The effects of traditional Chinese medicine sensory stimulation combined with transcranial direct current stimulation on deglutition and related complications in stroke patients with dysphagia: a randomized trial

xlomafota13 shared this article with you from Inoreader The effects of traditional Chinese medicine sensory stimulation combined with transcranial direct current stimulation on deglutition and related complications in stroke patients with dysphagia: a randomized trial Via Traditional dysphagia therapy Ann Palliat Med. 2021 Jun;10(6):6597-6605. doi: 10.21037/apm-21-1055. Epub 2021 Jun 11. ABSTRACT BACKGROUND: Stroke is a serious manifestation of a variety of cerebrovascular diseases and can cause significant morbidity and mortality. This study explored the effects of traditional Chinese medicine (TCM) sensory stimulation combined with transcranial direct current stimulation (tDCS) on swallowing function and related complications in stroke patients with dysphagia. METHODS: A total of 60 stroke patients with deglutition dysfunction admitted to our hospital from August 2019 to January 2021 were selected as research subjects. The patients were randomized into 3 different treatment groups, namely, the TCM group, the tDCS group, and the TCM combined with tDCS group (the combined group). Water swallowing tests (WSTs) were conducted to compare the swallowing function before and after treatment. Video fluoroscopic swallowing studies (VFSS) wer e conducted to analyze the scores of the oral phase, pharyngeal phase, and degree of aspiration. Brain activation and brain volume were examined using functional magnetic resonance imaging (fMRI). RESULTS: The WST and VFSS scores in the combined treatment group were significantly higher than that observed in the other two groups (P<0.05). The fMRI demonstrated that the brain activation volume in the combined treatment group was also greater than that in the other two groups (P<0.05). CONCLUSIONS: TCM combined with tDCS significantly improved deglutition and complications in stroke patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-TRC-12001972. PMID:34154344 | DOI:10.21037/apm-21-1055 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease

xlomafota13 shared this article with you from Inoreader Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease Via Traditional dysphagia therapy Ann Palliat Med. 2021 Jun;10(6):6669-6677. doi: 10.21037/apm-21-1154. Epub 2021 Jun 10. ABSTRACT BACKGROUND: Drug treatment is the main form of management for patient with gastroesophageal reflux disease (GERD). However, long-term medication can increase the psychological burden of patients. Furthermore, in some patients, standardized drug treatments do not effectively control their condition. Traditional anti-reflux surgery has a low degree of acceptance due to its trauma and many associated complications. In contrast, endoscopic minimally invasive surgery is preferable. This study explored the effects of endoscopic treatment of cardia diseases on GERD. METHODS: A retrospective analysis was conducted on 106 patients with cardia disease (including cardia polyp, precancerous lesion, and early cardia cancer) and reflux esophagitis (RE). Patients underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), and th e rates of complete resection, postoperative complications, and postoperative reflux were assessed. RESULTS: Among the 106 lesions, 104 lesions were completely resected, and 2 early cancers were cured. No delayed hemorrhage was detected in any of the cases. The GERD-HRQL (gastroesophageal reflux disease-health related quality of life) and GERD-Q (gastroesophageal reflux disease-questionnaires) scores decreased significantly at 3 and 6 months post-operation (P<0.001). Furthermore, the RE grade was significantly different before and after the operation (P<0.001). The basic cure rate at 3 and 6 months after the operation was 83.96% and 84.91%, respectively, and the significant remission rate was 10.38% and 8.49%, respectively. CONCLUSIONS: Endoscopic treatment of cardia conditions is advantageous due to low levels of trauma, higher complete resection rates, and fewer complications. Moreover, the fibrous scar generated after endoscopic treatment forms an anti-reflux ba rrier, which can alleviate or even cure RE to a certain extent. This may represent a promising method for the clinical treatment of GERD. PMID:34154339 | DOI:10.21037/apm-21-1154 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bone Changes in Chronic Rhinosinusitis: Pathological or Physiological?

