Free and total vitamin d in psoriatic patients treated with biological drugs

xlomafota13 shared this article with you from Inoreader Free and total vitamin d in psoriatic patients treated with biological drugs Via Experimental Dermatology Abstract Data regarding the association between psoriasis and vitamin D levels are controversial [S1‐S2], maybe due to the choice of dosing serum total 25(OH)D in order to assess the vitamin D nutritional state both at its basal levels and after supplementation [S3‐S4]. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Uvula Manipulation and Resonance (UMAR) Treatment for Puberphonia

xlomafota13 shared this article with you from Inoreader Uvula Manipulation and Resonance (UMAR) Treatment for Puberphonia Via Otolaryngology Indian Abstract Otolaryngologists and speech therapist can be experts in managing specific puberphonia lesions to improve voice. However, not all voice problems have lesions amenable to surgical or medical therapies. Many are associated with maladaptive speech behaviors. We may employ a variety of techniques to improve vocal quality and function in patients with and without structural or neurologic laryngeal pathology. There is an alarming increase in cases of puberphonia and it's after effects. Otolaryngologists can partner to manage a constellation of puberphonia voice problems with directed voice evaluation and therapy. We, in a small Otorhinolarygolist center in a small city, Chennai has registered and treated 600 cases of puberphonia. We are able to register the devastating problems of puberphonia. Regarding the treatment of puberphonia, in which laryngeal massage, outside the neck, is consistently highlighted as being an effective therapy technique for treating it. In ad dition, there have been several individual studies conducted to examine the effectiveness of laryngo pharyngeal manipulation inside the vocal tract, which also yielded positive results. A basic review of UMAR techniques and this partnership with yoga breathing trainers is presented which give almost immediate low pitch speech and give a good follow up. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Letter to Editor on “Changes in Acoustic Aspects of Voice Function in Children After Adenotonsillectomy”

xlomafota13 shared this article with you from Inoreader Letter to Editor on "Changes in Acoustic Aspects of Voice Function in Children After Adenotonsillectomy" Via Journal of Voice We read with great interest the article by Brkic et al on changes in Acoustic Aspects of Vocal Function in Children After Adenotonsillectomy.1 They have reported significant differences in the fundamental frequency, jitter, shimmer and harmonic noise ratio immediately after surgery.1 Of these the fundamental frequency was the earliest to return to normal in one month. This finding is used to allay the concerns of the parents regarding voice change. We commend the authors for sharing their valuable experience with voice change after adenotonsillectomy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The clinical anatomy of variations of the pectoralis minor

xlomafota13 shared this article with you from Inoreader The clinical anatomy of variations of the pectoralis minor Via radiol anat Surg Radiol Anat. 2021 Mar 9. doi: 10.1007/s00276-021-02703-y. Online ahead of print. ABSTRACT Shoulder pathology is a very common medical presentation and can be due to anatomical variations. Therefore, knowledge of variants is important for the clinician treating patients with such complaints so that misdiagnosis is minimized and iatrogenic injury prevented. A review of the literature was performed of the variant anatomy of the pectoralis minor muscle. The aim of this revi ew is to better inform clinicians who might treat patients with shoulder pathology so that if identified, variants of the pectoralis minor muscle are better appreciated. PMID:33687490 | DOI:10.1007/s00276-021-02703-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of clival bone growth on the localization of the abducens nerve at the petroclival region: a postmortem anatomical study

xlomafota13 shared this article with you from Inoreader Effect of clival bone growth on the localization of the abducens nerve at the petroclival region: a postmortem anatomical study Via radiol anat Surg Radiol Anat. 2021 Mar 9. doi: 10.1007/s00276-021-02691-z. Online ahead of print. ABSTRACT PURPOSE: To investigate the effect of the clival bone pattern on the abducens nerve (AN) localization in the petroclival region between the Pediatric and Adult Groups. METHODS: This study used 12 pediatric and 17 adult heads obtained from the autopsy. The length and width of the clivus and the length of the petrosphenoidal ligaments (PSLs) were measured. The ratio of the leng th and width of the clivus was accepted as the clival index (CI). The localization of the AN at the petroclival region below the PSL, classified as lateral and medial, were recorded. RESULTS: The average length of the clivus was 26.92 ± 2.88 mm in the Pediatric Group, and 40.66 ± 4.17 mm in the Adult Group (p < 0.001). The average width of the clivus was 22.35 ± 2.88 mm in the Pediatric Group, and 29.96 ± 3.86 mm in the Adult Group (p < 0.001). The average value of the CI was 1.20 in the Pediatric Group and 1.36 in the Adult Group (p = 0.003). The length of the PSL was 7.0 ± 1.47 mm in the Pediatric Group and 11.05 ± 2.95 mm in the Adult Group (p < 0.001). The nerve was located below the medial side of the PSL in the Pediatric Group and below the lateral side in the Adult Group (p = 0.002). CONCLUSIONS: The petrous apex localization of the AN in adults compared with pediatric subjects could be related to the increased growth in the length of the clivus tha n its width. PMID:33687488 | DOI:10.1007/s00276-021-02691-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The practical examination types (spot test and slide test) of gross anatomy course in faculty of medicine: a simultaneous evaluation of the aspect of student success

