Endoscopic Inferior Meatal Antrostomy for Antrochoanal Polyps: A Long-Term Follow-Up

xlomafota13 shared this article with you from Inoreader Endoscopic Inferior Meatal Antrostomy for Antrochoanal Polyps: A Long-Term Follow-Up Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Background: Endoscopic middle meatal antrostomy (EMMA) is considered the standard approach for surgical management of antrochoanal polyps (ACPs). Recently, an endoscopic inferior meatal antrostomy (EIMA) approach for clearing lesions in the maxillary sinus was described. In this study, we compared the long-term outcome of patients with ACP following surgical treatment using one of these 2 approaches (EIMA or EMMA). Methods: The medical charts of all patients treate d for ACPs in our institution between January 1, 2009, and July 1, 2020, were reviewed retrospectively. Patients were invited to complete a long-term follow-up assessment. Results: Thirty-eight patients were included in the study: EIMA was the only procedure performed in 25 patients (66%) and EMMA was the only procedure performed in 7 patients (18%). Both procedures were performed in 6 patients (16%): 2 patients (5%) underwent simultaneous EMMA and EIMA for better access and visualization and 4 patients (10.5%) underwent surgical revision consisting of EIMA secondary to failed EMMA at other institutions. Median follow-up was 44 months (range, 6 months–11 years). No evidence of recurrent ACPs, recirculation, synechiae, nasolacrimal duct injury, or bleeding was observed in any of our patients. Small nonobstructing cysts were observed in 2 patients (8%) following EIMA. Conclusions: EIMA prevents violation of the ostiomeatal complex. It provides access to t he anteroinferior aspect of the maxillary sinus and should be considered as an alternative to EMMA in patients with ACPs. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Linguistic Relevance and Applicability of the Spanish VHI-10 in a Population Outside Spain

xlomafota13 shared this article with you from Inoreader Linguistic Relevance and Applicability of the Spanish VHI-10 in a Population Outside Spain Via Folia Phoniatrica et Logopaedica Introduction: The Voice Handicap Index 10 (VHI-10) has been translated to many languages. There are substantial differences between the translation methods. Translated questionnaires without appropriate linguistic validation may not capture cultural differences or be understood by the participants in the manner intended by the original developers. This also holds true between dialects within a language. There are two versions of the VHI-10 in Spanish, both translated in Spain. Considering the cultural and dialectical differences am ongst Spanish speakers, it is hypothesized that these translations may not be applicable globally. The purpose of this study was to determine the linguistic relevance and applicability of the currently available versions of the VHI-10 in Spanish amongst Spanish speakers outside of Spain. Methods: This study used mixed methods qualitative and quantitative procedures consisting of semi-structured interviews and quantitative analysis of data. Sixty-nine participants met the inclusion criteria. Participants with and without a diagnosis of dysphonia were included. Demographic data collected included age, gender, cultural/dialectical background, level of education, and number of years residing in Southern California. Participants were provided the currently available translated versions of the VHI-10 in Spanish (V1 and V2). After reading both questionnaires, a semi-structured interview was conducted by a bilingual SLP. Semi-structured interview responses were coded to determine patterns of words marked as problematic/not understood or non-representative of the Spanish dialect spoken by the participants. Results: The majority of participants marked at least one word in both versions as problematic/not understood or non-representative of the Spanish dialect spoken (60/69, 87.0% for V1 and 63/69, 92.3%, for V2). The two words most frequently marked as problematic/not understood or non-representative of the Spanish dialect spoken were "hándicap" (marked by 51/69 participants, 73.9%) and "minusvalía" (marked by 52/69 participants, 75.4%). Conclusions: Data analysis demonstrates that the majority of participants marked words as not understood/non-representative of their dialect on either V1 or V2. One question not understood or not answered could have an impact on how we interpret this PRO measure in clinical practice. Use of currently available Spanish translations of the VHI-10 may yield unreliable results when used amongst Spanish speakers outside Spain due to dialectal and cultural differences. Future work will include validation of a voice patient-reported outcome (PRO) measure that is culturally and linguistically appropriate for Spanish speakers outside Spain. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior cerebral artery trifurcation with infraoptic origin and contralateral A1 segment absence

