Hypoglossal Nerve Stimulator Implantation in an Ambulatory Surgery Center Versus Hospital

xlomafota13 shared this article with you from Inoreader Hypoglossal Nerve Stimulator Implantation in an Ambulatory Surgery Center Versus Hospital Via The Laryngoscope Objectives/Hypothesis Hypoglossal nerve stimulator (HGNS) implantation is highly effective in treating obstructive sleep apnea (OSA) in select patient populations that are intolerant of continuous positive airway pressure. Implantation surgery is traditionally performed in hospital outpatient departments (HOPD) due to concern about anesthetic effects and airway manipulation in an OSA population. In this study, we examined complications and efficiency of HGNS implantation in an ambulatory surgery center (ASC) versus HOPD. Study Design Retrospective cohort study. Methods Patients with HGNS implantation performed between May 2015–January 2021 at our HOPD or ACS were included. Patient-related characteristics, surgical times, and postoperative complications were obtained via chart review. Reimbursement data on a national level for Medicare patients were calculated based on publicly available data from the Center for Medicare Services. Patient characteristics, surgical times, and complications were summarized as medians with interquartile ranges (IQRs) and proportions in each surgical setting group as appropriate. These were compared between surgical setting groups via Wilcoxon rank-sum testing and χ 2 testing. Results A total of 122 patients were included. Patients in the HOPD group had significantly higher median apnea-hypopnea index (AHI) (42.0 [IQR 27.9–51.0]) compared to the ASC group (31.0 [IQR 21.0–44.2], P = .005). The intervals between in-room and case start, case finish and out-of-room, and time in the postoperative area were significantly shorter in the ASC group compared to the HOPD group. Reimbursement on a national level was estimated at 18% lower for patients with surgery performed at the ASC. There was no significant difference in postoperative complications. Conclusions HGNS implantation in an ASC is safe and more efficient than in a HOPD, and may also be more cost-effective. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alternate dosage formulations of oral targeted anticancer agents

xlomafota13 shared this article with you from Inoreader Alternate dosage formulations of oral targeted anticancer agents Via Traditional dysphagia therapy J Oncol Pharm Pract. 2021 Sep 24:10781552211037976. doi: 10.1177/10781552211037976. Online ahead of print. ABSTRACT OBJECTIVE: Oral anticancer therapies have demonstrated superior outcomes compared to traditional cytotoxic chemotherapy in many disease states. However, certain patients may not be candidates for these agents due to odynphagia or dysphagia. The purpose of this review is to summarize the data for extemporaneous compounding of oral anticancer agents. DATA SOURCES: Food and drug administration approvals of oncology agents were reviewed to identify oral anticancer therapies. In order to find alternative administration options: the package inserts of each of these agents were reviewed, each medication was searched in a tertiary drug information resource, the medical information teams of each drug manufacturer were contacted to inquire about proprietary data, sites with pediatric trials were contacted, a primary literature searc h was performed, and listservs for national pharmacy and oncology organizations were reviewed. DATA SUMMARY: Eighty-five food and drug administration-approved oral anticancer therapies were identified to be included. Of those agents, nine (11%), had information in the package insert related to alternative administration. After further research, 46 (54%) of the agents had some information related to alternate formulations for administration. The recipes and stability of each of these compounds is included. CONCLUSIONS: The majority of agents do not have Phase I or II trials that assess safety or pharmacokinetics of alternative formulations. Clinicians should exercise caution when recommending or administering these agents outside of food and drug administration-approved indicated use and utilize clinical judgment in assessing the risks and benefits of altering anticancer compounds. However, the alternative administration considerations presented can increase access to onc ology patients who have difficulty swallowing. PMID:34558356 | DOI:10.1177/10781552211037976 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma Via Head & Neck Abstract Background The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC). Methods Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Multinomial logistic regression was performed to identify features predictive of ICA blowouts. Results Headache was significantly more common among ICA blowouts than ECA bleeds and controls (58.8% vs. 7.1% vs. 6.7%, p < 0.001). The petrous skull base and sphenoid sinus lateral wall was eroded in all petrous and cavernous segment blowouts, respectively. Nasoendoscopy showing exposed clivus (OR 20.5, 95%CI 1.3–324.2) and computed tomography demonstrating skull base erosion (OR 17.8, 95%CI 1.0–311.0) were significantly associated with ICA blowouts compared to controls. Conclusions Findings of headache and skull base erosion on nasoendoscopy or imaging during NPC surveillance warrants prophylactic intervention to avoid an ICA blowout. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Surgical Perspective on the Association between Cystic Lesions of the Pineal Gland (Descartes' Seat of the Soul) and the Pituitary (the Master Gland)

