Auswirkungen der COVID-19-Pandemie auf Konsultationen & Diagnosen in den HNO-Praxen in Deutschland

xlomafota13 shared this article with you from Inoreader Auswirkungen der COVID-19-Pandemie auf Konsultationen & Diagnosen in den HNO-Praxen in Deutschland Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1510-9686 Hintergrund Während der ersten Monate der COVID-19-Pandemie kam es zu einer deutlichen Reduktion in der Frequentierung der Institutionen im Gesundheitswesen. Dieser Umstand beeinflusste die rechtzeitige Diagnosestellung und subsequente Therapieeinleitung in nahezu sämtlichen Fachgebieten. Ziel der vorliegenden Untersuchung ist die Evaluation eines hypothetisch veränderten Gesundheitsbewusstseins in Bezug auf die ambulante Konsultation von HNO-Ärzten in Deutschland. Material und Methoden Diese Studie nutzte die anonymisierten Daten aus 146 HNO-Praxen in Deutschland und umfasste 162724 Patienten im 2. Quartal 2019, 158077 im 3. Quartal 2019, 128342 im 2. Quartal 2020 und 149153 im 3. Quartal 2020. Das erste Outcome war der Unterschied in der Anzahl der Patienten mit mindestens einem Besuch in diesen Praxen zwischen dem zweiten und dritten Quartal 2019 und dem zweiten und dritten Quartal 2020. Das zweite Outcome war die Anzahl der Patienten mit neuen Diagnosen pro Praxis, definiert als Diagnosen, die zuvor nicht in der Datenbank für einen bestimmten Patienten dokumentiert waren. Ergebnisse Die Anzahl der Patienten pro Praxis war im 2. Quartal 2020 im Vergleich zum 2. Quartal 2019 signifikant geringer (879 versus 1108; p<0,001). Beim Vergleich des 3. Quartals 2020 mit dem 3. Quartal 2019 zeigten sich keine signifikanten Unterschiede (1022 versus 1083; p=0,261). Diagnosen von Otitis media (-43%), akuten Infektionen der oberen Atemwege (-42%), chronischen Erkrankungen der oberen Atemwege (-21%) und Hörsturz (-20%) nahmen im 2. Quartal 2020 verglichen zum 2. Quartal 2019 signifikant ab. Im 3. Quartal 2020 gab es im Vergleich zum 3. Quartal 2019 darüber hinaus einen signifikanten Rückgang der Patientenzahlen für akute Infektionen der oberen Atemwege (-26%) und Otitis media (-25%). Schlussfolgerungen Die vorliegenden Ergebnisse sind, neben einer Vermeidung von Arztkontakten vonseiten der PatientInnen, sowohl auf die reduzierte Terminvergabe durch die HNO-Praxen als auch auf die konsequente Einhaltung und Umsetzung der Abstands- bzw. Hygieneregeln im Sinne der Verwendung von Atemschutzmasken (FFP2/KN95) zurückzuführen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstra ct  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation: A case report