xlomafota13 shared this article with you from Inoreader The practical examination types (spot test and slide test) of gross anatomy course in faculty of medicine: a simultaneous evaluation of the aspect of student success Via radiol anat Surg Radiol Anat. 2021 Mar 9. doi: 10.1007/s00276-021-02726-5. Online ahead of print. ABSTRACT PURPOSE: This study aimed to compare the students' scores of the spot (spotter/classical/traditional/tag/ring/bell-ringer) test (3D environment) performed in the laboratory with the slide test (gross anatomy images) (2D environment) in the class. The observation of our department regarding both types for practical examination was reported, in terms of exam marks of the students. Bo th are preferred as the practical examination types for gross anatomy course our in medical faculty. METHODS: The 29 blocks' scores in 5 years (2013/2014-2017/2018) belonging to first- and second-year medical students' spot tests and slide tests are evaluated retrospectively and statistically compared. Correlations of the spot tests and the slide tests, besides the correlations between theoretical examinations and the practical examination types, are calculated. RESULTS: Spot test scores were significantly higher (p < 0.05) in nine blocks, while slide test scores were higher significantly (p < 0.05) in fourteen. There was no statistically significant difference between the practical examination types (spot/slide) in six blocks. There were correlations between the spot test and the slide test in all blocks (p < 0.001). CONCLUSION: It is considered that the spot test reflects the success/ability in a 3D environment, while the slide test reflects it in the 2D environment. In conclusion, neither of these two types of examinations stands out absolutely. Both types of examinations have their own features in areas, such as assessment power, applicability, and effect on success. PMID:33687489 | DOI:10.1007/s00276-021-02726-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auditory and imaging markers of atypical enlarged vestibular aqueduct

xlomafota13 shared this article with you from Inoreader Auditory and imaging markers of atypical enlarged vestibular aqueduct 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 Mar 9. doi: 10.1007/s00405-021-06700-0. Online ahead of print. ABSTRACT PURPOSE: To characterize the auditory and imaging markers of atypical enlarged vestibular aqueduct (EVA). METHODS: 15 EVA cases (26 ears) confirmed via high-resolution MRI (HRMRI) that did not meet the Valvassori criterion on high-resolution CT (HRCT) were classified as atypical EVA. Another 21 EVA cases (40 ears) meeting the Valvassori criterion were randomly chosen as typical EVA. The hearing loss (HL), HRCT, and HRMRI findings were compared between the two groups. RESULTS: The difference of HL severity between atypical and typical EVA was not statistically significant (χ2 = 0.12, P > 0.05. The vestibular aqueducts (VA) of atypical EVA cases manifested as borderline dilation (n = 17), focal dilation (n = 3), and normal appearance (n = 6) on the HRCT. The midpoint width of atypical and typical EVA cases wa s 1.06 ± 0.18 mm and 2.10 ± 0.55 mm, respectively, exhibiting a significant difference (t = - 9.20, P < 0.05). In the HRMRI, the degree of dilation and shape of the intraosseous partition of endolymphatic duct and sac (ES) was similar to that of VA on HRCT, while their extraosseous ES was depicted variable slighter dilation compared to that of typical one, the difference between them was statistically significant (t = - 4.10, P < 0.05). CONCLUSION: The HL severity of atypical EVA ears was similar to that of typical ones. Nevertheless, borderline, focal dilation and normal-like appearance of VAs on HRCT and variablely slighter dilation of the extraosseous ES on HRMRI are its characteristic imaging findings. PMID:33687508 | DOI:10.1007/s00405-021-06700-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of antibiotics in the surgical management of paediatric obstructive sleep apnoea (OSA): a cohort study

