MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis

xlomafota13 shared this article with you from Inoreader MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis in Covid‐19 era Via Clinical Otolaryngology Abstract Objectives Acute invasive fungal sinusitis AIFS has high mortality rate, and its incidence has increased without explanation in Covid-19 era. Proper diagnosis and effective surgical debridement have a crucial role in decreasing this high mortality rate. MRI could detect early ischemic changes with localization of extrasinus devitalized fungal inflamed tissue to guide surgical intervention. Study design Prospective study Setting ORL-HNS department -Zagazig University. Methods T1 with gadolinium and T2 fat suppression sequences were investigated and correlated with surgical findings in cases recently recovered from Covid-19 "seroconversion". Loss of contrast enhancement LOCE/black sign in T1+G was hypothesized to reflect necrotic areas while hyperintense signal/white sign in T2 fat suppression was hypothesized to correlate with severely inflamed devitalized tissue in periantral region These radiological findings were correlated with intraoperative findings to identify positive predictive finding. Results 40 patients were included in this study, of which 38 had LOCE/ black sign in T1+G 95%. True ischemic turbinate was detected only in 35 cases (positive predictable value PPV= 92.1%). Hyperintense signal/ white sign in T2 fat suppression was detected in orbit, pterygopalatine-infratemporal fossa, sphenoid process, zygoma, external skin, and these findings were correlated with intraoperative findings (PPV ranging from 72.7% to 100%). Conclusion MRI has a crucial role in localization of devitalized tissue, and subsequently guides surgical intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction

xlomafota13 shared this article with you from Inoreader Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction 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 Dec 26. doi: 10.1007/s00405-021-07214-5. Online ahead of print. ABSTRACT PURPOSE: Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4-6 years later. METHODS: Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2-4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4-6 years, both groups were re-assessed with a questionnaire. RESULTS: We identified 116 eligible patients from the EILO-register. Response rates after 4-6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group (P = 0.003). After 2-4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7-0.3; P < 0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4-6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants. CONCLUSION: Self-reported EILO symptoms had improved after 4-6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follo w-up should be offered. PMID:34954812 | DOI:10.1007/s00405-021-07214-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Priority setting in breast reconstructive surgery: A DELPHI consensus

xlomafota13 shared this article with you from Inoreader Priority setting in breast reconstructive surgery: A DELPHI consensus Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00613-6. doi: 10.1016/j.bjps.2021.11.068. Online ahead of print. ABSTRACT OBJECTIVES: Breast reconstructive surgery is often performed following breast cancer treatment to restore the natural appearance of the breast. Despite various research performed in this field, there is a discrepancy between the research question that is considered crucial jointly by patients, carers and healthcare professionals and the research performed. The Breast Reconstruction Priority Setting Partnership was formed to determine the top research priorities in all aspects of breast reconstructive surgery. METHODS: The Priority Setting Partnership (PSP) was conducted in line with James Lind Alliance (JLA) principles involving patients and clinicians. An online survey was conducted to gather uncertainties related to breast reconstruction by involving patients, carers and clinicians. Following this, a modified Delphi consensus process was performed to identify the top 10 research priorities. RESULT: A total of 239 unique research uncertainties were identified via the online survey, which involved 100 participants. A review of literature established that 58 of these uncertainties did not have a high-quality systematic review, prompting the need for more in-depth research. A further 28 research uncertainties were obtained by performing a literature search. Of the final 86 unique questions, the Delphi panel achieved consensus on the top ten research priorities. Recommendations to address these research priorities have been put forward based on current evidence. CONCLUSION: This study involved patients, carers and healthcare professionals to establish the top 10 priority areas for research in breast reconstructive surgery. Recommendations have been put forward on the necessary future research that is required to address these uncertainties. PMID:34955391 | DOI:10.1016/j.bjps.2021.11.068 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The baseline neutrophil lymphocyte ratio predicts survival in soft-tissue sarcoma: A 17-year cohort study