xlomafota13 shared this article with you from Inoreader Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation: A case report Via Traditional dysphagia therapy Medicine (Baltimore). 2021 Jun 4;100(22):e26097. doi: 10.1097/MD.0000000000026097. ABSTRACT RATIONALE: Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal disease characterized by calcification of anterolateral ligaments of the spine and the rest of the body. DISH combined with disc herniation induces complex symptoms and is more difficult to treat. Here, we describe a complicated case of a patient diagnosed with DISH as well as cervical disc herniation that was successfully treated using anterior cervical surgery. PATIENTS CONCERN: A 69-year-old Asian male experienced dysphagia and weakness in his left limbs. He also experienced a stiff neck and right slant over a 6-month period. DIAGNOSIS: An X-ray revealed calcification of the C4-7 vertebral front edge and a narrowed intervertebral space between C5/6. Coronal and sagittal computerized tomography (CT) and magnetic resonance imaging (MRI) both showed compression of the spinal cord at the cervical 5/6. Esophagography revealed that osteophytes in the anterior margin of vertebral body (C4-C7) oppressed the esophagus. INTERVENTIONS: An operation focused on anterior cervical C5/6 disc fusion and anterior vertebral C4-7 osteophyte removal was performed. OUTCOMES: After the operation, X-ray and CT showed that most osteophytes were removed and spinal cord compression was relieved. One day following the operation, both dysphagia and numbness in limbs were improved. Strong recovery was observed at the three-month follow-up exam. LESSONS: This complex DISH combined with disc herniation case is rarely observed in patients. Anterior cervical disc fusion and anterior vertebral osteophyte removal were effective treatment measures. This case study provides insight into treating cases presented with cervical spine complications associated with DISH combined with other ailments. PMID:34087855 | PMC:PMC8183831 | DOI:10.1097/MD.0000000000026097 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thresholds, Firing Rates, and Order of Recruitment of Anterior Temporalis Muscle Single-Motor Units During Experimental Masseter Muscle Pain

xlomafota13 shared this article with you from Inoreader Thresholds, Firing Rates, and Order of Recruitment of Anterior Temporalis Muscle Single-Motor Units During Experimental Masseter Muscle Pain Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):93-104. doi: 10.11607/ofph.2719. ABSTRACT AIMS: To test the hypothesis that, in comparison with control, experimental noxious stimulation of the right masseter muscle would result in significant changes in the firing rates, thresholds, and recruitment orders of single-motor units (SMUs) of the nonpainful, synergistic right anterior temporalis muscle during goal-directed isometric biting task performance. METHODS: Twenty he althy volunteers received an infusion of hypertonic saline (HS; 5% sodium chloride) into the right masseter to produce pain intensity of 40 to 60 on a 100-mm visual analog scale (VAS). Isotonic saline (IS) infusion was a control. Standardized biting tasks were performed with an intraoral force transducer, and intramuscular electromyographic activity was recorded from the right anterior temporalis muscle. Tasks (slow and fast ramp biting tasks, two-step biting task) were performed in 3 blocks: baseline, HS infusion, and IS infusion. Across blocks, SMU thresholds and firing rates were statistically compared, and SMU recruitment sequences were qualitatively compared. Statistical significance was set at P < .05. RESULTS: No significant differences (P > .05) were noted between HS and IS infusion blocks in thresholds or firing rates of anterior temporalis SMUs. Individual SMUs showed increases or decreases in thresholds or firing rates or changes in recruitment sequences mostl y during HS compared to IS infusion. CONCLUSION: The reorganization of SMU activity that has been suggested to occur in both painful and nonpainful agonist jaw muscles may involve not only recruitments and de-recruitments of SMUs, but may also extend to more subtle increases and/or decreases in firing rates, thresholds, and recruitment sequences of individual SMUs in the nonpainful synergistic muscles. PMID:34129654 | DOI:10.11607/ofph.2719 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up

xlomafota13 shared this article with you from Inoreader Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):113-118. doi: 10.11607/ofph.2871. ABSTRACT AIMS: To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up. METHODS: A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to ma nage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. After the treatment cycle, clinical outcomes were assessed based on the following parameters: maximum mouth opening (MO), pain with function (PF), pain at rest (PR), and self-reported chewing efficiency (CE). Data were collected at baseline (T0) and at successive follow-up assessments, after at least 3 months (T1) and 1 year (T2), as per previous publications. Patients who had received treatment at least 10 years prior were then recalled for this study (T3: 10 to 22 years follow-up). Analysis of variance for repeated measures was performed to assess changes over time. RESULTS: Significant improvement in all clinical parameters was achieved at T1 and was maintained for up to 10 years (T3), with P < .01 for each parameter. At T3, treatment effectiveness was perceived as excellent by 56% and as good by 26.5% of subjects, while 10.7% perceived a moderate improvement, and 6.8% referred a slight improvement or did not have any improvement. Only seven individuals required additional treatments after T2. CONCLUSION: These findings suggest that the symptomatic management of TMJ DJD achieved in the short or medium term with a cycle of arthrocentesis and viscosupplementation was effectively maintained in the long term. PMID:34129656 | DOI:10.11607/ofph.2871 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Primary Headache and Bruxism: An Updated Systematic Review