xlomafota13 shared this article with you from Inoreader A Surgical Perspective on the Association between Cystic Lesions of the Pineal Gland (Descartes' Seat of the Soul) and the Pituitary (the Master Gland) Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1735635 Introduction Rene Descartes (1596–1650), the famous philosopher and scientist, identified the pineal gland as the only cerebral structure not represented bilaterally, the "seat of the soul"; and the source of rational thought. Pineal cysts (PCs) are often incidentally identified in MRI studies, with a reported prevalence of 1 to 4.3%. Rathke cleft cysts (RCCs) are pituitary lesions accounting for <1% of intracranial masses. There are scant data in the literature addressing any association between these two midline cystic lesions. Methods We reviewed the medical records of patients presenting at our institution from April 2008 through February 2020, whose records indicated a diagnosis of RCC, and those whose records included pineal lesions. Our objective was to evaluate the association between these two midline lesions. Brain MRI studies were reviewed for the presence of PCs; only patients with PCs that measured ≥5 mm in diameter were included. Results We identified 116 patients with RCCs, and 34 patients with PCs, treated from April 2008 through February 2020. Among the RCC group, 14/116 patients (12%) had PCs. Among the PC group, 3/34 patients (8.8%) had RCCs. Overall, 17 patients (11.3%) had concomitant RCCs and PCs. The mean maximal diameter of the PCs was 7.5 mm (range = 5–17 mm), whereas the mean maximal diameter of RCCs was 13 mm (range = 5–40 mm). Conclusion The incidental diagnosis of cystic lesions of the pineal and pituitary gland is increasingly reported, primarily because of advances in current diagnostic modalities. Our data demonstrated no clear consensual association between pineal and pituitary cysts. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

3D Real IR MR Findings in Acoustic Neuromas: Altered Perilymph Metabolism

xlomafota13 shared this article with you from Inoreader 3D Real IR MR Findings in Acoustic Neuromas: Altered Perilymph Metabolism Via ear nose throat Ear Nose Throat J. 2021 Sep 24:1455613211047124. doi: 10.1177/01455613211047124. Online ahead of print. ABSTRACT OBJECTIVES: This study aimed to investigate the perilymph metabolism by analyzing the 3D real IR MR findings in acoustic neuroma (AN) after intravenous administration of gadolinium (Gd). METHODS: Eleven patients (6 men and 5 women) diagnosed with AN were included, and 3D real IR MRI was performed 4 hours after intravenous Gd injection. The signal intensity a nd details of inner ear, tumor, and internal auditory canal (IAC) by MRI were analyzed. RESULTS: Four patients had tumors confined to the IAC, and 5 had tumors that extended to the cerebellopontine angle cistern. The signal intensity of the cochlea, vestibule, and IAC fundus was conspicuously enhanced in 3D real IR images than the control side. One patient had a tumor in the cochlea, in which the signal intensity of the semicircular canal and vestibule was increased. One patient had an intravestibular tumor in which the signal intensity of the semicircular canal was increased and the cochlea had endolymphatic hydrops in the affected ear. CONCLUSIONS: The synchronously increased signal intensity in the inner ear and IAC may indicate that IAC may serve as a channel for removal of the perilymph in the inner ear; the blockage by the tumor may have changed the hydrodynamics of the perilymph to cause a longer retention of Gd in the inner ear. PMID:34560831 | DOI:10.1177/01455613211047124 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The transcriptional characteristics of mast cells derived from skin tissue in type 2 diabetes patients at the single-cell level

