Pediatric Skull Base Tumors: A Management Challenge

xlomafota13 shared this article with you from Inoreader Pediatric Skull Base Tumors: A Management Challenge Via leak of cerebrospinal fluid J Pediatr Neurosci. 2021 Jan-Mar;16(1):35-43. doi: 10.4103/jpn.JPN_56_20. Epub 2021 Jun 25. ABSTRACT CONTEXT: Skull base tumors are varied in children and are particularly challenging to pediatric neurosurgeons, with few papers in the literature describing the evolution, complications, and outcome. The authors evaluated long-term outcomes in children submitted to skull base tumor surgery and performed a literature review. AIMS: The aim of this study was to analyze surgical results, complications, and outcomes, on comparison with previous publications. MATERIALS AND METHODS: A retrospective analysis of children undergoing surgery at a single institution between 2000 and 2018 for lesions of the cranial base was carried out. In addition, a literature review was carried out describing a total of 115 children operated on for skull base tumors. STATISTICAL ANALYSIS: Chi-squared and Fisher's exact tests were performed to compare th e distribution of categorical variables and a nonparametric Mann-Whitney U test was used to perform intergroup comparisons of continuous variables. RESULTS: Seventeen children ranging in age from 8 months to 17 years (mean, 10.9 years) underwent skull base approaches. Tumor types included schwannoma, meningioma, chondroid chordoma, mature teratoma, epidermoid cyst, hemangiopericytoma, rhabdomyosarcoma, myofibroblastic inflammatory tumor, fibromyxoid sarcoma, Crooke's cell adenoma, ossifying fibroma, osteoblastoma, nasopharyngeal angiofibroma and Ewing's sarcoma. Gross total resection was achieved in 6 patients (35.3%), 12 patients (70.6%) had benign histology, and 5 patients (29.4%) had a malignant tumor. Transient postoperative cerebrospinal fluid leak affected only one patient. Thirteen children (76.4%) had a residual neurological deficit at last follow-up evaluation. Three (17.6%) surviving patients received adjuvant therapy. The rate of recurrence or lesion progress ion was 17.6%. CONCLUSIONS: Skull base tumors in children present a therapeutic challenge because of their unique pathological composition and can lead to considerable morbidity and mortality in pediatric age. PMID:34316306 | PMC:PMC8276951 | DOI:10.4103/jpn.JPN_56_20 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tensile strain promotes osteogenic differentiation of bone marrow mesenchymal stem cells through upregulating lncRNA-MEG3

xlomafota13 shared this article with you from Inoreader Tensile strain promotes osteogenic differentiation of bone marrow mesenchymal stem cells through upregulating lncRNA-MEG3 Via Cellular and Molecular Biology Histol Histopathol. 2021 Jul 28:18365. doi: 10.14670/HH-18-365. Online ahead of print. ABSTRACT BACKGROUND: With the aging of the population, osteoporosis is becoming more and more common. This progressive bone disease increases the risk of fractures and pain and causes serious harm to people's health and quality of life. Several studies, including our previous studies, confirmed that tensile strain can promote bone marrow mesenchymal stem cell (BMSC) osteogenic differentiation in vitro. In this study, we further explored the mechanism by which tensile strain regulates BMSC differentiation. METHODS: A device designed by our group was used to apply tensile strain to BMSCs to study the effects of tensile strain on their differentiation. LncRNA-MEG3 overexpression and silencing models of BMSCs were constructed by lentivirus transfection to study the involvement of lncRNA-MEG3. We assessed osteogenic differentiation of BMSCs by alkal ine phosphatase (ALP) staining and the expression of Runx2 mRNA and BMP2 mRNA, while adipogenic differentiation was evaluated by oil red staining and the expression of PPARγ mRNA and C/EBPα mRNA. RESULTS: We demonstrated that proper tensile strain can promote osteogenic differentiation of BMSCs while inhibiting differentiation into adipocytes, and simultaneously promote the expression of lncRNA-MEG3. The overexpression of lncRNA-MEG3 further promotes osteogenic differentiation of stressed BMSCs and inhibits expression of miR-140-5p; the knockdown of lncRNA-MEG3 induces the opposite effects. CONCLUSION: Appropriate mechanical stimulation can inhibit the expression of miR-140-5p by promoting lncRNA-MEG3 expression, thereby promoting the osteogenic differentiation of BMSCs. Our results provide a theoretical basis for physical exercise to improve the prevention and treatment of osteoporosis. PMID:34318924 | DOI:10.14670/HH-18-365 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Basaloid squamous cell carcinoma of the hypopharynx: an analysis of 213 cases

