Microbiome profiling of uncinate tissue and nasal polyps in patients with chronic rhinosinusitis using swab and tissue biopsy

xlomafota13 shared this article with you from Inoreader Microbiome profiling of uncinate tissue and nasal polyps in patients with chronic rhinosinusitis using swab and tissue biopsy Via Nasal diseases by Sung-Woo Cho, Dong-Young Kim, Sungmi Choi, Sungho Won, Hye-Ryun Kang, Hana Yi Chronic rhinosinusitis (CRS) is characterized according to the presence or absence of nasal polyps (NPs) and displays nasal microbiota dysbiosis. However, optimal sampling methods of the nasal microbiome in CRS have not been identified. We aimed to assess the microbial composition in patients with CRS, comparing different sampling methods (swab and tissue biopsy), tissue types (uncinate tissue and NP), and disease subtypes. Samples were obtained by swabbing the middle meatus and taking a biopsy of uncinate tissue (UT) in patients with CRS with (CRSwNP, N = 8) or without NP (CRSsNP, N = 6) and controls (N = 8). NPs were also harvested in CRSwNP. DNAs were extracted from fifty-two samples and analyzed by 16S rRNA gene amplicon sequencing. As a result, a great interpersonal variance was observed in nasal swabs, while UT samples presented distinct microbiome with low inter-personal differences. Moreover, the UT microbiomes were further differentiated into three clusters which are associa ted with disease status (control, CRSsNP, and CRSwNP). Compared to UT, NP revealed a unique microbiome profile with significantly less bacterial diversity. Prevotella was the genus whose abundance was negatively correlated with disease severity in NP. In conclusion, tissue samples are better specimens than nasal swabs for assessing the microbiomes of CRS patients. Several bacteria in UT and NP tissues revealed an association with clinical severity of CRSwNP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spheno-Orbital Meningioma with Cavernous Sinus Extension

xlomafota13 shared this article with you from Inoreader Spheno-Orbital Meningioma with Cavernous Sinus Extension Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725942 We present a case of a 37-year-old female, with progressive left eye proptosis and an extensive ipsilateral en plaque spheno-orbital meningioma, with diffuse involvement of the lateral wall of the cavernous sinus and the orbit.A cranio-orbital zygomatic approach was performed to reach all extension of the lesion. We made an extradural clinoidectomy and an extensive bone removal of the orbit, exposition of the superior and lateral walls of the cavernous sinus, unroofing of the optic canal, superior orbital fissure, foramen rotundum, and foramen ovale. We performed the peeling of the lateral wall of cavernous sinus with total removal and preservation of the cranial nerv es anatomy and function.In this video, we illustrate the importance of the first time aggressive removal of such tumors. We also demonstrate the concept that secondary invasion of the cavernous sinus are suitable for removal with cranial nerve preservation.The link to the video can be found at https://youtu.be/GJmkqVa6jSs. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  | &nb sp;open access Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endolymphatic Sac Tumor Screening and Diagnosis in von Hippel-Lindau Disease: A Consensus Statement

xlomafota13 shared this article with you from Inoreader Endolymphatic Sac Tumor Screening and Diagnosis in von Hippel-Lindau Disease: A Consensus Statement Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725033 Objective Endolymphatic sac tumors (ELSTs) are a frequent cause of hearing loss and other audiovestibular dysfunction in patients with von Hippel-Lindau disease (VHL). Unified screening recommendations for VHL patients have not been established. To develop consensus guidelines, the VHL Alliance formed an expert committee to define evidence-based clinical screening recommendations. Patients and Methods Recommendations were formulated by using the Grading of Recommendations, Assessment, Development, and Evaluation framework after a comprehensive literature review. Results Diagnosis of ELSTs in VHL requires a combination of clinical evaluation and imaging and audiometric findings. Audiovestibular signs/symptoms are often an early feature of small ELSTs, including those that are not visible on imaging. Diagnostic audiograms have the greatest sensitivity for the detection of ELST-associated sensorineural hearing loss and can help confirm clinically relevant lesions, including those that may not be radiographically evident. Magnetic resonance imaging (MRI) can be a more specific test for ELSTs in VHL particularly when supplemented with computed tomography imaging for the identification of small tumors. VHL patients between the ages 10 and 60 years carry high preponderance for ELST presentation. Conclusion We recommend that clinical evaluation (yearly) and diagnostic audiograms (every other year) be the primary screening tools for ELSTs in VHL. We suggest that screening be performed between the ages 11 and 65 years or with the onset of audiovestibular signs/symptoms for synchronicity with other testing regimens in VHL. We recommend that baseline imaging (MRI of the internal auditory canals) can be performed between the ages of 15 and 20 years or after positive screening. [...] 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.

