Treatment of Graves' Disease Associated With Severe Neutropenia

xlomafota13 shared this article with you from Inoreader Treatment of Graves' Disease Associated With Severe Neutropenia Via radioactive iodine Cureus. 2022 Jan 7;14(1):e21014. doi: 10.7759/cureus.21014. eCollection 2022 Jan. ABSTRACT Severe neutropenia in newly diagnosed hyperthyroidism is a diagnostic and therapeutic dilemma since antithyroid drugs (ATDs) cannot be started if the absolute neutrophil count (ANC) is <1 x 109/L. We report the case of a patient followed for hyperthyroidism associated with severe neutropenia treated with dexamethasone and ATD. The patient was 51 years old and was hospitalized fo r hyperthyroidism with a thyroid stimulating hormone (TSH) level <0.005 (0.4-4) mUI/L, T4 at 415 (9.3-17.1) ng/L and T3 at 148 (2-4.4) pg/mL on Graves' disease (GD) confirmed by the TSH receptor antibodies at 38 IU/mL and scintigraphy, associated with neutropenia, with ANC at 0.4 x 109/L. He was put on prednisolone 60 mg/day and propranolol 60 mg/day for three weeks without improvement. Faced with the association of hyperthyroidism and severe neutropenia, we could not start the ATD for fear of agranulocytosis; we put the patient on propranolol 60 mg and dexamethasone 6 mg with progressive degression resulting in a spectacular increase of ANC from 0.4 x 109/L to 7.1 x 109/L, which allowed us to start the ATD (carbimazole) at a dose of 30 mg, and then 50 mg, with monitoring of ANC and transaminases every 48 hours. Euthyroidism was achieved after 15 days. A curative treatment with radioactive iodine ablation was administered. Our patient did not resp ond to prednisolone but responded dramatically to dexamethasone; this leads us to consider using dexamethasone for the rapid preparation for radical treatment of patients with GD. PMID:35154986 | PMC:PMC8818315 | DOI:10.7759/cureus.21014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of abnormal vestibular responses in children with sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader Prevalence of abnormal vestibular responses in children with sensorineural hearing loss 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. 2022 Feb 14. doi: 10.1007/s00405-021-07241-2. Online ahead of print. ABSTRACT PURPOSE: Dysfunction of the vestibular organs has a great deal of influence on children's balance. Children with sensorineural hearing loss (SNHL) may often have accompanying abnormal vestibular responses. Video head impulse test (vHIT) combined with a test battery of cervical and ocular vestibular evoked myogenic potentials (cVEMPs, oVEMPs) make it possible to determine the prevalence of abnormal vestibular response in any of the five paired vestibular organs amongst children with SNHL. METHOD: Prospective cross-sectional study including children aged 3-17 years with uni- or bilateral SNHL (bone-conduction (BC) pure tone average (PTA4) above 20 dB). Assessments included vHIT, cVEMP, and oVEMP. Descriptive data were analyzed. T-tests were performed to detect any correlation between the degree of SNHL and abnormal ve stibular responses. RESULTS: 42 children (27 males), a total of 63 ears with SNHL, mean BC PTA4 SNHL of 42.3 dB (32.0; 58.4 IR) were included. 28.6% had at least one ear with abnormal vestibular response. 97.6% (41/42) completed one and 75.0% (27/36) completed all vestibular examinations. Ears with two pathological examinations had significantly more severe SNHL than ears with one pathological or normal vestibular examinations (p = 0.008, p = 0.005). CONCLUSION: All test methods used with this study were easy, fast, and comfortable for children (as young as 3 years of age) to undergo. Even a moderate SNHL might be associated with abnormal vestibular response. Structural damage to the organs is the most likely cause of vestibular deficit. Consensus on criteria defining pathological examinations with both vHIT and VEMPs are required for more accurate comparison with previous studies. PMID:35156132 | DOI:10.1007/s00405-021-07241-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function