xlomafota13 shared this article with you from Inoreader Basaloid squamous cell carcinoma of the hypopharynx: an analysis of 213 cases 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 Jul 28. doi: 10.1007/s00405-021-07007-w. Online ahead of print. ABSTRACT PURPOSE: Basaloid squamous cell carcinoma (BSCC) is a rare aggressive variant of squamous cell carcinoma (SCC) with a poor prognosis. No large series of exclusively hypopharyngeal BSCC patients have been previously reported. Therefore, this retrospective population-based study aims to explain the patient demographics, clinicopathologic characteristics, incidence, and survival outcomes of hypopharyngeal BSCC and how it relates to conventional-type SCC. METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results database registry was queried for patients diagnosed with hypopharyngeal BSCC and conventional-type SCC between 2001 and 2016. RESULTS: The incidence of hypopharyngeal BSCC from 2001 to 2016 was 0.0161 per 100,000 individuals. The BSCC group comprised 213 patients, and the SCC group 7958 pa tients. The majority of BSCCs were considered high grade (Grade III/IV, 89.58%). Most BSCC patients were diagnosed at an advanced stage (American Joint Committee on Cancer [AJCC] stage IV, 65.38%). The 1-, 5-, and 10-year disease-specific survival (DSS) rates for hypopharyngeal BSCC were 84.10%, 57.40%, and 46.20%, respectively. Multivariate analysis, after adjustment for sex, age, race, tumor location, grade, and AJCC stage, showed that patients with BSCC had significantly better DSS than those with conventional-type SCC. Surgery with radiation contributed to a favorable DSS for BSCC patients in comparison with other treatments. CONCLUSION: This analysis of the largest hypopharyngeal BSCC series indicates a better prognosis for this pathologic type compared with conventional-type hypopharyngeal SCC. Multimodality treatment with surgery and radiation may result in a favorable prognosis for hypopharyngeal BSCC patients. PMID:34319483 | DOI:10.1007/s00405-021-07007-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Systematic review and meta-analysis of Sniffin Sticks Test performance in Parkinson's disease patients in different countries

xlomafota13 shared this article with you from Inoreader Systematic review and meta-analysis of Sniffin Sticks Test performance in Parkinson's disease patients in different countries 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 Jul 28. doi: 10.1007/s00405-021-06970-8. Online ahead of print. ABSTRACT INTRODUCTION: Olfaction impairment occurs in about 90% of patients with Parkinson's disease. The Sniffin Sticks Test is a widely used instrument to measure olfactory performance and is divided into three subtests that assess olfactory threshold, discrimination and identification. However, cultural and socioeconomic differences can influence test performance. OBJECTIVES: We performed a systematic review and meta-analysis of the existent data about Sniffin Sticks Test performance of Parkinson's disease patients and healthy controls in different countries and investigated if there are other cofactors which could influence the olfactory test results. A subgroup analysis by country was performed as well as a meta-regression using age, gender and air pollution as covariates. RESULTS: Four hundred and thirty studies were found and 66 articles were included in the meta-analysis. Parkinson's disease patients showed significantly lower scores on the Sniffin Sticks Test and all its subtests than healthy controls. Overall, the heterogeneity among studies was moderate to high as well as the intra-country heterogeneity. The subgroup analysis, stratifying by country, maintained a high residual heterogeneity. CONCLUSION: The meta-regression showed a significant correlation with age and air pollution in a few subtests. A high heterogeneity was found among studies which was not significantly decreased after subgroup analysis by country. This fact signalizes that maybe cultural influence has a small impact on the Sniffin Sticks Test results. Age and air pollution have influence in a few olfactory subtests. PMID:34319482 | DOI:10.1007/s00405-021-06970-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of Dental Bisphenol A-Glycidyl Methacrylate Composite to Repair Refractory Cerebrospinal Fluid Leaks Associated With Large-Scale Anterior Skull Base Defects