xlomafota13 shared this article with you from Inoreader Anterior cerebral artery trifurcation with infraoptic origin and contralateral A1 segment absence Via radiol anat Surg Radiol Anat. 2021 Nov 6. doi: 10.1007/s00276-021-02855-x. Online ahead of print. ABSTRACT PURPOSE: To describe an uncommon anatomical variant of the anterior cerebral artery and the imaging findings. METHODS: A 2-month-old infant with known history of atrial and ventricular septal defects was admitted to our institution for evaluation and management of growth failure. Given the clinical presentation and medical history, magnetic resonance imaging (MRI) of the brai n and MR angiography (MRA) were performed to exclude congenital hypopituitarism and any vascular abnormality. RESULTS: Time of flight MRA revealed trifurcation of the anterior cerebral artery with one of the vessels arising from the ophthalmic segment of the right internal carotid artery; thus, the A1 segment of the left anterior cerebral artery (ACA) was absent, and the right posterior cerebral artery (PCA) had a fetal origin. CONCLUSION: Anatomical variants of the cerebral circulation are asymptomatic and found incidentally. Knowledge of these variants and careful examination of CT/MRI angiograms are important for diagnosis and treatment planning. PMID:34741640 | DOI:10.1007/s00276-021-02855-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear implantation outcomes in patients with otosclerosis: a single-centre study

xlomafota13 shared this article with you from Inoreader Cochlear implantation outcomes in patients with otosclerosis: a single-centre study 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 Nov 6. doi: 10.1007/s00405-021-07157-x. Online ahead of print. ABSTRACT PURPOSE: To analyse surgical and auditory outcomes after cochlear implantation in otosclerosis and to compare them to the outcomes in patients with post-lingual hearing loss with different aetiology. METHODS: Medical records of 17 subjects (22 ears) diagnosed with otosclerosis were compared to 21 controls (25 ears) matched by age, sex, duration of hearing loss and experience with cochlear implant in years. Demographic characteristics, surgical complications, facial nerve stimulation, number and reason for deactivated electrodes and auditory outcome (monosyllabic word score) were analysed. The auditory outcome was further evaluated according to the anatomical localisation of the otosclerotic lesions (grades) and compared between patients with active and deactivated electrodes. RESULTS: Otosclerotic patients showed similar surgical outcome in comparison to the controls. A low frequency (13.6%) of facial nerve stimulation was observed in otosclerosis. A significantly higher (p = 0.014) number of deactivated electrodes (4.3%) in subjects with otosclerosis in comparison to non-otosclerosis patients (1.6%) was found. A trend of less speech discrimination of monosyllabic words (65%) in otosclerosis than in non-otosclerosis patients (80%) (p = 0.109) and no difference in the postoperative auditory assessment with regard to the disease grade and electrode disabling was found. CONCLUSIONS: Cochlear implantation by otosclerosis provides excellent auditory outcome with a low rate of surgical complications. Alteration in fitting strategy as electrodes disabling is frequently needed to overcome complications as incomplete insertion, facial nerve stimulation and poor sound quality. PMID:34741651 | DOI:10.1007/s00405-021-07157-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison between abdominal based and inner thigh based free flaps in breast reconstruction: A single surgeon's experience

xlomafota13 shared this article with you from Inoreader A comparison between abdominal based and inner thigh based free flaps in breast reconstruction: A single surgeon's experience Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 22:S1748-6815(21)00487-3. doi: 10.1016/j.bjps.2021.09.048. Online ahead of print. NO ABSTRACT PMID:34742658 | DOI:10.1016/j.bjps.2021.09.048 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute appendicitis secondary to desmoplastic melanoma metastasis in immune-checkpoint inhibitors era

