Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report

xlomafota13 shared this article with you from Inoreader Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report Via leak of cerebrospinal fluid J Pediatr Adolesc Gynecol. 2021 Nov 26:S1083-3188(21)00343-0. doi: 10.1016/j.jpag.2021.11.004. Online ahead of print. ABSTRACT BACKGROUND: Ventriculo-peritoneal shunt (VPS) is usually placed inside the peritoneal cavity for cerebrospinal fluid drainage. Rarely, it can migrate to various pelvic visceral organs. Inside the pelvis, the distal end of the shunt can perforate anywhere from the uterus or adnexa to the vulva and migration through the uterus is extremely rare. CASE: A three-and-a-half-year-old girl presented with CSF leak through the vagina following uterine perforation by VPS. The diagnosis was made with an ultrasound. Her symptoms resolved following revision surgery. CONCLUSION: In a patient with a VPS in situ, presenting with a watery fluid leak through vagina, perforation of fornix or uterus must always be kept in mind. Timely diagnosis and intervention can result in the prevention of complications. PMID:34843976 | DOI:10.1016/j.jpag.2021.11.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoperative cerebrospinal fluid leak graded by Esposito grade is a predictor for diabetes insipidus after endoscopic endonasal pituitary adenoma resection

xlomafota13 shared this article with you from Inoreader Intraoperative cerebrospinal fluid leak graded by Esposito grade is a predictor for diabetes insipidus after endoscopic endonasal pituitary adenoma resection Via leak of cerebrospinal fluid World Neurosurg. 2021 Nov 26:S1878-8750(21)01802-7. doi: 10.1016/j.wneu.2021.11.090. Online ahead of print. ABSTRACT BACKGROUND: Diabetes insipidus (DI) is a well-known complication of transsphenoidal surgery (TSS). However, the risk factors for DI remain controversial. METHODS: We conducted a retrospective study of the patients who underwent endoscopic TSS for pituitary adenoma at our institution during a 5-year period. The patients were divided into a DI group and a non-DI group. Logistic regression analyses were used to identify risk factors for postoperative DI. In subgroup analysis, the DI group was divided into transient-DI and permanent-DI groups and the perioperative factors were compared between groups. RESULTS: Among 101 patients, 58 patients were classified as non-DI (57.4%) and 43 patients as DI (42.6%) group. Permanent DI occurred in seven patients （6.9%）. In the univariate analyses, statistically significant risk factors were suprasellar extension, tumor functionality and intraoperative cerebrospinal fluid (CSF) leaks by Esposito grade. In the multivariate logistic regression analysis, Esposito grade was the only statistically significant risk factor (P=0.015). The frequency of DI increased as the Esposito grade increased (P=0.0002 for the trend). In subgroup analysis, postoperative nadir sodium concentration was lower in the permanent-DI group (128.1±2.78 mmol/L) than in the transient-DI group (135±1.22 mmol/L) (P=0.035) and the optimal cut-off value was 124.5 mmol/L, with a sensitivity of 57.1% and a specificity of 91.7% (Area Under the Curve=0.76, P=0.034). CONCLUSIONS: Intraoperative CSF leak by Esposito grade is associated with postoperative DI. These data can be applied to help identify high-risk patients who need more-aggressive follow-up and fluid management. PMID:34844009 | DOI:10.1016/j.wneu.2021.11.090 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comprehensive gene cluster analysis of head and neck squamous cell carcinoma TCGA RNA‐seq data defines B cell immunity‐related genes as a robust survival predictor

xlomafota13 shared this article with you from Inoreader Comprehensive gene cluster analysis of head and neck squamous cell carcinoma TCGA RNA‐seq data defines B cell immunity‐related genes as a robust survival predictor Via Head & Neck Abstract Background The authors aimed to define novel gene expression signatures that are associated with patients' survival with head and neck squamous cell carcinoma (HNSCC). Methods TCGA RNA-seq data were used for gene expression clusters extraction from 499 tumor samples by the "EPIG" method. Tumor samples were then partitioned into lower and higher than median level groups for survival relevant analysis by Kaplan–Meier estimator. Results We found that two gene clusters (_1, _2) are favorably, while two (_3, _4) are unfavorably, associated with patients' survival with HNSCC. Notably, most genes on the top lists of cluster_2 are associated with B cells. A gene expression signature with combined genes from cluster_2 and _4 was further determined to be associated with HNSCC survival rate. Conclusion Our work strongly supported a favorable role of B cells in patients' survival with HNSCC and identified a novel coexpressed gene signature as prognostic biomarker for patients' survival with HNSCC estimation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Geographic disparities in head and neck cancer survival