Combined Transcavernous and Kawase's Approach for Gross Total Resection of a Cavernous Sinus Meningioma

xlomafota13 shared this article with you from Inoreader Combined Transcavernous and Kawase's Approach for Gross Total Resection of a Cavernous Sinus Meningioma Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725025 Microsurgery of cavernous sinus (CS) lesions is generally considered to be associated with a high rate of morbidity and cranial nerve deficits. The success for surgical removal of CS meningiomas is debatable and achieving a good functional outcome with preservation of the cranial nerves is the goal. Surgery of these lesions is challenging, recurrence rates are high, and therapeutic strategies remain controversial. In this video, we present a case of a CS meningioma that extended to Meckel's cave and the posterior fossa in a 46-year-old woman with history of a left-sided cerebellopontine angle World Health Organization (WHO) grade-I meningioma with extension to the lef t CS. Seven years ago, she had a microsurgical resection of a Cerebellopontine angle (CPA) meningioma. She later received radiotherapy for the slowly growing meningioma of the posterior CS. The patient presented with newly onset headache and facial pain. Magnetic resonance imaging (MRI) showed a meningioma of the left CS and Meckel's cave extending into the ambient cistern, with a mild mass effect on the pons, and a size increase compared with prior imaging. Since this area previously received radiotherapy, and the patient was symptomatic from trigeminal compression, the decision was made to proceed with surgical resection of the tumor via combined transcavernous and anterior petrosectomy. Postoperatively, the patient woke up with the same neurological status. MRI confirmed gross total resection of the tumor. The histopathology was a WHO grade-II chordoid meningioma. The patient is currently receiving radiotherapy. This video demonstrates the surgical approach and the resection step s of this pathology.The link to the video can be found at: https://youtu.be/HrU1VOzUGWU. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pretemporal Transcavernous Approach for Resection of an Orbito-Cavernous Oculomotor Schwannoma

xlomafota13 shared this article with you from Inoreader Pretemporal Transcavernous Approach for Resection of an Orbito-Cavernous Oculomotor Schwannoma Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1724116 The following operative video demonstrates surgical tenets and nuances of the pretemporal transcavernous approach in an unusual case of a 33-year-old patient suffering new onset diplopia and a third nerve palsy due to an orbito-cavernous oculomotor schwannoma. Near total resection was accomplished through an extended pterional craniotomy with pretemporal transcavernous exposure of her lesion, resulting in resolution of her preoperative oculomotor palsy and visual dysfunction. When combined with extended pterional and modified frontotemporal orbitozygomatic approaches, the pretemporal transcavernous approach provides excellent surgical access to the parasellar region i ncluding the superior orbital fissure and cavernous sinus. Meticulous dissection and early identification of tissue planes, including cranial nerve and vascular anatomy, allows for safe removal of tumors arising in this region.The link to the video can be found at: https://youtu.be/EuIRTP7wWBQ. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clip Reconstruction of a Previously Leaked Large Complex Posterior Communicating Segment Aneurysm with Extradural Anterior Clinoidectomy