xlomafota13 shared this article with you from Inoreader Acute appendicitis secondary to desmoplastic melanoma metastasis in immune-checkpoint inhibitors era Via Melanoma Research - Current Issue No abstract available View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors in pediatric melanoma: a retrospective study of 39 cases

xlomafota13 shared this article with you from Inoreader Risk factors in pediatric melanoma: a retrospective study of 39 cases Via Melanoma Research - Current Issue Pediatric melanoma is a rare form of the tumor whose epidemiology is widely increasing thanks to the improvement of dermoscopic and anatomopathologic diagnostic techniques. Although it is a tumor of considerable interest in adults, little has been described about the pediatric field. The objective of our study was then to identify the possible risk factors for the development of melanoma in the pediatric population. We performed a retrospective study conducted in the Melanoma and Skin Cancer Unit and Unit of Dermatology (Livorno, Italy). We analyzed a population of 38 children under 21 years with a diagnosis of melanoma. This population was compared with a control population of 114 children followed up in our dermatologic clinic. From our combined univariate-multivariate statistics analysis, the number of nevi [regression coefficient (RC) of 1.04 and odds ratio (OR) of 2.8 confidence interval (Cl, 1.2–6.6)], and family history of melanoma [RC of 1.99 and OR of 7.3 (Cl, 2.3–22.7)] emerged as possible risk factors for the development of melanoma. The identification of these elements would allow the physician to carry out a more targeted preliminary assessment of the patient, potentially decisive in cases of diagnostic doubt of the lesion. Our study also lays the foundations for identifying those children who, despite not having received a diagnosis of melanoma on histologic examination, should be considered as patients susceptible to a focused follow-up, because of the presence of the risk factors that emerged from our research. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Regression of nevi, vitiligo-like depigmentation and halo phenomenon may indicate response to immunotherapy and targeted therapy in melanoma

xlomafota13 shared this article with you from Inoreader Regression of nevi, vitiligo-like depigmentation and halo phenomenon may indicate response to immunotherapy and targeted therapy in melanoma Via Melanoma Research - Current Issue We present two patients with stage IV melanoma, the first with BRAF wild-type melanoma with multiple visceral metastases treated with immunotherapy (pembrolizumab) and the second with BRAFV600E melanoma with subcutaneous and lymph nodes metastasis treated with BRAF and MEK-inhibitors (dabrafenib/trametinib). Already after the second cycle of immunotherapy, the first patient developed a diffuse regression of nevi, perceptible only with the use of dermoscopy and 3 months later a clinically evident poliosis of the eyebrows. The second patient, treated with dabrafenib/trametinib, developed small areas of leukoderma on his chest and white halos around nevi with a dermoscopic globular or structureless pattern. Both observations are suggestive for an immune reaction against melanocytic cells, which is further supported by the complete response to systemic therapy in both patients. It has been demonstrated that the development of vitiligo-like depigmentation during immunotherapy is associated with a better prognosis; in our patient, the phenomenon of poliosis appeared much later than the dermoscopic presence of regression among his nevi, suggesting that the latter may be an early sign (along with vitiligo-like phenomena) of good response to immunotherapy. On the other hand, the development of halo nevi and leukoderma during treatment with BRAF/MEK-inhibitors, suggests that not only immunotherapy but also targeted therapy may induce an immunologic response against melanoma and nevi, again indicative of a favorable prognosis. More data are needed to confirm these findings; however, they indicate that d ermatologists should be involved in the follow-up of patients with melanoma, both in studies and clinical practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prospective study of clinical characteristics of melanoma patients with retinopathy caused by a high-dose interferon α-2b