xlomafota13 shared this article with you from Inoreader Geographic disparities in head and neck cancer survival in Upstate New York 2011–2019 Via Head & Neck Abstract Purpose To examine the association between distance to care-center and urban–rural residence on 5-year overall survival (OS) from head and neck cancer (HNC). Materials and methods Five-year OS was retrospectively measured from date of initial diagnosis for patients with HNC treated at a single tertiary care center. Distances were calculated based on ZIP code of patient's residence and care center. Multilevel Weibull regression was used to adjust for confounders and identify disparities in 5-year all-cause mortality. Results A total of 670 patients included in study. Multivariable analysis revealed older age or late-stage cancer at diagnosis, and HPV negative status were associated with poorer OS. Patients residing in isolated small rural town (HR = 2.20, p = 0.015) or small rural town (HR = 2.07, p = 0.015) had lower OS. Distance to care center was not associated with OS (HR = 0.996, p = 0.11). Conclusions Greater rurality was associated with poorer OS among HNC patients in Upstate New York. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Achieving negative resection margins in oral cavity cancer with masticator space involvement—Is it feasible? An international collaborative study

xlomafota13 shared this article with you from Inoreader Achieving negative resection margins in oral cavity cancer with masticator space involvement—Is it feasible? An international collaborative study Via Head & Neck Abstract Background Masticator space involvement in oral cavity squamous cell carcinoma (OCSCC) is considered an unresectable disease. Nevertheless, achieving negative resection margins is feasible in limited masticatory space involvement. Materials and Methods A multi-institutional study on OCSCC patients with masticator space invasion who underwent surgical resection. Margin status was assessed according to anatomic tumor involvement of the inframandibular and supra-mandibular notch. Results One-hundred and thirty-two patients met the inclusion criteria. Then, 67 patients (50.8%) were diagnosed with a supra-notch tumor and 65 (49.2%) with an infra-notch disease. Negative margins were more common in the infra-notch group (43.3 vs. 23.1%, p = 0.014), and positive margins were more common in the supra-notch group (41.5 vs. 23.9%, p = 0.041). Multivariable analysis demonstrated that supra-notch tumors had an increased likelihood for involved resection margins (odds ratio = 2.46, p = 0.036). Conclusion OCSCC patients with masticator space involvement are prone for positive surgical margins in tumors extending above the supra-mandibular notch. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quercetin regulates inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells by promoting PVT1 expression

xlomafota13 shared this article with you from Inoreader Quercetin regulates inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells by promoting PVT1 expression Via histochem Acta Histochem. 2021 Nov 26;123(8):151819. doi: 10.1016/j.acthis.2021.151819. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the effect and potential mechanism of quercetin on inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells. MATERIALS AND METHODS: H9C2 cells were obtained from the Shanghai Institutes for Biological Sciences, Chinese Academy of Science, and randomly divided into six groups: control, model, PVT 1 overexpression (OV), quercetin, OV + quercetin, and NAC groups. The CCK-8 assay was performed to examine cell proliferation. Flow cytometry was used to examine cell apoptosis, cell membrane potential, and ROS levels. The expression of endothelial nitric oxide synthase (eNOS), malondialdehyde (MDA), and superoxide dismutase (SOD) was measured by ELISA and a Biochemical kit. Western blotting was used to determine the levels of p-DRP1 (s637), MFN2, NF-kB, p-NF-kB, IkB, and p-IkB. IL-6, IL-10, TNF-α, and IL-1β mRNA expression was examined by RT-PCR. Electron microscopy was used to observe the structure of mitochondria in H9C2 cells. RESULTS: MDA, p-NF-κB, p-IKB, IL-6, IL-1β, and TNF-α expression levels, and the cell apoptosis rate were significantly higher in the model group than in the control group (P < 0.05). In contrast, the cell proliferation rate and IL-10, SOD, eNOS, and ATP levels were significantly lower in the model group (P < 0.05). Moreover, MDA expression was significantly lower in the OV, quercetin, quercetin + OV, and NAC groups than in the model group (P < 0.05), while SOD, eNOS, and ATP levels were higher. The electron microscopy results showed that PVT1 overexpression or quercetin treatment could inhibit inflammation-induced mitochondrial fission and promote mitochondrial fusion. CONCLUSION: Quercetin promotes the proliferation of H9C2 cells, while inhibiting inflammation, oxidative stress, and cell apoptosis, and alleviating the structural and functional dysfunction of mitochondria. These effects are achieved by promoting PVT1 expression. PMID:34844154 | DOI:10.1016/j.acthis.2021.151819 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures

xlomafota13 shared this article with you from Inoreader Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 15:S1748-6815(21)00575-1. doi: 10.1016/j.bjps.2021.11.036. Online ahead of print. ABSTRACT BACKGROUND: Since the earliest use of microscopes in surgery, several modifications have been made to improve the ergonomics of movement and posture, increase the resolution, and expand the visual field. The three-dimensional microscopes are latest innovation in this field. Despite the wider use of 3D microscopes in other specialities, their use in the reconstructive microsurgery in the United Kingdom is still limited. Reconstructive microsurgeons are highly skilled surgeons that are trained to operate utilising the microscope for long hours. This poses an occupational risk with a specific pattern of work-related conditions. AIMS AND METHODS: We aim in this report to demonstrate our experience utilising 3D microscopes in small cohort of patients matched to a control of patients operated utilising the traditional microscopes. Patients were matched by age, comorbidities, oncologic procedures. This was complemented by a survey completed by the operating surgeons. RESULTS: Nine patients were included in each group. There was no significant difference in operative or ischemia time and no significant post-operative complications in both groups. The surgeons reported better ergonomics, improved staff engagement, and a better teaching experience when utilising the 3D microscopes compared to traditional microscopes. CONCLUSION: The utilisation of the 3D microscopes in reconstructive microsurgery has shown to provide comfort, improve ergonomics of movement and posture without significant clinical implications in this series. PMID:34844881 | DOI:10.1016/j.bjps.2021.11.036 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A study of the effects of delayed patient presentation on cutaneous SCC progression

xlomafota13 shared this article with you from Inoreader A study of the effects of delayed patient presentation on cutaneous SCC progression Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00455-1. doi: 10.1016/j.bjps.2021.09.015. Online ahead of print. ABSTRACT BACKGROUND: A cohort study of patients, who underwent cutaneous squamous cell carcinoma (SCC) excision, was undertaken to evaluate the effects of the COVID-19 pandemic on treatment times and histopathological features. METHODS: We identified all patients who had SCCs excised in October 2020 (pandemic group); the control group included all patients who underwent excision of SCCs during October 2019 (pre-pandemic group). Collected data included SCC subtype, thickness, size, clearance margins, referral details, patient comorbidities and operative data. RESULTS: There were 140 patients (174 SCCs; pre-pandemic group=74; pandemic group=100) identified for study inclusion. Both groups were well matched for age, sex, previous history of cancer, cutaneous SCC and histological subtype. There was a delay in median patient presentation time to the GP in the pandemic versus pre-pandemic group (106 days vs. 56 days, p <0.001); this led to a longer overall time to surgery (167 days vs. 110.5 days, p < 0.001). Pandemic group SCCs had larger median Breslow depths (4 mm vs. 3 mm, p = 0.01), a greater proportion of Clark's level 4 and 5 lesions (76.9% vs. 61.1%, p = 0.03), and a higher rate of high (20-40 mm) and very high (>40 mm) risk SCCs as defined by British Association of Dermatology diameter criteria (56.1% vs. 39.2%, p = 0.03), versus the pre-pandemic group. CONCLUSIONS: There was a 57-day median SCC treatment delay, and an associated development of higher risk SCCs by the time of surgery. Despite the challenges of a pandemic, patients should seek early consultation for suspicious skin changes, and healthcare systems should maintain skin cancer treatment pathways. PMID:34844882 | DOI:10.1016/j.bjps.2021.09.015 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perceived gender and client satisfaction in transgender voice work: comparing self and listener rating scales across a training program