xlomafota13 shared this article with you from Inoreader The transcriptional characteristics of mast cells derived from skin tissue in type 2 diabetes patients at the single-cell level Via histochem Acta Histochem. 2021 Sep 21;123(7):151789. doi: 10.1016/j.acthis.2021.151789. Online ahead of print. ABSTRACT OBJECTIVES: The mechanisms underlying the role of mast cells in wound healing have not been thoroughly studied, and even fewer data are available on studies related to mast cells in the skin of patients with type 2 diabetes mellitus (T2DM). Therefore, this study aims to explore the transcriptional characteristics of mast cells at the single-cell level in patients wit h T2DM and provide experimental data for studying mast cell behaviors under abnormal glucose metabolism. METHODS: Two patients with T2DM and one trauma patient without diabetes were enrolled. Samples were derived from skin tissue resected at the time of surgery and were isolated by single cell capture technology on BD platform to prepare single cell cDNA library. Seurat was used to process raw reads and analyze data downstream of single-cell RNA sequencing, including removal of low-quality cells, identification of cell clusters at the single-cell level, and screening for differential genes with fold change > 1.5 and p < 0.05 by two-sided t-test. We performed single-cell RNA sequencing on skin tissues of T2DM patients and non-diabetics and identified the cell cluster of skin, single-cell subsets, and transcriptional characteristics of mast cells at a single-cell level. Meanwhile, gene set enrichment(GSEA) analysis was performed on the differentially expressed genes. RESULTS: A total of 8888 cells were obtained from skin tissue. Clustering analysis revealed eight-cell clusters, identified as smooth muscle cells, dendritic cells, mast cells, and T cells, respectively. Cluster 6 was identified as mast cells with the marker genes TPSAB1, CPA3, TPSB2, MS4A2,KIT, etc., which accounting for 2.7% of the total cell number.Compared with the control group, the genes highly expressed in MCs from T2DM patients, include ADH1C, PAXIP1, HAS1, ARG1, etc., and the low expression genes include PHACTR2, GGA1, RASSF2, etc. GSEA analysis suggested that the signal pathways of MCS in T2DM patients included VEGF signaling pathway, Fc gamma R-mediated phagocytosis, the B cell receptor signaling pathway, natural killer cell-mediated cytotoxicity. CONCLUSIONS: The characteristic genes of MCs in the skin tissues of T2DM patients were described at the single-cell level. These genes and enriched signaling pathways provide a theoretical basis and data support for furth er researches on dermatopathy in patients with diabetes mellitus. PMID:34560403 | DOI:10.1016/j.acthis.2021.151789 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interest of the bc-GenExMiner web tool in oncology

xlomafota13 shared this article with you from Inoreader Interest of the bc-GenExMiner web tool in oncology Via Association française pour l'étude du cancer Bull Cancer. 2021 Sep 21:S0007-4551(21)00299-X. doi: 10.1016/j.bulcan.2021.05.008. Online ahead of print. ABSTRACT We are taking advantage of the launch of the latest version (v4.6) of our web-based data mining tool "breast cancer gene-expression miner" (bc-GenExMiner) to take stock of its position within the oncology research landscape and to present an activity report ten years after its establishment (http://bcgenex.ico.unicancer.fr). bc-GenExMiner is an open-access, user-friendly tool for statistical mining on breast tumor transcriptomes, annotated with more than 20 clinicopathologic and molecular characteristics. The database comprises more than 16,000 patients from 64 cohorts - including TCGA, METABRIC and SCAN-B - for whom several thousands of genes have been quantified by microarrays or RNA-seq. Correlation, expression and prognostic analyses are available for targeted, exhaustive or customized explorations of queried genes. bc -GenExMiner facilitates the validation, investigation, and prioritization of discoveries and hypotheses on genes of interest. It allows users to analyse large databases, create data visualizations, and obtain robust statistical analysis, thereby accelerating biomarker discovery. Ten years after its launch, judging by the number of visits, analyses, and scientific citations of bc-GenExMiner, we conclude that this web resource serves its purpose in the international scientific community working in breast cancer research, with a never-ending rise in its use. PMID:34561023 | DOI:10.1016/j.bulcan.2021.05.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A rare case report: bilateral occipital artery arising from the vertebral artery

xlomafota13 shared this article with you from Inoreader A rare case report: bilateral occipital artery arising from the vertebral artery Via radiol anat Surg Radiol Anat. 2021 Sep 24. doi: 10.1007/s00276-021-02842-2. Online ahead of print. ABSTRACT BACKGROUND: Variations of the origin of the occipital artery (OA) can be considered as congenital anomalies that are often asymptomatic and detected incidentally on angiography or during cadaver dissection. While OA normally originates from the posterior aspect of the external carotid artery (ECA), recent evidence also reflects that OA may infrequently originate from the internal carotid artery (ICA); however, OA originating from the vertebral artery (VA) is a highly rare phenomenon. CASE PRESENTATION: In a 54-year-old female patient with the complaint of left hemiparesis, computed tomography (CT) angiography revealed nonstenotic calcified plaques at the beginning of right ICA where common carotid artery (CCA) bifurcates. We also incidentally observed that bilateral OA originated from the VA using maximum intensity projection (MIP) technique. In addition to this rare variation, CT angiography showed the osseous anomaly termed as high-riding VA (HRVA) in the C1/2 vertebral space of the V3 segment of the VA. CONCLUSION: To the best of our knowledge, a case of bilateral OA originating from the VA has not been reported to date. We believe that recognition of this rare variation may contribute to the relevant literature and it is of importance to consider this variation in radiological imaging and surgical procedures involving this region. PMID: 34561718 | DOI:10.1007/s00276-021-02842-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of retrootolithic function using galvanic vestibular-evoked myogenic potentials in patients with benign paroxysmal positional vertigo