xlomafota13 shared this article with you from Inoreader Prospective study of clinical characteristics of melanoma patients with retinopathy caused by a high-dose interferon α-2b Via Melanoma Research - Current Issue Retinopathy is a rare side effect of interferon α-2b treatment. The goal of this study was to prospectively investigate the clinical characteristics of Chinese patients with melanomas who developed retinopathy following high doses of interferon α-2b (HD-IFN) therapy. The study included 56 melanoma stage I–III patients that were treated with HD-IFN. Fourty-three patients developed HD-IFN-induced retinopathies. Forty-three melanoma patients (76%) developed retinopathy after being treated with HD-IFN. Among these patients, 49% had cotton–wool spots, 19% had retinal hemorrhage, and 30% had retinal hemorrhage. The me dian time of occurrence of retinopathy was 4 weeks after treatment, and the median time of duration was 4 weeks. No patient showed other symptoms except one who had blurred vision. A comparison of clinical characteristics (age, gender, primary site, stage, and ulceration) and laboratory examinations (white blood cell and platelet counts, hemoglobin, serum lactate dehydrogenase, alanine transaminase, aspartate aminotransferase, triiodothyronine, thyroxine, thyroid-stimulating hormone, and lipid) between the HD-IFN-induced retinopathy patients and nonretinopathy patients did not show any significant differences (P > 0.05). Although all patients that developed retinopathy had diabetes or hypertension, an equal percentage of patients were without retinopathy had diabetes or hypertension. HD-IFN therapy in patients with melanomas may induce mild retinopathy. Our results; however, do not necessarily suggest to discontinue the HD-IFN treatment because retinopathy is a reversible disorder. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retrospective analysis of adjuvant therapy using dabrafenib plus trametinib in Japanese patients with advanced melanoma: analysis of 36 cases

xlomafota13 shared this article with you from Inoreader Retrospective analysis of adjuvant therapy using dabrafenib plus trametinib in Japanese patients with advanced melanoma: analysis of 36 cases Via Melanoma Research - Current Issue Patients with resected stage IIIB, IIIC and IIID melanomas have a high risk of recurrence. Therefore, an appropriate protocol for stage III melanoma is needed. Since adjuvant dabrafenib plus trametinib (D+T) combined therapy and anti-PD1 antibody (Ab) therapy reduce the risk of recurrence in patients with resected stage III BRAF-mutated melanoma, selecting the adjuvant therapy for BRAF-mutated melanoma is controversial. The efficacy and safety profiles of D+T combined therapy in the adjuvant setting were retrospectively analyzed in 36 Japanese. BRAF-mutated advanced melanoma patients. The relapse-free rate (RFR) at 1 2 months was 82.1% (95% confidential interval (CI), 63.9–92.6%). In the 21 patients who completed the protocol, the RFR at 12 months was 85.7% (95% CI, 64.5–95.9%). In the seven patients whose protocol was interrupted by adverse events, the RFR was 71.4% (95% CI, 35.2–92.4%). The incidence rate of any AEs for all patients was 69.7% (95% CI, 52.5–82.8%), including 13 cases of pyrexia, five cases of skin rash and four cases of liver dysfunction. The present study suggested that D+T therapy in the adjuvant setting is a useful and very tolerable protocol for BRAF-mutated melanoma in the Japanese population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic and prognostic value of Beclin 1 expression in melanoma: a meta-analysis

xlomafota13 shared this article with you from Inoreader Diagnostic and prognostic value of Beclin 1 expression in melanoma: a meta-analysis Via Melanoma Research - Current Issue Autophagy plays a complicated role in the occurrence and development of cancer. Beclin 1 is a significant autophagy-related protein that plays an essential role in tumorigenesis, but its expression is controversial in melanoma. In this meta-analysis, we searched seven studies involving 638 melanoma patients. PubMed, Web of Science, Google Scholar, Elsevier, and Chinese National Knowledge Infrastructure were used for literature retrieval. The I2 index was used to assess heterogeneity. The expression of Beclin 1 in the primary melanoma group was significantly lower than the non-tumor group tissues (P 0.05). Different expres sion intensities of Beclin 1 did not affect the overall survival and disease-free survival of melanoma patients. This study showed a trend of low expression of Beclin 1 in melanoma; patients with low expression of Beclin 1 were prone to the possibility of distant metastasis. The inconsistent profile of Beclin 1 expression in the prognosis of melanoma patients warrants further clinical investigation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.