xlomafota13 shared this article with you from Inoreader Association Between Primary Headache and Bruxism: An Updated Systematic Review Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):129-138. doi: 10.11607/ofph.2745. ABSTRACT AIMS: To answer the question: among observational studies, is there any association between primary headaches and bruxism in adults? MATERIALS AND METHODS: A systematic review of observational studies was performed. The search was performed in seven main databases and three gray literature databases. Studies in which samples were composed of adult patients were included. Primary h eadaches were required to be diagnosed by the International Classification of Headache Disorders. Any diagnostic method for bruxism was accepted. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Tool and the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Associations were analyzed by calculating odds ratios (OR) in Review Manager 5.3 software. The evidence certainty was screened by Grading of Recommendations Assessment, Development, and Evaluation criteria. RESULTS: Of the 544 articles reviewed, 5 met the inclusion criteria for qualitative analysis. The included studies evaluated both awake and sleep bruxism, as well as tension-type headaches and migraines as primary headaches. Among two migraine studies, one showed an OR of 1.79 (95% CI: 0.96 to 3.33) and another 1.97 (95% CI: 1.5 to 2.55). On the other hand, among three tension-type headache studies, there was a positive association only with awake bruxism, with an OR of 5.23 (95% CI: 2.57 to 10.65). All included articles had a positive answer for more than 60% of the risk of bias questions. The evidence certainty varied between low and very low. Due to high heterogeneity among the studies, it was impossible to perform a meta-analysis. CONCLUSION: Patients with awake bruxism have from 5 to 17 times more chance of having tension-type headaches. Sleep bruxism did not have any association with tension-type headache, and the association with migraines is controversial. PMID:34129658 | DOI:10.11607/ofph.2745 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Hormonal Contraceptive Use with Headache and Temporomandibular Pain: The OPPERA Study

xlomafota13 shared this article with you from Inoreader Association of Hormonal Contraceptive Use with Headache and Temporomandibular Pain: The OPPERA Study Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):105-112. doi: 10.11607/ofph.2727. ABSTRACT AIMS: To determine the relationship between hormonal contraceptive (HC) use and painful symptoms, particularly those associated with headache and painful temporomandibular disorders (TMD). METHODS: Data from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) prospective cohort study were used. During the 2.5-year median follow-up period, quarterly health update (QHU) questionnaires were completed by 1,475 women aged 18 to 44 years who did not have TMD, menopause, hysterectomy, or hormone replacement therapy use at baseline. QHU questionnaires evaluated HC use, symptoms of headache and TMD, and pain of ≥ 1 day duration in 12 body regions. Participants who developed TMD symptoms were examined to classify clinical TMD. Headache symptoms were classified based on the International Classification of Headache Disorders 3 (ICHD-3). Associations between HC use and pain symptoms were analyzed using generalized estimating equations and Cox models. RESULTS: HC use, endorsed in 33.7% of QHU questionnaires, was significantly associated with concurrent symptoms of TMD (odds ratio [OR]: 1.20, 95% CI: 1.06 to 1.35) and headache (OR: 1.26, 95% CI: 1.11 to 1.43). HC use was also significantly associated with concurrent pain of ≥ 1 day duration in the head (OR: 1.38, 95% CI: 1.16 to 1.63), face (OR: 1.44, 95% CI: 1.13 to 1.83), and legs (OR: 1.22, 95% CI: 1.01 to 1.47), but not elsewhere. Initiation of HC use was associated with increased odds of subsequent TMD symptoms (OR: 1.37, 95% CI: 1.13 to 1.66) and pain of ≥ 1 day in the head (OR: 1.37, 95% CI: 1.01 to 1.85). Discontinuing HC use was associated with lower odds of subsequent headache (OR: 0.82, 95% CI: 0.67 to 0.99). HC use was not significantly associated with subsequent onset of examiner-classified TMD. CONCLUSION: These findings imply that HC influences craniofacial pain, and that this pain diminishes after cessation of HC use. PMID:34129655 | DOI:10.11607/ofph.2727 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Headache Attributed to Temporomandibular Disorders: Axis I and II Findings According to the Diagnostic Criteria for Temporomandibular Disorders