xlomafota13 shared this article with you from Inoreader Bone Changes in Chronic Rhinosinusitis: Pathological or Physiological? Via Otolaryngology Indian Abstract Bone remodelling is a normal physiological process which occurs in all bones. Hence bone changes should also be detected in undiseased or minimally diseased ethmoids as well as in chronic rhinosinusitis (CRS) patients. To test this hypothesis, we compared ethmoid bone histology between two groups of patients; a study group of CRS patients and a group of patients whose radiological, endoscopic and symptom scores were significantly less when compared to the CRS group. The study group had 75 patients who underwent functional endoscopic sinus surgery for CRS. The control group included 16 patients who had significantly different endoscopic and radiological scores from the study group. On histopathology, the bone harvested from the ethmoid sinuses were grouped as no remodelling activity (Score 1), mild activity (Score 2) and marked activity (Score 3). Thirty-six percent of patients in the study group and 37.5% of patients in the control group had Score 2 and 3 bone ch anges and the difference was not statistically significant (χ2 = 1.824, p = 0.402). Correlation of bone changes in CRS done with parameters like Lund–Mackay radiological, surgical and symptom scores and Lund–Kennedy endoscopic scores showed no statistical significance. Similar bone changes were detected in CRS patients and the control group. The bone changes seen in histopathology in CRS patients could partly be due to the normal physiological remodelling occurring in all bones. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Differences in visual information processing style between Idiopathic Generalized Epilepsy with and without photosensitivity

xlomafota13 shared this article with you from Inoreader Differences in visual information processing style between Idiopathic Generalized Epilepsy with and without photosensitivity Via cortical auditory Epilepsy Behav. 2021 Jul 9;122:108183. doi: 10.1016/j.yebeh.2021.108183. Online ahead of print. ABSTRACT PURPOSE: Recently, altered visual cortical processes i.e., lack of habituation to visual evoked potentials (VEP), has been highlighted in both photosensitive epilepsy and in a specific i.e., analytic mode of processing visual inputs. In this study we aimed at evaluating the relationship between photosensitivity (PS) and analytic style of processing visual information, in a sample of 30 patients with Idiopathic Generalized Epilepsy (IGE) and matched healthy controls. METHODS: At our Epilepsy unit of the Sapienza University of Rome, we consecutively enrolled 15 patients with IGE with PSand matched them with 15 patients with IGE without PS and 15 Healthy Volunteers. All patients underwent EEG recording in basal conditions during hyperventilation (3 Min), and intermittent light stimulation. The most effective frequencies comprised from 1 2 to 16 Hz. The instruments used to gather psychological cognitive behavioral data, consisted of participation in two tests: the Sternberg-Wagner Self-Assessment Inventory and the Mariani Learning Style Questionnaire. RESULTS: Compared to controls, both IGE groups show significantly higher scores for the analytic style (One-way ANOVA, F(2,44) = 110.3, p < 0.0001). Epilepsy groups thereby showed very distinctive cognitive styles as measured with the Sternberg test. In the visual style, scores of the photosensitive Individuals with IGE were significantly higher than the non-photosensitive individuals with IGE (p < 0.0001, Tukey's post hoc test). CONCLUSIONS: An association between analytic style of processing visual information and PS in IGE has been shown. The common neurophysiological features between these two factors, suggest the possibility to evaluate this cognitive behavior as a potential target for nonpharmacological therapeutic strategies in photo sensitive epilepsy. PMID:34252831 | DOI:10.1016/j.yebeh.2021.108183 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel mechanisms of microbial crosstalk with skin innate immunity

xlomafota13 shared this article with you from Inoreader Novel mechanisms of microbial crosstalk with skin innate immunity Via Experimental Dermatology Abstract Skin is an organ with a dynamic ecosystem that harbors pathogenic and commensal microbes, which constantly communicate amongst each other and with the host immune system. Evolutionarily, skin and its microbiota have evolved to remain in homeostasis. However, frequently this homeostatic relationship is disturbed by a variety of factors such as environmental stress, diet, genetic mutations, and the microbiome itself. Commensal microbes also play a major role in the maintenance of microbial homeostasis. In addition to their ability to limit pathogens, many skin commensals such as Staphylococcus epidermidis and Cutibacterium acnes have recently been implicated in disease pathogenesis either by directly modulating the host immune components or by supporting the expansion of other pathogenic microbes. Likewise, opportunistic skin pathogens such as Staphylococcus aureus and Staphylococcus lugdunensis are able to breach the skin and cause disease. Though much h as been established about the microbiota's function in skin immunity, we are in a time where newer mechanistic insights rapidly redefine our understanding of the host/microbial interface in the skin. In this review, we provide a concise summary of recent advances in our understanding of the interplay between host defense strategies and the skin microbiota. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vesicular hand eczema transcriptome analysis provides insights into its pathophysiology

