Skin-sparing mastectomy and mastopexy: A safe 'one step' option with immediate DIEP flap and simultaneous Nipple areola complex reconstruction

xlomafota13 shared this article with you from Inoreader Skin-sparing mastectomy and mastopexy: A safe "one step" option with immediate DIEP flap and simultaneous Nipple areola complex reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 26:S1748-6815(22)00104-8. doi: 10.1016/j.bjps.2022.02.035. Online ahead of print. NO ABSTRACT PMID:35279420 | DOI:10.1016/j.bjps.2022.02.035 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Repair of postoperative and recurrent nasal septal perforations using L-strut overlay flap

xlomafota13 shared this article with you from Inoreader Repair of postoperative and recurrent nasal septal perforations using L-strut overlay flap 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 Mar 13. doi: 10.1007/s00405-022-07332-8. Online ahead of print. ABSTRACT BACKGROUND: Despite the many described techniques, surgical repair of iatrogenic nasal septal perforations is still challenging. The authors present a novel technique for endoscopic closure of postoperative and recurrent nasal septal perforations. METHOD: The technique is based on the elevation of a vascularized flap from the L-strut area and the creation of the bed site without dissection of the surrounding septum. Seven patients were operated using "L-strut overlay" flap from June 2018 to October 2020. All patients had their perforations closed 12 months after surgery. CONCLUSION: Early results of our surgical technique have proven its simplicity and high effectiveness. PMID:35279737 | DOI:10.1007/s00405-022-07332-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Closure of spontaneous cerebrospinal fluid leakage via fistula at the lateral wall of the sphenoid sinus using a bone pile

xlomafota13 shared this article with you from Inoreader Closure of spontaneous cerebrospinal fluid leakage via fistula at the lateral wall of the sphenoid sinus using a bone pile Via leak of cerebrospinal fluid Clin Case Rep. 2022 Mar 3;10(3):e05510. doi: 10.1002/ccr3.5510. eCollection 2022 Mar. ABSTRACT This report describes a case of spontaneous cerebrospinal fluid leak through a narrow canal-like fistula in the lateral wall of the sphenoid sinus, which was managed through rigid reconstruction. Rigid reconstruction of the skull base was performed by fitting a pile-shaped bone into the fistula like the pile-driving technique. PMID:35280093 | PMC:PMC8894578 | DOI:10.1002/ccr3.5510 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of systematic voice training combined with swallowing function exercises for the prevention of swallowing dysfunction in stroke patients: a retrospective study

xlomafota13 shared this article with you from Inoreader Efficacy of systematic voice training combined with swallowing function exercises for the prevention of swallowing dysfunction in stroke patients: a retrospective study Via swallowing exercises Ann Transl Med. 2022 Feb;10(4):195. doi: 10.21037/atm-22-101. ABSTRACT BACKGROUND: Stroke is a common clinical brain disease, and swallowing dysfunction is one of the most common complications in stroke patients. Despite multiple treatments for swallowing dysfunction, it often leads to a series of complications. Interventions such as systematic voice training and swallowing function exercises have emerged in recent years, but their effectiveness remains unclear. Therefore, this stu dy was conducted to investigate the effect of systematic voice training combined with swallowing function exercise for the prevention of swallowing dysfunction and improving the quality of life of stroke patients. METHODS: We retrospectively analyzed 90 stroke patients admitted to Baotou Central Hospital from October 2018 to October 2021 as study subjects, and divided the patients into a combined voice training group (n=45) and a single swallowing exercise group (n=45) according to the interventions. The single swallowing exercise group received routine swallowing function exercise, and the combined voice training group used systematic voice training combined with swallowing function exercise. The incidence of swallowing dysfunction, malnutrition, aspiration pneumonia, and exercise compliance rate were compared between the two groups, and the quality of life of the two groups was evaluated by the Generic Quality of Life Inventory 74 (GQOLI-74) before and after the intervention s, respectively. RESULTS: The incidence of swallowing dysfunction, aspiration pneumonia, and malnutrition were lower in the combined voice training group than in the single swallowing exercise group (P<0.05), and there was no statistically significant difference in the exercise compliance rate between the two groups. The combined voice training group had higher psychological dimensions, physical dimensions, social adaptation, and total quality of life scores than the single swallowing exercise group (all P<0.05). Compared with the conventional intervention group, the combined voice training group had higher patient satisfaction (P<0.05). CONCLUSIONS: Systematic voice training combined with swallowing function exercise can effectively prevent the occurrence of swallowing dysfunction and improve the quality of life of patients with stroke. PMID:35280372 | PMC:PMC8908138 | DOI:10.21037/atm-22-101 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018