xlomafota13 shared this article with you from Inoreader Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function Via ear nose throat Ear Nose Throat J. 2022 Feb 14:1455613221077601. doi: 10.1177/01455613221077601. Online ahead of print. NO ABSTRACT PMID:35152782 | DOI:10.1177/01455613221077601 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope

xlomafota13 shared this article with you from Inoreader Message: Bow hunter syndrome (BHS) is an uncommon cause of vertebrobasilar insufficiency that results from occlusion or injury to the vertebral artery (VA) during neck rotation. The cause is often a bony abnormality that may compress the VA compromising distal flow or lead to vessel wall injury resulting in thromboembolism. Thyroid Cartilage Compression Causing Bow Hunter's Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 12:34894221077477. doi: 10.1177/00034894221077477. Online ahead of print. ABSTRACT OBJECTIVES AND METHODS: We report a unique case of Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope despite previous decompressive surgery at vertebral levels C5-C6. RESULTS: Re-evaluation with computed tomography-scan during provocation of dizziness by neck rotation revealed compression of the right VA at level C6 from against the ipsilateral posterior border and superior cornu of the thyroid cartilage. Laryngoplasty resulted in complete resolution of symptoms. CONCLUSION: This extremely rare cause of Bow's Hunter's syndrome should be considered, especially in refractory cases after neurosurgical decompression, and surgical management is straightforward and successful. PMID:35152775 | DOI:10.1177/00034894221077477 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sclerotherapy for Hereditary Hemorrhagic Telangiectasia-Related Epistaxis: A Systematic Review

xlomafota13 shared this article with you from Inoreader Sclerotherapy for Hereditary Hemorrhagic Telangiectasia-Related Epistaxis: A Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 12:34894221078075. doi: 10.1177/00034894221078075. Online ahead of print. ABSTRACT OBJECTIVES: Hereditary hemorrhagic telangiectasia (HHT) is a common inherited condition characterized by mucosal telangiectasias, recurrent epistaxis, and arteriovenous malformations. HHT results in detriment to quality of life. Morbidity and mortality result from severe anemia. Conventional interventions for HHT-related epistaxis include nasal packing, diath ermy, lasers, coblation, microdebridement, bevacizumab (topical and systemic), as well as septodermoplasty and nasal closure. Sclerotherapy has been recently described in the literature as a novel approach to HHT-related epistaxis. We hypothesize that sclerotherapy is an effective treatment for HHT-related epistaxis and improves upon the current standard of care for this disease. METHODS: A systematic review was conducted to study sclerotherapy for treating HHT-related epistaxis. Ovid MEDLINE, Ovid EMBASE, Scopus, and Web of Science were searched. Articles were evaluated and excluded according to PRISMA guidelines and reviewed by 2 authors. Reported variables included number of injections, months of follow up, changes in Epistaxis Severity Score, previous treatments used to control epistaxis, and post-injection side effects. RESULTS: Seven studies with a total of 196 patients met inclusion criteria. Three studies reported significant improvement as measured by the Epista xis Severity Score scale. One reported improvement through subjective patient surveys and others used the Bergler-Sadick scale to measure frequency and intensity of epistaxis. All studies reported improvement in HHT-related epistaxis. The lack of uniform reporting measures however precluded formal meta-analysis. CONCLUSIONS: Based on limited data, sclerotherapy appears to be effective for treating HHT-related epistaxis and offers promise for treating this recalcitrant condition. However, larger, prospective, multi-centered studies using universally validated instruments for epistaxis are needed to definitively evaluate outcomes from sclerotherapy. PMID:35152768 | DOI:10.1177/00034894221078075 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Cartilage Compression Causing Bow Hunter's Syndrome