xlomafota13 shared this article with you from Inoreader Vesicular hand eczema transcriptome analysis provides insights into its pathophysiology Via Experimental Dermatology ABSTRACT Background Hand eczema is a common inflammatory skin condition of the hands whose pathogenesis is largely unknown. More insight and knowledge of the disease on a more fundamental level might lead to a better understanding of the biological processes involved, which could provide possible new treatment strategies. We aimed to profile the transcriptome of lesional palmar epidermal skin of patients suffering from vesicular hand eczema using RNA-sequencing. Methods RNA-sequencing was performed to identify differentially expressed genes in lesional versus non-lesional palmar epidermal skin from a group of patients with vesicular hand eczema compared to healthy controls. Comprehensive real-time quantitative PCR analyses and immunohistochemistry was used for validation of candidate genes and protein profiles for vesicular hand eczema. Results Overall, a significant and high expression of genes/proteins involved in keratinocyte host defense and inflammation was found in lesional skin. Furthermore, we detected several molecules, both up- or downregulated in lesional skin, which are involved in epidermal differentiation. Immune signaling genes were found to be upregulated in lesional skin, albeit with relatively low expression levels. Non-lesional patient skin showed no significant differences compared to healthy control skin. Conclusion Lesional vesicular hand eczema skin shows a distinct expression profile compared to non-lesional skin and healthy control skin. Notably, the overall results indicate a large overlap between vesicular hand eczema and earlier reported atopic dermatitis lesional transcriptome profiles, which suggests that treatments for atopic dermatitis could also be effective in (vesicular) hand eczema. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Differing Progression to Posterior Glottic Stenosis in Autoimmune and Idiopathic Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Differing Progression to Posterior Glottic Stenosis in Autoimmune and Idiopathic Subglottic Stenosis Via The Laryngoscope Objectives/Hypothesis We sought to characterize rates of progression to posterior glottic stenosis (PGS) from autoimmune or idiopathic subglottic stenosis. Study Design This was a retrospective review. Methods Patients from a tertiary-care laryngology practice over a 10-year period with autoimmune or idiopathic subglottic stenosis (SGS) were included. Patients with a history of prolonged intubation or other causes of iatrogenic stenosis were excluded. PGS was confirmed on videostrobolaryngoscopy recordings by a fellowship-trained laryngologist. PGS type (1–4) was also recorded. Demographic information was recorded, and if applicable, autoimmune disease type was specified. Time until PGS was recorded along with the number of interventions. Chi-squared analysis was used to compare PGS in autoimmune and idiopathic SGS. Results A total of 77 patients were identified with autoimmune (32 patients) or idiopathic (45 patients) subglottic stenosis. Autoimmune pathologies included systemic lupus erythematosus, granulomatosis with polyangiitis (GPA), rheumatoid arthritis, relapsing polychondritis, and sarcoidosis, with GPA the most common (14/32). Patients with autoimmune SGS had a higher rate of PGS (10 of 32) compared to idiopathic subglottic stenosis (1 of 45) for an odds ratio of 20 (95% CI: 2.4–166.4, P = .006). Patients with idiopathic SGS were more likely to be female (all 45 compared to 29/32 autoimmune, P = .07) and older (mean 53 (range 29–75) compared to 46 (20–82), P = .02). Conclusions In this large patient cohort, autoimmune SGS patients were found to have a higher likelihood of developing PGS compared to their idiopathic counterparts, suggesting that counseling for this progression may be warranted. Level of Evidence 4 Laryngoscope, 131:1816–1820, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Tracheal Lobular Capillary Hemangioma: A Case Report and Review of the Literature

xlomafota13 shared this article with you from Inoreader Pediatric Tracheal Lobular Capillary Hemangioma: A Case Report and Review of the Literature Via The Laryngoscope Chronic cough is a common complaint in the pediatric population and can have many different etiologies. We present a rare case of a tracheal lobular capillary hemangioma (LCH), also known as pyogenic granuloma, causing chronic cough in a child. In this case, the tracheal LCH was managed successfully with laser ablation. A review of the literature reveals only 2 other reported pediatric cases of tracheal LCH. Laryngoscope, 131:1729–1731, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus

xlomafota13 shared this article with you from Inoreader Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus Via The Laryngoscope Objective/Hypothesis To investigate the risk of nasal septal abscess (NSA) in patients with type 2 diabetes mellitus (T2DM) after septoplasty. Study Design Retrospective cohort study through Taiwan National Health Insurance database. Methods The Taiwan National Health Insurance Research Database was used to conduct this retrospective cohort study. A total of 382 patients with T2DM (DM group) diagnosed between 2000 and 2010 and 382 matched patients without a DM diagnosis (non-DM group) were enrolled. Patients were followed up until death or December 31, 2013. NSA incidence was the main outcome. Results After septoplasty, the cumulative incidence of NSA in the DM group was significantly higher than that in the non-DM group (P < .001). Cox proportional hazards regression indicated a significant association between T2DM and higher NSA incidence (adjusted hazard ratio, 2.62; 95% CI, 1.44–3.61; P < .001). However, subgroup analysis and sensitivity testing demonstrated that the effect of T2DM on NSA risk was stable. In addition, the subgroup with a Diabetes Complications Severity Index (DCSI) of ≥1 had higher NSA risk than that with DCSI = 0 (adjusted hazard ratio, 3.58; 95% CI, 2.10–6.09; P < .001). The treatment type for NSA did not differ between the groups. Conclusions T2DM is an independent risk factor for NSA in patients undergoing nasal septoplasty, and the NSA risk is greater among patients with high DM severity. Level of Evidence IV Laryngoscope, 131:E2420–E2425, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tertiary Lymphoid Organs: A Primer for Otolaryngologists

xlomafota13 shared this article with you from Inoreader Tertiary Lymphoid Organs: A Primer for Otolaryngologists Via The Laryngoscope Objectives/Hypothesis Lymphoid neogenesis or the development of organised, de novo lymphoid structures has been described increasingly in chronically inflamed tissues. The presence of tertiary lymphoid organs (TLOs) has already been demonstrated to result in significant consequences for disease pathology, severity, prognosis and patient outcomes. Whilst the wider medical community has embraced TLOs as important markers of disease and potential therapeutic targets, the otolaryngology field has only begun turning to these entities in an academic capacity. This review aims to outline the role of tertiary lymphoid organs in disease and summarise key early findings in the ENT field. We also an overview of TLOs, their developmental process and clinicopathological implications. Study design Literature review. Methods A literature search for all relevant peer-reviewed publications pertaining to TLOs and ENT diseases. Search was conducted using PubMed, Embase and CINAHL databases. Results A total of 24 studies were identified relevant to the topic. The majority of TLO research in ENT fell into the areas of oral squamous cell carcinoma (SCC) and chronic rhinosinusitis (CRS). Conclusions Early research into both oral SCC and CRS suggests that TLOs have significant roles within ear, nose and throat (ENT) diseases. At this point in time, however, TLOs remain somewhat a mystery amongst otolaryngologists. As information in this field increases, we may develop a better understanding of how lymphoid neogenesis can influence disease outcomes amongst our patients and, ultimately, how they can be utilised in an immunotherapeutic manner. Laryngoscope, 131:1697–1703, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long‐term Follow‐up After Radiation Therapy for Laryngeal Amyloidosis

xlomafota13 shared this article with you from Inoreader Long‐term Follow‐up After Radiation Therapy for Laryngeal Amyloidosis Via The Laryngoscope Objectives Laryngeal amyloidosis (LA) is a rare disease characterized by extracellular protein deposition within the larynx. Treatment is difficult due to the frequently submucosal and multifocal nature of disease. The mainstay of treatment is surgical resection; however, recurrence rates are high. Recently, use of radiotherapy (RT), either alone or postoperatively, for LA has been adapted from the management of extramedullary plasmacytoma and has been shown to provide local disease control. Here, we describe the experience with adjuvant RT for LA at our center. Study Design Retrospective case series. Methods Retrospective study of patients with amyloidosis of the larynx, with or without other disease sites, seen at a tertiary academic center between 2011 and 2019. Outcomes included disease characteristics, recurrence rates, treatment modalities, and pre- and posttreatment voice handicap index (VHI)-10. Results Ten patients met eligibility criteria. Mean follow-up time for all patients was 62.0 ± 41.0 months; mean follow-up time after last treatment was 51 ± 55 months. All but one patient underwent surgical resection of disease. Seven patients underwent subsequent RT. Of these seven, six underwent RT at our institution; five received a dose of 45 Gray (Gy); and one received a dose of 20 Gy. All seven completed RT without toxicity-related interruption. Patients undergoing RT underwent 2.1 ± 1.3 surgical procedures prior to RT; no patients required surgery after RT. Mean pretreatment VHI-10 was 22.9 ± 8.1; mean posttreatment VHI-10 was 12.9 ± 13.3. Conclusion RT after surgery for LA can provide good local control without unacceptable toxicity and may decrease the need for further surgery. Level of Evidence 4 Laryngoscope, 131:1810–1815, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.