xlomafota13 shared this article with you from Inoreader Perceived gender and client satisfaction in transgender voice work: comparing self and listener rating scales across a training program Via Folia Phoniatrica et Logopaedica Background/Aim: Scales used to collect perceptual ratings related to a speaker's gender are widely used in gender affirming voice training for trans individuals. Such scales may be used as outcome measures to gain insight into whether training has helped clients meet personal goals related to gender expression. These scales are also widely used in general research investigating the relationship between vocal characteristics and perceptions of speaker gender. However, past studies in these areas have varied in the terminology used to label rating scales and the impact of this variation is currently unknown. Additionally, research has not yet fully explored the relationship between self- and listener-ratings of trans participant voices and trans participant satisfaction with voice, and whether or not these relationships change after trans participants undertake gender affirming voice training. This research paper aimed to explore these relationships and address these research gaps. Methods: A group of 34 trans participants were asked to rate their voices before and after participating in gender affirming voice training. Trans participant voice samples from before and after training were also presented to a group of 25 listeners for rating. Perceptual ratings were made on two Visual Analogue Scales (VAS) with anchors 'very feminine/very masculine' and 'very female/very male'. Trans participants also rated their satisfaction with their current voice on a VAS with anchors 'very satisfied/very unsatisfi ed'. Correlation coefficients were calculated to investigate the relationship between collected ratings. Results: Differences in scale labels were found to have minimal impact on ratings made by both trans participants and listeners. Trans participant self-ratings were found to correlate with listener ratings, but this correlation was not strong Trans participant self-ratings had a consistently stronger relationship with their self-rated vocal satisfaction. The study contributed new findings that these differences may be more pronounced after trans participants have completed voice training. Discussion/conclusion: This study suggests that results from past studies that have used differently labelled scales to collect ratings related to gender perception based on voice are suitable to compare. This study also discusses the implications reported differences between trans participant self-ratings and listener ratings may have for research and clinical practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose

xlomafota13 shared this article with you from Inoreader Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Nov 10:S1808-8694(21)00183-X. doi: 10.1016/j.bjorl.2021.09.009. Online ahead of print. ABSTRACT OBJECTIVES: To highlight the prevalence of respiratory epithelial adenomatoid hamartomas in the olfactory cleft of patients with nasal polyposis. To demonstrate characteristics indicative of hamartoma on the CT scans of paranasal sinuses during surgery and in histopathological exams. METHOD: Cross-sectional study carried out in Hospital das Clínicas da UFMG and Núcleo de Otorrino BH. We performed 114 nasal endoscopic surgeries for polyposis, between February 2015 and November 2019. We assessed the olfactory cleft width in all preoperative CT scans. Upon seeing an indication of hamartoma on the CT scan, we took a tissue sample from the olfactory cleft during the surgery and sent for histopathological exam. We referred the samples to a pathologist experienced in the anatomopathological diagnosis of respira tory epithelial adenomatoid hamartomas. RESULTS: Of the 114 patients with polyposis, 54 (47.4%) had olfactory cleft enlargement and, 100% of them had tissue with a dense and hardened polypoid aspect, with a slight cerebriform appearance in this region during the surgery. Histology confirmed a respiratory epithelial adenomatoid hamartoma. CONCLUSION: This observation suggests that the presence of hamartomas in polyposis is common, but underdiagnosed. LEVEL OF EVIDENCE: Step 3 (Level 3). PMID:34844870 | DOI:10.1016/j.bjorl.2021.09.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proximal tibial dimensions in a formalin-fixed neonatal cadaver sample: an intraosseous infusion approach

xlomafota13 shared this article with you from Inoreader Proximal tibial dimensions in a formalin-fixed neonatal cadaver sample: an intraosseous infusion approach Via radiol anat Surg Radiol Anat. 2021 Nov 29. doi: 10.1007/s00276-021-02843-1. Online ahead of print. ABSTRACT PURPOSE: Methods to administer intramedullary medication and fluid infusion in both adults and children date to the early twentieth century. Studies have shown that intraosseous access in the proximal tibia is ideal for resuscitation efforts as fewer critical structures are at risk, and neither is the blood flow to the lower limbs compromised. Insertion of a needle in children you nger than 5 years does have the risk to damage to the epiphyseal growth plate. Therefore, the aim of this study was to determine the ideal intraosseous insertion site distal to the epiphyseal growth plate in neonates. METHODS: The samples consisted of both the left and right sides of 15 formalin-fixed neonatal cadavers. The dimensions were measured on the superior surfaces of each section, anteromedial border, cortical thickness, and medullary space. RESULTS: The most desirable location to gain vascular access is at 10 mm inferior to the tibial tuberosity. CONCLUSION: The smallest cortical thickness (1.32 mm), the largest medullary space (4.50 mm), and the largest anteromedial surface (7.72 mm) were observed at 10 mm inferior to the tibial tuberosity. It is imperative that health care professionals are familiar with the osteological sites that could be safely used for an intraosseous infusion procedure. PMID:34845509 | DOI:10.1007/s00276-021-02843-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.