xlomafota13 shared this article with you from Inoreader Thyroid Cartilage Compression Causing Bow Hunter's Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 12:34894221077477. doi: 10.1177/00034894221077477. Online ahead of print. ABSTRACT OBJECTIVES AND METHODS: We report a unique case of Bow Hunter's syndrome with a dominant aberrantly coursing right vertebral artery (VA), presenting with persistent dizziness and syncope despite previous decompressive surgery at vertebral levels C5-C6. RESULTS: Re-evaluation with computed tomography-scan during provocation of dizziness by neck rotation revealed compression of the right VA at level C6 from against the ipsilateral posterior border and superior cornu of the thyroid cartilage. Laryngoplasty resulted in complete resolution of symptoms. CONCLUSION: This extremely rare cause of Bow's Hunter's syndrome should be considered, especially in refractory cases after neurosurgical decompression, and surgical management is straightforward and successful. PMID:35152775 | DOI:10.1177/00034894221077477 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low MICA Gene Expression Confers an Increased Risk of Graves' Disease: A Mendelian Randomization Study

xlomafota13 shared this article with you from Inoreader Low MICA Gene Expression Confers an Increased Risk of Graves' Disease: A Mendelian Randomization Study Via liebertpub1 Thyroid, Volume 32, Issue 2, Page 188-195, February 2022. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Serratus Anterior-Rib Composite Flap as a Novel Approach for Tracheal Reconstruction

xlomafota13 shared this article with you from Inoreader Serratus Anterior-Rib Composite Flap as a Novel Approach for Tracheal Reconstruction Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 13:34894211067608. doi: 10.1177/00034894211067608. Online ahead of print. ABSTRACT OBJECTIVE: To report a novel case of tracheal reconstruction using a serratus anterior-rib composite flap. METHODS: Case report and literature review. RESULTS: A 46-year-old male with a 4 cm anterior tracheal wall defect underwent reconstruction with a serratus anterior-rib composite flap. The patient experienced excellent results regarding phonati on, swallowing, and cosmesis. CONCLUSION: The serratus anterior-rib composite flap appears to be a suitable candidate for tracheal reconstruction and merits further analysis in this context. The flap's intrinsic incorporation of a perfused rib segment allows for reliable reconstruction of the neotrachea and maintenance of proximal dynamic airway support. PMID:35156399 | DOI:10.1177/00034894211067608 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction following transoral robotic surgery for head and neck cancer: Systematic review

xlomafota13 shared this article with you from Inoreader Reconstruction following transoral robotic surgery for head and neck cancer: Systematic review Via Head & Neck Abstract We performed a systematic review to characterize reconstructive modalities and postoperative surgical outcomes following TORS resection. A search of the PubMed, SCOPUS, and EMBASE databases was conducted to identify studies describing patients undergoing reconstruction of TORS defects. Twenty-six studies met inclusion criteria, consisting of 260 patients who underwent TORS resection followed by reconstruction. Twenty-one studies reported tumor classification information, with TORS performed for 44 (23.0%) T1, 86 (45.0%) T2, 33 (17.3%) T3, and 28 (14.7%) T4 tumors. Eighteen distinct reconstructive modalities were described in the studies identified, including nine unique free flap types. The most commonly performed reconstruction was the radial forearm free flap (RFFF), accounting for 121/260 (46.5%) of reconstructions performed. Reported surgical complications included 5 pharyngocutaneous fistulae, 13 hemorrhagic complications, 24 infectious complications, and 5 free flap failures . Our findings demonstrate favorable surgical outcomes but minimal quantitative functional data to compare reconstructive options following TORS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Discriminant Ability of the Eating Assessment Tool‐10 to Detect Swallowing Safety and Efficiency Impairments