xlomafota13 shared this article with you from Inoreader Clip Reconstruction of a Previously Leaked Large Complex Posterior Communicating Segment Aneurysm with Extradural Anterior Clinoidectomy Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1726425 Fusiform or near-fusiform aneurysms that involve the long segment of the supraclinoid internal carotid artery (ICA) pose significant challenges to neurovascular surgeons. Involvement of the origin of vital branching arteries in this segment may preclude safe treatment with flow diverting stents. In addition, clip reconstruction may also not be possible in this region due to entire or near-entire involvement of the circumference of the ICA (Fig. 1). In this video article, we present a case of a complex and previously leaked, (visualized with hemosiderin) aneurysm of the posterior communicating segment of the ICA, in a 60-year-old female. Multiple complexities made this aneurysm challenging to treat. These included (1) a 270-degree encirclement of the ICA with multiple lobulations that left only a small section of nondiseased vessel wall, (2) a relatively short segment of the supraclinoidal ICA that made proximal control challenging thus requiring an extradural anterior clinoidectomy, (3) a fetal posterior communicating artery that originated immediately proximal to the beginning of the aneurysm, and lastly, (4) an anterior choroidal artery that was firmly adherent over the aneurysm dome. In this video, we present the microsurgical steps for dealing with this complex aneurysm, including extradural clinoidectomy and clip reconstruction (Fig. 2). Postoperatively, the patient woke up without any deficits. Angiography showed complete obliteration of the aneurysm.The link to the video can be found at: https://youtu.be/C3Vc0maWChc. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Man With Fever and Groin Mass

xloma.fota.13 shared this article with you from Inoreader Man With Fever and Groin Mass Via Annals of Emergency Medicine A 54-year-old man with a history of hypertension, hyperuricemia, and dyslipidemia presented to the emergency department (ED) with fever and a mass in the left side of the groin since 3 days earlier. One month before presenting to the ED, he received a diagnosis of a urinary tract infection and was treated with oral antibiotics. On arrival in the ED, he was well oriented and had a temperature of 38.1°C and 100.58 °F. Physical examination revealed a firm, tender, longitudinal mass over the left side of the groin (Figure 1). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High prevalence of methotrexate use in patients with Epstein–Barr virus-positive mucocutaneous ulcer may cause confounding bias

xloma.fota.13 shared this article with you from Inoreader High prevalence of methotrexate use in patients with Epstein–Barr virus-positive mucocutaneous ulcer may cause confounding bias Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 23 March 2021; doi:10.1038/s41379-021-00798-7 High prevalence of methotrexate use in patients with Epstein–Barr virus-positive mucocutaneous ulcer may cause confounding bias View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inflammatory rhabdomyoblastic tumor with progression to high-grade rhabdomyosarcoma

xloma.fota.13 shared this article with you from Inoreader Inflammatory rhabdomyoblastic tumor with progression to high-grade rhabdomyosarcoma Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 23 March 2021; doi:10.1038/s41379-021-00791-0 Inflammatory rhabdomyoblastic tumor with progression to high-grade rhabdomyosarcoma View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Toward a unifying entity that encompasses most, but perhaps not all, inflammatory leiomyosarcomas and histiocyte-rich rhabdomyoblastic tumors

xloma.fota.13 shared this article with you from Inoreader Toward a unifying entity that encompasses most, but perhaps not all, inflammatory leiomyosarcomas and histiocyte-rich rhabdomyoblastic tumors Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 24 March 2021; doi:10.1038/s41379-021-00797-8 Toward a unifying entity that encompasses most, but perhaps not all, inflammatory leiomyosarcomas and histiocyte-rich rhabdomyoblastic tumors View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

PDGFB RNA in situ hybridization for the diagnosis of dermatofibrosarcoma protuberans

xloma.fota.13 shared this article with you from Inoreader <i>PDGFB</i> RNA in situ hybridization for the diagnosis of dermatofibrosarcoma protuberans Via Modern Pathology - AOP - nature.com science feeds Modern Pathology, Published online: 24 March 2021; doi:10.1038/s41379-021-00800-2 PDGFB RNA in situ hybridization for the diagnosis of dermatofibrosarcoma protuberans View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Cross-sectional Analysis of High-Acuity Professional Services Performed by Urban and Rural Emergency Care Physicians Across the United States

xloma.fota.13 shared this article with you from Inoreader A Cross-sectional Analysis of High-Acuity Professional Services Performed by Urban and Rural Emergency Care Physicians Across the United States Via Annals of Emergency Medicine We seek to examine differences in the provision of high-acuity professional services between rural and urban physicians receiving reimbursement for emergency care evaluation and management services from Medicare fee-for-service Part B. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.