xlomafota13 shared this article with you from Inoreader Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018 Via The Laryngoscope Objectives 1) To determine the prevalence polysomnogram (PSG) and continuous positive airway pressure (CPAP) therapy use in children who received adenotonsillectomy (AT) for sleep symptoms. 2) To identify health care disparities in these regards. Study Design Retrospective database analysis. Methods This study used data from Optum (Health Services Innovation Company) to identify 92,490 children who received AT for sleep symptoms between 2004 and 2018. Prevalence of preoperative PSG and postoperative PSG and CPAP were described. Clinical and demographic characteristics were compared between children who had preoperative PSG and those who did not. Characteristics of children with trisomy 21 (T21) were compared to assess PSG and CPAP use in a high-risk cohort. Predictive modeling was used to identify patient characteristics associated with postoperative PSG and CPAP use. Results Preoperative PSG was obtained in 5.5% of children overall and 33.2% of children with T21. Male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with preoperative PSG. Fewer than 3% of children received postoperative PSGs and approximately 3% went on to receive CPAP therapy postoperatively. Multiple logistic regression showed that age at surgery, male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with postoperative PSG and CPAP use. Conclusions and Relevance This study described the prevalence pre-AT PSG use and post-AT PSG and CPAP use for persistent symptoms and identified sleep health care disparities in these regards. These results show that increased, equitable access to PSG is needed in children, particularly in the workup and treatment persistent symptoms after AT. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Omaveloxolone attenuates squamous cell carcinoma growth and disease severity in an Epidermolysis Bullosa mouse model

xlomafota13 shared this article with you from Inoreader Omaveloxolone attenuates squamous cell carcinoma growth and disease severity in an Epidermolysis Bullosa mouse model Via Experimental Dermatology Abstract Patients with Epidermolysis Bullosa (EB) are susceptible to development of squamous cell carcinomas (SCC) at sites of chronic inflammation and fibrosis. While triterpenoids such as RTA 408 (Omaveloxolone) have been shown to reduce inflammation and inhibit tumor growth in various cancer models, the utility of this class of drugs in the treatment of SCC has not been investigated. Given the dual anti-inflammatory and anti-neoplastic properties of triterpenoids, we hypothesized RTA 408 would be an effective treatment for SCCs that arise in the chronic inflammatory setting in EB. We tested the effects of topical RTA 408 on a mouse model of non-Herlitz, junctional EB. RTA 408 significantly reduced phenotypic severity in the affected ears of Lamc2jeb mice. In cultures, RTA 408 reduced cell viability in EB-associated SCC cell lines and normal human epidermal keratinocytes. When administered in vivo, RTA 408 inhibited SCC tumor growth in mice without cutaneous or systemic tox icity. These results suggest that RTA 408 can be a promising new therapy to reduce inflammation and inhibit SCC growth in patients with EB. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Uveal melanoma metastatic at initial diagnosis: a case series

xlomafota13 shared this article with you from Inoreader Uveal melanoma metastatic at initial diagnosis: a case series Via Melanoma Research - Current Issue Detectable metastasis at the time of initial diagnosis of uveal melanoma (UM) is rare. The purpose of this investigation was to evaluate the characteristics and outcomes in patients with metastatic UM (MUM) at initial diagnosis. An institutional review board-approved retrospective case series analysis was performed in 21 patients that presented for management of MUM at initial diagnosis. Patient, tumor and treatment parameters were recorded, and ophthalmic symptoms, metastasis response and overall survival were assessed. Among 21 patients, median tumor diameter was 18 mm (range, 9.1–35 mm), with 76% classified as a Collaborative Ocular Melanoma Study (COMS) large size. Sites of metastasis included liver (95%), bone (29%) and lung (29%), among others, and were confirmed by biopsy in 95% of patients studied. Symptomatic primary tumors were present in 81%, causing pain (24%) or vision loss (57%). Primary tumor therapy (PTT) was provided upfront for 52% of patients with enucleation (24%) and brachytherapy (29%). Eye pain developed 3–6 months after diagnosis in four of 10 patients who did not receive upfront PTT, whereas it did not occur in any of the 11 patients who received upfront PTT (P = 0.04). PTT palliated pain in all cases. The median overall survival was 11.9 months (range, 2.5–21.1 months). Patients presenting with MUM at initial diagnosis have high-risk tumors and experience survival like patients who develop metastases metachronously. PTT is not associated with survival but may mitigate ophthalmic symptoms, especially in patients with large tumors at risk for causing symptoms. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tumor mutational burden and somatic mutation status to predict disease recurrence in advanced melanoma