xlomafota13 shared this article with you from Inoreader Use of Dental Bisphenol A-Glycidyl Methacrylate Composite to Repair Refractory Cerebrospinal Fluid Leaks Associated With Large-Scale Anterior Skull Base Defects Via leak of cerebrospinal fluid J Craniofac Surg. 2021 Jul-Aug 01;32(5):1805-1809. doi: 10.1097/SCS.0000000000007568. ABSTRACT Treatment of refractory cerebrospinal fluid (CSF) leaks, particularly those associated with large skull base defects, is challenging. A variety of synthetic biomaterial-based systems have been investigated in experimental models and/or humans for reconstructing cranial base defects. A widely used dental composite (bisphenol A-glycidyl methacrylate [bis-GMA]) has been shown to be effective for reconstruction of anterior skull base defects in animal models. Here, we report 4 patients who underwent reconstruction of large anterior skull base defects (1405.8 ± 511 mm2) secondary to tumor resection and traumatic injury using the dental bis-GMA resin-based composite. A vascularized pericranial flap with fibrin glue was initially performed in all patients with concurrent use of dental bis-GMA during the primary surgery in 2 patients, and later use (in a r epeat surgery) in other 2 cases. In these latter 2, CSF rhinorrhea persisted after the initial surgery (in the absence of bis-GMA use) despite external CSF drainage with lumbar drain. Following treatment with bis-GMA, rigid structural support and watertight closure of the defect were successfully achieved. At the follow-up, CSF leak did not recur and none of the patients had any complications related to the surgery or the composite. The results obtained from this series are promising, and dental bis-GMA resin seems to provide an effective and feasible material for the treatment and prevention of CSF leaks related to large-scale anterior skull base defects. However, further studies with longer clinical follow-up and larger number of patients are required to prove the safety and efficacy of this matrix in the long run. PMID:34319681 | DOI:10.1097/SCS.0000000000007568 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patients with COVID-19-associated olfactory impairment also show impaired trigeminal function.

xlomafota13 shared this article with you from Inoreader Patients with COVID-19-associated olfactory impairment also show impaired trigeminal function. Via Auris Nasus Larynx Publication date: Available online 26 July 2021 Source: Auris Nasus Larynx Author(s): Martin Sylvester Otte, Marie-Luise Bork, Philipp Heinrich Zimmermann, Jens Peter Klussmann, Jan Christoffer Luers View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alopecia and cancers: From basics to clinical practice

xlomafota13 shared this article with you from Inoreader Alopecia and cancers: From basics to clinical practice Via Association française pour l'étude du cancer Bull Cancer. 2021 Jul 22:S0007-4551(21)00209-5. doi: 10.1016/j.bulcan.2021.04.011. Online ahead of print. ABSTRACT Alopecia, although long considered an unavoidable consequence of cancer therapy, currently presents a multifaceted challenge. The knowledge of the physiology of the hair and consequently of the pathophysiology of alopecia has led to show that there is not one but several types of alopecia. Transposed to the world of oncology, different types of alopecia and subsequently molecular pathways have been characterized, allowing a better understanding of the underlying mechanisms. Thus, in patients with cancer, alopecia can be iatrogenic (chemotherapies, endocrine therapies, targeted therapies, immunotherapies, radiotherapy, surgery) or directly the consequence of the disease itself (malnutrition, scalp metastases, paraneoplastic syndromes). Knowledge of the incriminated mechanism(s) could thus make it possible to deploy an appro priate care component, whether on the preventive or curative sides or in terms of supportive care. These are particularly essential regarding the psychological repercussions caused by alopecia, with significant consequences on the quality of life of patients and with a potential impact on treatment compliance. On the preventive side, the last few years have seen the advent of the automated scalp cooling therapy, supported by several randomized clinical trials. On the curative side, several therapeutic proposals are currently deployed or under development in order to provide relevant treatments. PMID:34304865 | DOI: 10.1016/j.bulcan.2021.04.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transfer of the deep temporal nerve for eyelid reconstruction in Mobius syndrome - an anatomic feasibility study and proposed surgical approach