xlomafota13 shared this article with you from Inoreader The role of antibiotics in the surgical management of paediatric obstructive sleep apnoea (OSA): a cohort 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 Mar 9. doi: 10.1007/s00405-021-06720-w. Online ahead of print. ABSTRACT PURPOSE: Obstructive sleep apnoea (OSA) describes an irregular night-time breathing pattern that is present in approximately 1.8% of children and can have a negative impact on quality of life. The use of antibiotics postoperatively is controversial. They are commonly prescribed; however, they can also be associated with side effects and resistance. This study explores the role of antibiotics in the post-operative management of children with OSA in a cohort of children. METHODS: We conducted a retrospective cohort study of children undergoing surgery for OSA or sleep disordered breathing (SDB) at a tertiary paediatric ENT referral centre from November 2018 to November 2019. RESULTS: This study identified 382 children who had undergone surgical treatment for OSA or sleep disordered breathing (SDB); 319 underwent adenotonsil lectomy, 53 adenoidectomy and 10 tonsillectomies. Antibiotics were given post-operatively to 158 (41%) patients and 18 (11%) of these patients presented to hospital with post-operative complications. A higher number of patients re-presented to hospital from the group who did not receive antibiotics (p = 0.982). Bleeding (p = 0.886) and infection (p = 0.823) were also more common in those children who did not receive antibiotics. CONCLUSION: Antibiotics led to fewer complications and re-presentations to hospital in children undergoing operative management of OSA; however, this trend was not found to be statistically significant. PMID:33687506 | DOI:10.1007/s00405-021-06720-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical high-resolution imaging and grading of endolymphatic hydrops in Hydropic Ear Disease at 1.5 T using the two-slice grading for vestibular endolymphatic hydrops in less than 10 min

xlomafota13 shared this article with you from Inoreader Clinical high-resolution imaging and grading of endolymphatic hydrops in Hydropic Ear Disease at 1.5 T using the two-slice grading for vestibular endolymphatic hydrops in less than 10 min 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 Mar 9. doi: 10.1007/s00405-021-06731-7. Online ahead of print. ABSTRACT BACKGROUND: Hydropic Ear Disease (Menière) is one of the most common inner ear disorders and one of the most common causes of vertigo attacks. The underlying pathology is a distension of the endolymphatic space of the inner ear, termed endolymphatic hydrops. However, the unequivocal morphologic confirmation of ELH has been restricted to post-mortem histologic analysis until 2007, when the first clinical MR imaging report demonstrated ELH in living patients with Menière's disease at 3 T combined with intratympanic application of contrast. Imaging techniques have since then evolved further. However, a high magnetic field strength of 3 T has consistently been mandatory for reliable clinical imaging of ELH. This limitation has significantly prevented ELH imaging from being widely available across different health care systems around th e world. With the aim of filling this gap, in the present study, we aim to describe the feasibility of ELH imaging at 1.5 T in clinical practice and to develop a dedicated grading system for cochlear and vestibular ELH for MR imaging at 1.5 T. METHODS: In this retrospective study, we examined 30 patients with suspected hydropic ear disease undergoing diagnostic MR imaging. Contrast agent was diluted eightfold in saline solution and unilaterally applied by intratympanic injection as described previously. MRI scanning was performed using a 16-channel head coil on a 1.5 T Achieva Philips Medical Systems Scanner using a 3D FLAIR sequence. For the cochlea, a 3-stage grading was developed. For the vestibulum, a 4-stage grading based on two axial slices was developed by analysing both the superior and the inferior part of the vestibulum. The presence of hydropic herniation of the endolymphatic space into the posterior crus of the horizontal semicircular canal was evaluated. RES ULTS: In all 30 patients, the perilymphatic fluid spaces of the inner ear showed clear and high signal intensity, while the endolymphatic space was not enhanced. In all patients, the vestibular endolymphatic space could be clearly delineated and differentiated from the perilymphatic space. Analysis of the cochlear endolymphatic space revealed no evidence of ELH in 7 patients, a grade 1 cochlear ELH in 11 patients and a grade 2 cochlear ELH in 12 patients. Analysis of the vestibular endoylmphatic space revealed no evidence of ELH in 8 patients, a grade 1 vestibular ELH in 5 patients, a grade 2 vestibular ELH in 9 patients and a grade 3 vestibular ELH in 8 patients. Three patients showed a clear hydropic herniation of the vestibular endolymphatic space into the posterior non-ampullated crus of the horizontal SCC. CONCLUSION: In summary, the findings presented in this study offer an easy, reliable and universally available technique of ELH imaging for diagnostic management of pat ients with suspected Hydropic Ear Disease. PMID:33687507 | DOI:10.1007/s00405-021-06731-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical and videofluoroscopic outcomes of laparoscopic treatment for sliding hiatal hernia and associated gastroesophageal reflux in brachycephalic dogs