xlomafota13 shared this article with you from Inoreader Tumor mutational burden and somatic mutation status to predict disease recurrence in advanced melanoma Via Melanoma Research - Current Issue Tumor mutational burden (TMB) has recently been identified as a biomarker of response to immune checkpoint inhibitors in many cancers, including melanoma. Co-assessment of TMB with inflammatory markers and genetic mutations may better predict disease outcomes. The goal of this study was to evaluate the potential for TMB and somatic mutations in combination to predict the recurrence of disease in advanced melanoma. A retrospective review of 85 patients with stage III or IV melanoma whose tumors were analyzed by next-generation sequencing was conducted. Fisher's exact test was used to assess differences in TMB category by somatic mutation status as well as recurrence locations. Kaplan–Meier estimates and Cox-proportional regression model were used for survival analyses. The most frequently detected mutations were TERT (32.9%), CDKN2A (28.2%), KMT2 (25.9%), BRAF V600E (24.7%), and NRAS (24.7%). Patients with TMB-L + BRAFWT status were more likely to have a recurrence [hazard ratio (HR), 3.43; confidence interval (CI), 1.29–9.15; P = 0.01] compared to TMB-H + BRAF WT. Patients with TMB-L + NRASmut were more likely to have a recurrence (HR, 5.29; 95% CI, 1.44–19.45; P = 0.01) compared to TMB-H + NRAS WT. TMB-L tumors were associated with local (P = 0.029) and in-transit (P = 0.004) recurrences. Analysis of TMB alone may be insufficient in understanding the relationship between melanoma's molecular profile and the body's immune system. Classification into BRAFmut, NRASmut, and tumor mutational load groups may aid in identifying patients who are more likely to have disease recurrence in advance d melanoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proof-of-concept of a new FFP2 mask adapted to Otolaryngological practice in pandemic: a prospective study

xlomafota13 shared this article with you from Inoreader Proof-of-concept of a new FFP2 mask adapted to Otolaryngological practice in pandemic: a prospective 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. 2022 Mar 14. doi: 10.1007/s00405-022-07319-5. Online ahead of print. ABSTRACT OBJECTIVE: The objective of this study was to appreciate the tolerance and convenience of a new FFP2 mask allowed the realization of nasal examination in period of pandemic. METHODS: Fifty-one patients were prospectively recruited from two European hospitals to test the FFP2 mask prototype. The following outcomes were evaluated in patients after the clinical examination: fear about coronavirus disease 2019 (COVID-19) infection; easiness of mask placement; tolerability; reassurance; and overall satisfaction about the use of this kind of mask in a pandemic context. Seven otolaryngologists evaluated the mask acceptance and usefulness in patients through a standardized physician-reported outcome questionnaire. RESULTS: Fifty patients completed the evaluation. There were 25 males and 25 females. The mean age of patients was 4 1 years. Ninety percent of patients considered that the use of the mask reduced the risk to be infected during the examination. Seventy percent of patients reported high or very high satisfaction and should recommend mask to other patients in pandemic period. The realization of nasal examination was easier with optic compared with flexible trans-nasal examination (p = 0.001), which significantly impacted the satisfaction level of physician (p = 0.001). The physician difficulty to perform the examination significantly impacted the satisfactory of patient (p = 0.033). CONCLUSION: The new bioserenity FFP2 mask allows the realization of the trans-nasal endoscopic examination during a pandemic. The use of this mask requires little training period of physician. The use of this mask prototype is well received by patients who reported better perception of self-protection against the virus. PMID:35286440 | DOI:10.1007/s00405-022-07319-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosis and correction of the obstructive sleep apnea syndrome in children with tonsillar ring pathological conditions

xlomafota13 shared this article with you from Inoreader Diagnosis and correction of the obstructive sleep apnea syndrome in children with tonsillar ring pathological conditions Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):4-8. doi: 10.17116/otorino2022870114. ABSTRACT To summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders. The effectiveness of adenotomy, adenotonsillotomy and/or adenotonsillectomy in children is demonstrated, depending on the severity of obstructive sleep apnea syndrome. Evaluation of breathing in sleeping children by polygraphic methods is necessary for early detection of obstructive sleep apnea syndrome and monitoring the effectiveness of surgical treatment. PMID:35274885 | DOI:10.17116/otorino2022870114 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing loss due to mutations in the genes responsible for Usher syndrome

xlomafota13 shared this article with you from Inoreader Hearing loss due to mutations in the genes responsible for Usher syndrome Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):52-59. doi: 10.17116/otorino20228701152. ABSTRACT Usher syndrome is characterized by congenital bilateral sensorineural hearing loss and progressive retinitis pigmentosa, and has an autosomal recessive type of inheritance. The purpose of this work is to summarize the modern data of a clinical picture of Usher syndrome and analyse hearing impairment properties. The frequency of the syndrome among children suffering from hearing loss and deafness is from 3 to 10%. The prevalence of the syndrome in the world is estimated as 4.4 per 100.000 population. The complexity of the diagnosis of the syndrome lies in the significant clinical and genetic heterogeneity. Hearing and vision problems begin at different ages. Primary diagnosis begins with the clinical diagnosis of bilateral hearing loss and visual impairment manifests later. In this case the initial diagnosis of nonsyndromal hearing loss will not be defin itive. Molecular genetic studies contribute to the early clinical diagnosis of the syndrome. Understanding the cause of the disease allows to conduct correct medical and genetic counseling and get closer to solving treatment problems. PMID:35274893 | DOI:10.17116/otorino20228701152 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.