xlomafota13 shared this article with you from Inoreader Transfer of the deep temporal nerve for eyelid reconstruction in Mobius syndrome - an anatomic feasibility study and proposed surgical approach Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 12:S1748-6815(21)00318-1. doi: 10.1016/j.bjps.2021.05.059. Online ahead of print. ABSTRACT Facial paralysis may result in significant functional, esthetic, and psychological morbidity. Mobius syndrome is a form of bilateral congenital facial paralysis that is particularly difficult to treat owing to the lack of readily available donor nerves, particularly in the upper face. In this study, we evaluate the feasibility of using the deep temporal nerves as donors for the innervation of free muscle grafts in the periorbital region. Preserved and fresh cadaver facial halves are dissected, and the course of the deep temporal nerves delineated. We find the middle branch of the deep temporal nerve to be located consistently 4.6 cm from the posterior edge of the tragus along the zygomatic arch, giving an easily identifiable surface landmark for our donor. Finally, we outline a proposed surgical approach fo r using the middle deep temporal nerve to innervate a free muscle graft to the eyelids through an interpositional nerve graft. PMID:34305023 | DOI:10.1016/j.bjps.2021.05.059 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aesthetic forehead reduction in female patients: Surgical details and analysis of outcome

xlomafota13 shared this article with you from Inoreader Aesthetic forehead reduction in female patients: Surgical details and analysis of outcome Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 18:S1748-6815(21)00335-1. doi: 10.1016/j.bjps.2021.06.002. Online ahead of print. ABSTRACT INTRODUCTION: Primary aesthetic hairline lowering, also known as forehead reduction, is a relatively unexplored procedure, and the perceived satisfaction with outcome has not been previously discussed in scientific literature. The objectives of this study were to review the surgical technique and to analyze outcome assessing objective reduction, improvement of facial balance, patient satisfaction, and complications. PATIENTS AND METHODS: This was a prospective cohort study of patients seeking aesthetic forehead reduction since 2010. Inclusion criteria were as follows: women with a high but stable hairline. We excluded smokers, those seeking combined surgery, and those who had history of scalp surgery or hair loss. All patients were operated following the same protocol. Forehead reduction was measured comparing the pre- and postoperative distance from the glabella to the trichion. Improvement in facial balance was assessed comparing the pre- and postoperative quotient between the upper and middle thirds of the face. The forehead FACE-Q tool and the Vancouver Scar Scale were used to assess patient satisfaction. All complications were registered with a minimum follow-up of 6 months. RESULTS: Twenty-six women aged 16 to 56 years were included. The average reduction was 2.03 cm. The facial balance quotient improved from 1:1.44 preoperatively to 1:1.05 postoperatively (p < 0.01). Both the forehead FACE-Q and the Vancouver Scar Scale showed significantly positive results. Complications included transient scalp numbness in 23 subjects, small areas of scar widening in 3 patients, and minor seroma in 1 patient. CONCLUSION: With meticulous execution, aesthetic forehead reduction in female patients is effective and safe, resulting in high patient satisfaction. The FACE-Q is o wned by the Memorial Sloan Kettering Cancer Center (MSKCC) and was used with permission for this research. PMID:34305024 | DOI:10.1016/j.bjps.2021.06.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spectrum of Neurological Outcomes in Diphtheria: A Case Series