xlomafota13 shared this article with you from Inoreader Headache Attributed to Temporomandibular Disorders: Axis I and II Findings According to the Diagnostic Criteria for Temporomandibular Disorders Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):119-128. doi: 10.11607/ofph.2863. ABSTRACT AIMS: To analyze Axis I and II findings of patients diagnosed as having painful temporomandibular disorder (TMD) with headache attributed to TMD (HAattrTMD) in order to assess whether HAattrTMD is associated with a specific Axis I and II profile suggestive of the central sensitization process. METHODS: This retrospective study included 220 patients with painful TMD divided into th ose with (n = 60) and those without (n = 160) HAattrTMD, and the patients were compared for Axis I and II results according to the Diagnostic Criteria for TMD (DC/TMD). A P value < .05 was considered statistically significant. RESULTS: A total of 27.3% of the patients received a diagnosis of HAattrTMD. Myofascial pain with referral was significantly more common in the HAattrTMD group (P < .001), while local myalgia was significantly more common in the non-HAattrTMD group (P < .001). Characteristic pain intensity was significantly higher in the HAattrTMD group (P = .003), which also showed significantly higher levels of depression (P = .002), nonspecific physical symptoms (P = .004), graded chronic pain (P = .008), and pain catastrophizing (P = .013). Nonspecific physical symptoms were positively associated with HAattrTMD (odds ratio [OR] = 1.098, 95% CI = 1.006 to 1.200, P = .037). Local myalgia was negatively associated with HAattrTMD (OR = .295, 95% CI = 0.098 to 0. 887, P = .030). CONCLUSIONS: Painful TMD patients who report headache in the temple area and are diagnosed as having local myalgia rather than myofascial pain with referral probably do not have HAattrTMD. The diagnosis of HAattrTMD may point to a central sensitization process and possible current/future chronic TMD conditions. PMID:34129657 | DOI:10.11607/ofph.2863 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cell therapy and delivery strategies for spinal cord injury

xlomafota13 shared this article with you from Inoreader Cell therapy and delivery strategies for spinal cord injury Via Cellular and Molecular Biology Histol Histopathol. 2021 Jun 10:18350. doi: 10.14670/HH-18-350. Online ahead of print. ABSTRACT Spinal cord injury (SCI) is a complex neuropathological condition that represents a major challenge for clinicians and scientists due to patient's functional dysfunction and paralysis. Several treatments have been proposed including biological factors, drugs and cells administered in various ways. Stem cells arise as good candidates to treat SCI since they are known to secrete neurotrophic factors, improving neuroregeneration, but also due to their role in modulating the inflammatory process, favoring a pro-regenerative status. There are several types of cells that have been tested to treat SCI in experimental and clinical studies, but we still face many unanswered questions; one of them is the type of cells that can offer the best benefits and, also the ideal dose and administration routes. This review aimed to summarize recent research on cell treatment, focusing on current delivery strategies for SCI therapy and their effects in tissue repair and regeneration. PMID:34109994 | DOI:10.14670/HH-18-350 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution

xlomafota13 shared this article with you from Inoreader A conservative treatment for chronic obstructive sialoadenitis by intraductal instillation of mucolytic, steroids and antibiotic solution 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 10. doi: 10.1007/s00405-021-06930-2. Online ahead of print. ABSTRACT PURPOSES: Reporting our experience in treating chronic obstructive sialadenitis with a protocol consisting of sialoendoscopy and intraductal instillation of antibiotics, steroids and n-acetyl-cysteine (NAC) solution. METHODS: Prospective study of patients with chronic obstructive sialadenitis with no apparent lithiasic obstructions, with recurrent non-lithiasic sialoadenitis and patients with lithiasic sialoadenitis not solved with sialoendoscopy. In all cases, a sialoendoscopy was performed. All the patients affected by lithiasic sialoadenitis where the chronic inflammation was resolved with sialoendoscopy were excluded from the study. The mid-term follow-up was performed at 12 months via phone interview, to understand whether patients had developed any further symptoms after the treatment. RESULTS: This study included 26 patients. All the patient without sialolithiasis have not reported any symptoms during the follow-up period. Two of those with sialolithiasis have not shown any signs of recurrence. The remaining three patients with non-resolved sialolithiasis had a recurrence of symptoms which were treated again with 1 intraductal administration of betamethasone, gentamicine and NAC, showing immediately a regression of the symptoms. CONCLUSIONS: Intraductal administration of gentamicin + NAC + betamethasone seemed effective for the therapy of chronic obstructive sialoadenitis. Our protocol seemed effective also in that cases where it was not possible to remove or detect endoscopically an obstruction. In all these cases we have noticed an increase in the symptom-free time even in cases where it was not possible to remove the stones. PMID:34110456 | DOI:10.1007/s00405-021-06930-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery'

xlomafota13 shared this article with you from Inoreader "Benefits of the pedicled osteoplastic flap as a surgical approach of mastoidectomy in cochlear implant surgery" 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 10. doi: 10.1007/s00405-021-06907-1. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the esthetic and functional results of an osteoplastic flap for mastoid cavity closure in cochlear implant surgery. STUDY DESIGN: Double-blind, prospective, randomized clinical trial. SETTING: tertiary referral center. INTERVENTION(S): On hundred and twenty-six patients were randomized in 2 groups for cochlear implant surgery. Cases (n: 63) underwent simple mastoidectomy using an anteriorly pedicled osteoplastic flap for mastoid closure. In controls (n: 63), a traditional periosteal flap was used. Evaluation with the POSAS questionnaire was performed 1 year after surgery to assess surgical wound esthetics. Sixteen patients from each group had postoperative CT-scans and wideband tympanometry to assess mastoid aeration and middle ear absorbance. Gender and time after surgery were correlated. MAIN OUTCOME MEASURE(S): Evaluation of the quality of the surgical wound with the application of a questionnaire validated in the medical literature and translated into Portuguese language called POSAS, considering the perception of the blinded patient and doctor regarding the surgical technique proceeded. A lower POSAS score suggests better esthetics of the surgical wound. Secondary outcomes are volumetric measurement of aeration inside mastoid cavity using 3D computer tomography exam, which aims to analyze the influence of fibrocicatricial retraction in the surgical wound into the mastoid and the interference of its aeration volume in the absorption of sound in the middle ear, using the wideband tympanometry exam. RESULTS: The POSAS questionnaire in the Case group showed a lower level of local pain and itchiness, a skin color and thickness more similar to the surrounding skin and less irregularity and stiffness, with no influence from time after surgery and gender compar ed to the Control group. The median tomographic volume was 6.37 cc in the cases and 4.60 cc in controls. Wideband tympanometry showed general smaller sound absorbance in the Case group results, specially, at 1000 Hz frequency. No intraoperative or postoperative complications were observed with the osteoplastic flap. CONCLUSIONS: This technique is an effective and safe alternative to alleviate common problems of mastoid surgery for cochlear implantation. In addition to esthetic benefits, it has less interference in middle ear physiology of sound absorbance and less fibrous tissue into the mastoid cavity during the follow-up of more than 1 year. PMID:34110455 | DOI:10.1007/s00405-021-06907-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.