xlomafota13 shared this article with you from Inoreader Evaluation of retrootolithic function using galvanic vestibular-evoked myogenic potentials in patients with benign paroxysmal positional vertigo 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 Sep 25. doi: 10.1007/s00405-021-07094-9. Online ahead of print. ABSTRACT PURPOSE: The purpose is to investigate possible vestibulopathy in patients with benign paroxysmal positional vertigo (BPPV), inner ear tests, including cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) via various stimulation modes, were adopted. METHODS: Fifty BPPV patients were enrolled in this study. All patients underwent pure tone audiometry, cVEMPs, oVEMPs, and caloric tests. The recurrence status, abnormal rates of inner ear tests, and the characteristic parameters of VEMPs, such as wave latencies and amplitudes, were analyzed. RESULTS: In affected ears, the abnormal rates of acoustic cVEMPs, vibratory oVEMPs, galvanic cVEMPs, and galvanic oVEMPs were 62%, 28%, 36%, and 14%, respectively. The abnormalities of acoustic cVEMPs were significantly larger than those of vibratory oVEMPs, and acoustic/vibratory VEMPs had significantly higher abnormal rates than the corresponding galvanic VEMPs. CONCLUSION: BPPV patients may have both otolithic and neural dysfunctions. Otolithic organ damage occurs more frequently than retrootolithic neural degeneration, and the saccular macula might have a greater extent of damage than the utricular macula. PMID:34562111 | DOI:10.1007/s00405-021-07094-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lachnospira is a signature of antihistamine efficacy in chronic spontaneous urticarial

xlomafota13 shared this article with you from Inoreader Lachnospira is a signature of antihistamine efficacy in chronic spontaneous urticarial Via Experimental Dermatology Abstract Chronic spontaneous urticaria (CSU) is a mast cell-driven disease with many advances in its etiology and pathogenesis over the past years. The main treatment of CSU is oral second-generation antihistamines. However, only an average of 50% of CSU patients responded adequately to conventional or quadruple doses of non-sedative antihistamines. Meanwhile, gut microbiota can affect the efficacy of drugs. The purpose of this study was to investigate the relationship between gut microbiota and the efficacy of antihistamines in patients with CSU. The patients with CSU were divided into responders and non-responders according to the efficacy of antihistamine monotherapy. The gut microbiota of fecal samples from 15 responders and 15 non-responders was detected by 16S rDNA sequencing, and the differential bacterial species between the two groups were verified by quantitative polymerase chain reaction (qPCR). Additional fecal samples from 30 responders and 30 non-responders were used as an ex tended cohort to further verify the above differential bacterial species by qPCR. Lachnospiraceae and its subordinate taxa were found to be the main differences in gut microbiota between responders and non-responders. The abundance of Lachnospira in responders was higher than that in non-responders. Lachnospira exhibits moderate diagnostic value in evaluating the efficacy of antihistamine. Lachnospira is a signature for predicting the efficacy of antihistamine in patients with CSU. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Maximum Phonation Time as a Predictor of Lactate Threshold during Intermittent Incremental Endurance Test

xlomafota13 shared this article with you from Inoreader Maximum Phonation Time as a Predictor of Lactate Threshold during Intermittent Incremental Endurance Test Via Journal of Voice The aim of the present study was to examine whether the exercise intensity corresponding to the lactate threshold may be predicted by the Maximum Phonation Time task (MPT). Ten Greek amateur football players (age: 18.4 ± 1.0 years), performed a graded cycling exercise test to exhaustion in order to determine lactate threshold. A number of physiological variables were measured including perceived exertion, cardiopulmonary values and blood lactate. The MPT variable was correlated with all of the physiological variables. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.