016/j.acthis.2021.151720. Online ahead of print. ABSTRACT Transplantation of bone marrow stem cells (BMSCs) has shown to have a vital role in promoting nerve regeneration after SCI. The aim of this study was to investigate the effect of BMSCs transplantation in healing of spinal cord injury (SCI) in mice based on morphologic parameters. Forty two male mice were randomly divided into 3 groups of control with no intervention, experi mental SCI without treatment, and experimental SCI transplanted with 2 × 105 BMSCs intravenously. To induce SCI bilaterally, T10 was compressed for 2 min. The animals were sacrificed 3 and 5 weeks after SCI and T7-T11 segments of spinal cord were removed and stained by Giemsa and H&E methods. Stereological assessment estimated the gray and white matter volume, the number of neurons and neuroglia and diameter of central canal. The average amount of gray matter in SCI injury group was significantly lower than control group. An increase in the number of neurons was noted after cell transplantation. The number of neurons in SCI injury group significantly decreased in comparison to the control group. In cell transplantation group, a significant increase in the number of neurons was visible when compared to SCI injury group. The increase in the number of neurons after cell transplantation denotes to the regenerative potential of BMSCs in SCI. These findings can be added to the literature and open a new window when targeting treatment of SCI. PMID:34083065 | DOI:10.1016/j.acthis.2021.151720 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term medical and productivity costs of severe trauma: Results from a prospective cohort study

xlomafota13 shared this article with you from Inoreader Long-term medical and productivity costs of severe trauma: Results from a prospective cohort study Via Speech therapy by Marjolein van der Vlegel, Juanita A. Haagsma, Roos J. M. Havermans, Leonie de Munter, Mariska A. C. de Jongh, Suzanne Polinder Background Through improvements in trauma care there has been a decline in injury mortality, as more people survive severe trauma. Patients who survive severe trauma are at risk of long-term disabilities which may place a high economic burden on society. The purpose of this study was to estimate the health care and productivity costs of severe trauma patients up to 24 months after sustaining the injury. Furthermore, we investigated the impact of injury severity level on health care utilization and costs and determined predictors for health care and productivity costs. Methods This prospective cohort study included adult trauma patients with severe injury (ISS≥16). Data on in-hospital health care use, 24-month post-hospital health care use and productivity loss were obtained from hospital registry data and collected with the iMTA Medical Consumption and Productivity Cost Questionnaire. The questionnaires were completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log -linked gamma generalized linear models were used to investigate the drivers of health care and productivity costs. Results In total, 174 severe injury patients were included in this study. The median age of participants was 55 years and the majority were male (66.1%). The mean hospital stay was 14.2 (SD = 13.5) days. Patients with paid employment returned to work 21 weeks after injury. In total, the mean costs per patient were €24,760 with in-hospital costs of €11,930, post-hospital costs of €7,770 and productivity costs of €8,800. Having an ISS ≥25 and lower health status were predictors of high health care costs and male sex was associated with higher productivity costs. Conclusions Both health care and productivity costs increased with injury severity, although large differences were observed between patients. It is important for decision-makers to consider not only in-hospital health care utilization but also the long-term consequences and associated cos ts related to rehabilitation and productivity loss. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Follow-up of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany

xlomafota13 shared this article with you from Inoreader Follow-up of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany Via hno HNO. 2021 Jun 4. doi: 10.1007/s00106-021-01075-4. Online ahead of print. ABSTRACT PURPOSE: The SARS-CoV‑2 pandemic has affected the health and practice of otorhinolaryngologists (ORLs) for over 1 year. Follow-up data of a national survey with German ORLs were evaluated regarding differences between the two waves of the pandemic. METHODS: As in the initial survey, German ORLs were addressed via e‑mail through the German Society of ORL, Head and Neck Surgery and the German ENT Association. All ORLs afflicted with SARS-CoV‑2 were invited to participate in a web-based survey. General data on infections and concomitant parameters were evaluated. RESULTS: Since the start of the pandemic, 129 ORLs reported testing positive for SARS-CoV‑2 in Germany. The ORLs infected during the first wave had a relative risk (RR) of 4.07 (95% CI: 3.20; 5.19) of contracting SARS-CoV‑2. During the second wave, the RR decreased to 0.35 (95% CI: 0.28; 0.45). The availability of personal protective equipment (PPE) increased from the first to the second wave along with an increased perception of protection in the professional environment. The source of infection shifted from infections via medical staff during the first wave to patients and household exposure during the second wave. Regular medical practice was resumed by clinicians and general practitioners in the second wave. Nevertheless, a proportionally lower infection rate was observed compared with the German population as a whole. CONCLUSION: The data reflect a unique long-term survey of ORLs during the pandemic. Differences in the source of infection were seen between the first and second wave, confirming the need for appropriate PPE for medical professionals working in high-risk environments. Further strategies to reduce the risk of infection include consistent testing for SARS-CoV‑2 in healthcare professionals, patients, and the general public as well as vaccination of high-risk medical groups. PMID:34086058 | DOI:10.1007/s00106-021-01075-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosing Laryngopharyngeal Reflux: A Comparison between 24-hour pH-Impedance Testing and Pharyngeal Probe (Restech) Testing, with Introduction of the Sataloff Score

xlomafota13 shared this article with you from Inoreader Diagnosing Laryngopharyngeal Reflux: A Comparison between 24-hour pH-Impedance Testing and Pharyngeal Probe (Restech) Testing, with Introduction of the Sataloff Score Via Journal of Voice The purpose of this study was to compare the diagnostic utility of pH monitoring using 24-hour esophageal pH-Impedance (HEMII-pH) testing versus pharyngeal pH (Restech) testing (Respiratory Technology Corporation, Houston, Texas) for diagnosing laryngopharyngeal reflux (LPR). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.