xlomafota13 shared this article with you from Inoreader Spectrum of Neurological Outcomes in Diphtheria: A Case Series Via Otolaryngology Indian Abstract Diphtheria is an acute infectious disease caused by the exotoxin produced by Corynebacterium diphtheriae, a gram positive bacteria. It has propensity to affect mainly cardiac muscle and nervous system. To study the percentage, spectrum of patients with various neurological complications and the pattern of recovery in followed up confirmed cases of diphtheria. Single centre prospective analysis of neurological complications in diphtheria patients from June 2019 to September 2020 at SMS Medical College and hospital,Jaipur. In this study, 60 cases were included. Immunised cases were 60% (36 out of 60 cases) whereas unimmunised constituted the rest 40% (24 out of 60 cases). Neurological complications were observed in 15% of the cases (9 out of 60). Isolated palatal palsy was the most common complication (4 out of 9 cases, 44.44%), succeeded by lower limb LMN palsies (2 out of 9 cases, 22.22%) with unilateral facial nerve palsy, bilateral abductor palsy and paralytic ileus constituting the rest (1 out of 9 cases each, 11.11% each). Onset of complications ranged from 10 to 36 days whereas recovery was complete and without any residual sequelae between 60 to 240 days. Our study concluded that neurological complications form a sizeable portion of post diptheritic complications and carries good prognosis, hence timely diagnosis and differentiation from other neuropathies is a pre requisite for rational management and contact tracing. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of small-dose ganciclovir on cytomegalovirus infections in children and its effects on liver function and miR-UL112-3p expression

xlomafota13 shared this article with you from Inoreader Efficacy of small-dose ganciclovir on cytomegalovirus infections in children and its effects on liver function and miR-UL112-3p expression Via Experimental and therapeutic medicine Exp Ther Med. 2021 Sep;22(3):912. doi: 10.3892/etm.2021.10344. Epub 2021 Jun 29. ABSTRACT The aim of the study was to explore the efficacy of small-dose ganciclovir on cytomegalovirus infections as well as its effects on the liver function and miR-UL112-3p of children. A total of 141 children infected with cytomegalovirus admitted to the Affiliated Hospital of Weifang Medical University from May 2015 to August 2017 were enrolled, of which 74 children were treated with small-dose ganciclovir as an observation group (Obs group), and the rest were treated with conventional-dose ganciclovir as a control group (Con group). The two groups were compared in efficacy after treatment, changes of liver function indexes [total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)] and miR-UL112-3p before and after treatment, and adverse reactions after treatment. A receiver operating characteristic (ROC) curve was dr awn to analyze the value of miR-UL112-3p in predicating efficacy on cytomegalovirus infections in children, and Pearson's correlation analysis was carried out to analyze the correlation between miR-UL112-3p expression and TB, ALT and AST. The MV-DNA level between the two groups after treatment was compared. The two groups showed no significant difference in efficacy and adverse reactions (both P>0.05), and before treatment, there was also no significant difference between the two groups in miR-UL112-3p, TB, ALT, and AST, while after treatment, both groups showed lower levels of miR-UL112-3p, TB, ALT, and AST, and the Obs group showed significantly lower levels thereof than the Con group (all P<0.05). In addition, the area under the curve (AUC), specificity, and sensitivity of miR-UL112-3p in the ROC curve of the Obs group were 0.866, 73.77 and 84.62%, respectively, while the AUC, specificity, and sensitivity of the ROC of the Con group were 0.837, 75.44, and 90.00%, respective ly. Furthermore, miR-UL112-3p was positively correlated with TB, ALT, and AST, respectively. The CMV-DNA level in the Obs group was lower than that in the Con group, but the difference was not significant, and the level of CMV-DNA was positively correlated with that of miR-UL112-3p. In conclusion, small-dose ganciclovir can better improve the liver function of the children, and downregulate miR-UL112-3p in them. The AUC, specificity, and sensitivity of miR-UL112-3p for predicting the efficacy of small-dose ganciclovir were 0.866, 73.77 and 84.62%, respectively, and the AUC, specificity, and sensitivityfor predicting the efficacy of conventional-dose ganciclovir were 0.837, 75.44 and 90.00%, respectively. PMID:34306186 | PMC:< a href="https://www.ncbi.nlm.nih.gov/pmc/PMC8281003/?utm_source=Inoreader&utm_medium=rss&utm_content=1ba2t84FK1dz-fAY5g7-lbp7yzA9oSsgU2XptRGyGkyx-wIkEA&ff=20210726210215&v=2.14.5" target="_blank" rel="noopener" class="underlink bluelink">PMC8281003 | DOI:10.3892/etm.2021.10344 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.