xlomafota13 shared this article with you from Inoreader Discriminant Ability of the Eating Assessment Tool‐10 to Detect Swallowing Safety and Efficiency Impairments Via The Laryngoscope Objectives/Hypothesis Quick, sensitive dysphagia screening tools are necessary to identify high-risk patients for further evaluation in busy multidisciplinary amyotrophic lateral sclerosis (ALS) clinics. We examined the relationship between self-perceived dysphagia using the validated Eating Assessment Tool-10 (EAT-10) and videofluoroscopic analysis of swallowing safety and efficiency. Study Design Prospective, observational, longitudinal study. Methods Individuals with ALS completed the EAT-10 and a videofluoroscopic swallowing study. Duplicate, independent, blinded analyses of the validated Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale were performed to index swallowing safety and efficiency (mild dysphagia: DIGEST ≥ 1, moderate dysphagia: DIGEST ≥ 2). A between-groups analysis of variance with Games-Howell test for post-hoc pairwise comparisons was performed to examine EAT-10 scores across dysphagia severity levels. Receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive–negative predictive values (PPV, NPV), and odds ratios (OR) were derived. Results Four hundred and thirty five paired EAT-10 and DIGEST scores were analyzed. Mean EAT-10 score was 8.48 (95% confidence interval [CI]: 7.63–9.33). Individuals with dysphagia demonstrated higher EAT-10 scores (mild: 4.1 vs. 11.3, moderate: 6.0 vs. 17.5, P < .001). Mean EAT-10 scores increased across DIGEST levels (D0: 4.1, D1: 7.9, D2: 15.1, D3: 20.4, D4: 39.0). For mild dysphagia, an EAT-10 cut score of 3 was optimal: AUC 0.74 (95% CI: 0.69–0.78; sensitivity: 77%; specificity: 53%; PPV: 71%; NPV: 60%; OR: 3.5). An EAT-10 cut score of 7 optimized detection of moderate dysphagia: AUC 0.83 (95% CI: 0.78–0.87; sensitivity: 81%; specificity: 66%; PPV: 39%; NPV: 93%; OR: 8.1). Conclusion The EAT-10 is an easy-to-administer dysphagia screening tool with good discriminant ability for use in ALS clinics. Level of Evidence 2 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of cosmetic surgery on mental self-image and life satisfaction in women undergoing breast augmentation: An intermediate role of evaluating the surgery as one of the most important life events

xlomafota13 shared this article with you from Inoreader The effect of cosmetic surgery on mental self-image and life satisfaction in women undergoing breast augmentation: An intermediate role of evaluating the surgery as one of the most important life events Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 21:S1748-6815(22)00033-X. doi: 10.1016/j.bjps.2022.01.018. Online ahead of print. ABSTRACT AIM: To estimate changes in self-perception and satisfaction in women undegoing breast augmentation surgery (BAS). METHODS: Using a quasi-experimental questionnaire study design, we enrolled a cohort of BAS women treated at a private clinic during a 5-year interval. The primary predictor variable was treatment (before/after). The main outcome variables included effect of considering breast augmentation as one of the most important life events on self-image (BAOMILE), and subjective evaluation of physical appearance and life satisfaction. Other study variables were demographic data. The Mann-Whitney and the Wilcoxon signed-rank tests were used to compare the outcomes between before and after the surgery. The Spearman rank correlation and the Pearson chi-squared test were computed to analyze the relatio nships among variables. RESULTS: The sample consisted of 53 subjects (52.3% married; 40.9% from medium-sized towns) with a mean age of 33.2 ± 6.4 years (range, 21-46). Life satisfaction was significantly increased after BAS in the whole cohort (preop., 7.83 vs. postop., 8.42; P = .003; 95% CI, -0.95 to -0.22) as well as in the BAOMILE subgroup (preop., 7.87 vs. postop., 8.56; P = .011; 95% CI, -1.20 to -0.17). Within the BAOMILE subgroup, there was a positive correlation between the appearance assessment and the number of positive traits before surgery (ρ = 0.63; P = .002; 95% CI, 0.27-0.83) and life satisfaction after surgery (ρ = 0.480; P = .03; 95% CI, 0.06-0.74). CONCLUSIONS: The results of this study suggest that BAS improves self-perception and life satisfaction of the patients. The psychologist's role in understating patient's motivation for cosmetic surgery and the revision of their attitudes towards expected effects require further investigations. PMID: 35140045 | DOI:10.1016/j.bjps.2022.01.018 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.