xlomafota13 shared this article with you from Inoreader Clinical and videofluoroscopic outcomes of laparoscopic treatment for sliding hiatal hernia and associated gastroesophageal reflux in brachycephalic dogs Via swallowing exercises Vet Surg. 2021 Mar 9. doi: 10.1111/vsu.13622. Online ahead of print. ABSTRACT OBJECTIVE: To describe a laparoscopic technique for treatment of sliding hiatal hernia (SHH) and associated gastroesophageal reflux (GER) in brachycephalic dogs and document clinical and videofluoroscopic outcomes postoperatively. STUDY DESIGN: Prospective clinical trial. ANIMALS: Eighteen client-owned dogs. METHODS: A three-port laparoscopic approach was used. Intracorporeal suturing wa s used for hiatal plication and esophagopexy, and left-sided laparoscopic or laparoscopic-assisted gastropexy was performed. A standardized canine dysphagia assessment tool (CDAT) questionnaire was completed by owners pre- and postoperatively. Videofluoroscopic swallow studies (VFSS) were used to evaluate esophageal function, and impedance planimetry was used to assess lower esophageal sphincter geometry preoperatively and in a subset of dogs postoperatively. RESULTS: Median age was 27.5 (range 5-84) months. Conversion to open surgery was necessary in 1 (5.5%) of 18 dogs. Regurgitation after eating, and associated with activity/exercise, improved significantly when comparing pre- and postoperative CDAT assessments. Hiatal hernia and GER severity scores improved significantly between pre- and postoperative VFSS assessments, whereas SHH and GER frequency scores did not. One dog developed pneumothorax intraoperatively, underwent cardiopulmonary arrest, and died. Minor complicatio ns included splenic (n = 6) and hepatic lacerations (n = 3) that did not require specific therapy. CONCLUSION: A laparoscopic approach to treatment of SHH and GER led to improvements in clinical and VFSS indices in the majority of brachycephalic dogs. However, a subset of dogs still demonstrated some clinical signs postoperatively. CLINICAL RELEVANCE: In experienced hands, laparoscopic treatment of SHH and GER offers a minimally invasive alternative to open surgery. PMID:33687078 | DOI:10.1111/vsu.13622 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of Radiofrequency Technology in Endonasal Skull Base and Transcranial Procedures

xlomafota13 shared this article with you from Inoreader Use of Radiofrequency Technology in Endonasal Skull Base and Transcranial Procedures Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1721820 Objective Radiofrequency ablation is widely utilized in otorhinolaryngology. It is used for ablation, coagulation and resection, and hemostasis. It causes tissue destruction through a chemical interaction of ions. The potential benefit is to cause less thermal injury to surrounding tissues compared with other coagulative tools. In this article, we present novel uses of radiofrequency ablation in endoscopic endonasal, and transcranial surgery. This is the first study to describe its use in transcranial cases. Design, Setting, and Participants This is a retrospective study of patients between 2016 and 2018 who underwent either endoscopic endonasal or transcranial surgery where radiofrequency ablation was used. Main Outcome Measures We looked at indication for usage, blood loss, postoperative imaging to identify any stroke or edema, and clinical outcomes of these patients. Results The radiofrequency device was used in eight endoscopic endonasal cases and four craniotomies. Four cases were for encephalocele repair and eight were for various intracranial pathologies. In endonasal encephalocele repair, the radiofrequency ablation helped in shrinking the herniated brain while minimizing thermal injury to the surrounding tissue. In tumors resection, the combination of ablation and coagulation effect was particularly effective for highly vascularized tumors. There were no vascular or major neurologic injuries. Postoperative periencephalocele edema was noted in one case. Conclusion Initial experience with radiofrequency ablation showed that it was a safe technique to use in both endonasal skull-base and transcranial procedures. It seemed particularly useful for highly vascularized tumors but a greater experience is needed to further clarify its role in these procedures. [...] 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.