xlomafota13 shared this article with you from Inoreader The baseline neutrophil lymphocyte ratio predicts survival in soft-tissue sarcoma: A 17-year cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 27:S1748-6815(21)00606-9. doi: 10.1016/j.bjps.2021.11.063. Online ahead of print. ABSTRACT BACKGROUND: Abnormal ratios of peripheral blood cells, e.g. neutrophil-lymphocyte ratio (NLR), are strongly associated with poor outcomes in numerous cancers. In soft-tissue sarcoma (STS), the NLR has been studied in populations outside the UK although many have major methodological flaws, which represents the rationale for this study. METHODS: Over 17 years old (2002-2019) adults with extremity STS were included. The baseline NLR (at the time of diagnosis) was calculated. The association between NLR, disease recurrence and survival was explored using cubic splines and a threshold of 3 selected, which is in keeping with the literature. Multivariable Cox regression was used to estimate overall survival, disease-free survival and recurrence with Hazard Ratios (HR) and 95% confidence intervals (CI). < p>RESULTS: Overall, 401 patients were included. The median follow-up was 3 years 8 months (interquartile range 1 years 7 months to 5 years 2 months). During surveillance 148 died (37%), of which 123 (76%) were attributable to sarcoma. At the time of diagnosis, an NLR≥3 was independently associated with worse overall survival (adjusted HR 1.44 [95% 1.01, 2.03]). However, the baseline NLR was not associated with the risk of recurrence (adjusted HR 0.98 [95% CI 0.62, 1.57]) or disease-free survival (adjusted HR 1.11 [95% CI 0.79, 1.56]). CONCLUSIONS: At the time of diagnosis of STS, the NLR is strongly associated with survival and may serve as a cheap and readily available biomarker to personalise treatment plans for patients. PMID:34955395 | DOI:10.1016/j.bjps.2021.11.063 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review

xlomafota13 shared this article with you from Inoreader Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 5:S1748-6815(21)00628-8. doi: 10.1016/j.bjps.2021.11.076. Online ahead of print. ABSTRACT BACKGROUND: Pain after amputation can be known as residual limb pain (RLP) or phantom limb pain (PLP); however, both can be disabling in daily life with reported incidences of 8% for finger amputations and up to 85% for major limb amputations. The current treatment is focused on reducing the pain after neuropathic pain occurs. However, surgical techniques to prevent neuropathic pain after amputation are available and effective, but they are underutilized. The purpose of the review is to investigate the effects of techniques during amputation to prevent neuropathic pain. METHODS: A systematic review was performed in multiple databases (Embase, Medline, Web of Science, Scopus, Cochrane, and Google Scholar) and following the PRISMA guidelines. Studies that reported surgical techniques to prevent neuropath ic pain during limb amputation were included. RESULTS: Of the 6188 selected studies, 13 eligible articles were selected. Five articles reported techniques for finger amputation: neurovascular island flap, centro-central union (CCU), and epineural ligatures, and flaps. For finger amputations, the use of prevention techniques resulted in a decrease of incidences from 8% to 0-3% with CCU being the most beneficial. For major limb amputations, the incidences for RLP were decreased to 0 to 55% with TMR and RPNI and compared to 64-91% for the control group. Eight articles reported techniques for amputations on major limbs: targeted muscle reinnervation (TMR), targeted nerve implantation, concomitant nerve coaptation, and regenerative peripheral nerve interface (RPNI). CONCLUSIONS: Based on the current literature, we state that during finger and major limb amputation, the techniques to prevent neuropathic pain and PLP should be performed. PMID:34955394 | DOI:10.1016/j.bjps.2021.11.076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic histologique et moléculaire des cancers de l'ovaire - recommandations pour la pratique clinique Saint-Paul 2021: Histological and molecular diagnosis of ovarian

xlomafota13 shared this article with you from Inoreader Diagnostic histologique et moléculaire des cancers de l'ovaire - recommandations pour la pratique clinique Saint-Paul 2021: Histological and molecular diagnosis of ovarian Via Association française pour l'étude du cancer Bull Cancer. 2021 Dec;108(9S1):S33-S38. doi: 10.1016/S0007-4551(21)00585-3. ABSTRACT Oncogenetic testing is now part of standard management in high grade ovarian cancer, including at least mutational status of BRCA1/BRCA2 genes. If necessary, tumor genetic testing is followed by constitutional testing to either confirm the constitutional origin of variants identified in BRCA1/2 genes or detect variants in other predisposition genes. The whole process including prescription of tumoral testing, retrieval of analysis report and communication of results must be formalized, as well as information on possible consequences of the results for the patient and her family. Tumor material must meet criteria of size and cellularity to allow high-quality analysis. These samples are processed during the preanalytical phase with two major steps : time of cold ischemia and fixation. Only pathogenic (Class V) and likely pathogenic (Class IV) variants sh own in tumor tissue are mentioned in the report. Currently, only BRCA1 and BRCA2 genes are routinely studied but, in the future, analysis will be extended to other genes involved in homologous recombination repair. In patients without BRCA mutation, other biomarkers reflecting sensitivity to PARP inhibitors, such as HRD scores (homologous recombination deficiency) that appeared recently, will have to be implemented in routine practice in order to better select patients for these treatments and choose optimal therapy. PMID:34955160 | DOI:10.1016/S0007-4551(21)00585-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ponatinib-induced eruptive nevi and melanocytic proliferation

xlomafota13 shared this article with you from Inoreader Ponatinib-induced eruptive nevi and melanocytic proliferation Via Melanoma Research - Current Issue Ponatinib, an oral third-generation tyrosine kinase inhibitor, is indicated for the treatment of imatinib-resistant leukemia. We experienced a case of ponatinib-induced eruptive nevi, and the biologic effects of ponatinib on melanocytes were investigated. Treatment with ponatinib significantly increased the proliferation of normal human melanocyte or melanoma cells through the upregulation of the extracellular signal-regulated kinase and protein kinase B signaling pathways. The downstream molecules of cyclin B1 and D1 were significantly increased in ponatinib-treated melanocytes. These results demonstrate the capacity of ponatinib to induce the proliferation and tumorigenesis of melanocytes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eruptive melanocytic nevi in a patient with amelanotic melanoma: a paraneoplastic phenomenon?

xlomafota13 shared this article with you from Inoreader Eruptive melanocytic nevi in a patient with amelanotic melanoma: a paraneoplastic phenomenon? Via Melanoma Research - Current Issue Eruptive melanocytic nevi (EMN) describes the sudden onset of cutaneous nevi over weeks or months. Such a clinical event is generally seen in young adult patients and may be related to several possible causes. We report here a case of EMN in an old male patient followed up for a thick amelanotic cutaneous melanoma. A few months after the eruption, multiple hepatic masses, diagnosed as melanoma metastasis, were detected. The presented case may suggest that EMN may be a paraneoplastic phenomenon of alert in patients being followed for melanoma or other malignancies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Downregulation of miR-485-3p promotes proliferation, migration and invasion in prostate cancer through activation of TGF-β signaling

xlomafota13 shared this article with you from Inoreader Downregulation of miR-485-3p promotes proliferation, migration and invasion in prostate cancer through activation of TGF-β signaling Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 27:18416. doi: 10.14670/HH-18-416. Online ahead of print. ABSTRACT BACKGROUND: Prostate cancer (PC) is the second leading cause of cancer-related death among men worldwide. Downregulation of miR-485-3p has been revealed to participate in the tumorigenesis and progression of many types of cancer. However, the clinical and biological role of miR-485-3p in PC remains largely unknown. METHODS: The expression of miR-485-3p was analyzed in the published databases and detected in our clinical samples and cell lines by RT-qPCR assay. CCK8, transwell invasion and migration, and colony formation assays were performed to investigate the biological function of miR-485-3p. Bioinformatical analysis, RIP, western blotting and luciferase reporter assays were carried out to explore the downstream mechanism of miR-485-3p. RESULTS: The level of miR-485-3p was downregulated in PC tissues, particularly in primary PC tissues with metastasis relative to normal prostate tissues. miR-485-3p downregulation was positively correlated with poor disease-free and overall survival in patients with PC. Functionally, miR-485-3p overexpression dramatically suppressed the proliferation, migration and invasion ability of PC cells in vitro. Mechanistically, miR-485-3p overexpression suppressed the activity of TGF-β signaling by targeting TGFBR2 to play tumor-suppressive roles in PC progression. CONCLUSION: Our study reports the miR-485-3p/TGFBR2/ TGF-β signaling axis in tumor development of PC, suggesting miR-485-3p may be a potential target to develop therapeutic strategies against PC. PMID:34958117 | DOI:10.14670/HH-18-416 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism

xlomafota13 shared this article with you from Inoreader An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.