Conservative Management of Post-Operative Cerebrospinal Fluid Leak following Skull Base Surgery: A Pilot Study

xlomafota13 shared this article with you from Inoreader Conservative Management of Post-Operative Cerebrospinal Fluid Leak following Skull Base Surgery: A Pilot Study Via leak of cerebrospinal fluid Brain Sci. 2022 Jan 24;12(2):152. doi: 10.3390/brainsci12020152. ABSTRACT BACKGROUND/AIMS: Iatrogenic CSF leaks after endoscopic endonasal transsphenoidal surgery remain a challenging entity to manage, typically treated with CSF diversion via lumbar drainage. OBJECTIVE: To assess the safety and efficacy of high-volume lumbar puncture (LP) and acetazolamide therapy to manage iatrogenic CSF leaks. METHODS: We performed a prospective pilot study of four patients who developed iatrogenic postoperative CSF leaks after transsphenoidal surgery and analyzed their response to treatment with concomitant high-volume lumbar puncture followed by acetazolamide therapy for 10 days. Data collected included demographics, intra-operative findings, including methodology of skull base repair and type of CSF leak, time to presentation with CSF leak, complications associated with high-volume LP and acetazolamide treatment, and length of follow-up. < p>RESULTS: Mean patient age was 44.28 years, with an average BMI of 27.4. Mean time from surgery to onset of CSF leak was 7.71 days. All four patients had resolution of their CSF leak at two- and four-week follow-up. Mean overall follow-up time was 179 days, with a 100% CSF leak cure rate at the last clinic visit. No patient suffered perioperative complications or complications secondary to treatment. CONCLUSION: Although our pilot case series is small, we demonstrate that a high-volume LP, followed by acetazolamide therapy for 10 days, can be considered in the management of post-operative CSF leaks. PMID:35203915 | DOI:10.3390/brainsci12020152 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation between olfactory function, age, sex, and cognitive reserve index

xlomafota13 shared this article with you from Inoreader Correlation between olfactory function, age, sex, and cognitive reserve index in the Italian population 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 Feb 24. doi: 10.1007/s00405-022-07311-z. Online ahead of print. ABSTRACT PURPOSE: Loss of smell decreases the quality of life and contributes to the failure in recognizing hazardous substances. Given the relevance of olfaction in daily life, it is important to recognize an undiagnosed olfactory dysfunction to prevent these possible complications. Up to now, the prevalence of smell disorders in Italy is unknown due to a lack of epidemiological studies. Hence, the primary aim of this study was to evaluate the prevalence of olfactory dysfunction in a sample of Italian adults. METHODS: Six hundred and thirty-three participants (347 woman and 286 men; mean age 44.9 years, SD 17.3, age range 18-86) were recruited from 10 distinct Italian regions. Participants were recruited using a convenience sapling and were divided into six different age groups: 18-29 years (N = 157), 30-39 years (N = 129), 40-49 year s (N = 99), 50-59 years (N = 106), > 60 years (N = 142). Olfactory function, cognitive abilities, cognitive reserve, and depression were assessed, respectively, with: Sniffin' Sticks 16-item Odor Identification Test, Montreal Cognitive Assessment, Cognitive Reserve Index, and the Beck Depression Inventory. Additionally, socio-demographic data, medical history, and health-related lifestyle information were collected. RESULTS: About 27% of participants showed an odor identification score < 12 indicating hyposmia. Multiple regression analysis revealed that OI was significantly correlated with age, sex, and cognitive reserve index, and young women with high cognitive reserve index showing the highest olfactory scores. CONCLUSION: This study provides data on the prevalence of olfactory dysfunction in different Italian regions. PMID:35211821 | DOI:10.1007/s00405-022-07311-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between Thyroid Cancer and Breast Cancer: Two Longitudinal Follow-Up Studies Using a National Health Screening Cohort

xlomafota13 shared this article with you from Inoreader Association between Thyroid Cancer and Breast Cancer: Two Longitudinal Follow-Up Studies Using a National Health Screening Cohort Via radioactive iodine J Pers Med. 2022 Jan 20;12(2):133. doi: 10.3390/jpm12020133. ABSTRACT Background: The purpose of this study was to evaluate the association between thyroid cancer and breast cancer. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort were collected from 2002 to 2013. In study I, 3949 thyroid cancer participants were 1:4 matched with 15,796 control I participants, and hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer were evaluated using a stratified Cox proportional hazard model. In study II, 3308 breast cancer participants were 1:4 matched with 13,232 control II participants, and HRs with 95% CIs for thyroid cancer were assessed in the same way as in study I. In the subgroup analyses, associations were analyzed according to radioactive iodine (RAI) treatment and age (<60 years old and ≥60 years old). Results: The adjusted HR for breast cancer in the thyroid cancer group was 1.64 (95% CI = 1.13-2.39, p = 0.010). The adjusted HR for thyroid cancer in the breast cancer group was 1.91 (95% CI = 1.47-2.49, p < 0.001). In the subgroup analyses, the groups that were older and not treated with RAI treatment showed consistent results in study I, and the younger and older groups showed consistent results in study II. Conclusions: Based on this cohort study, breast and thyroid cancer have a reciprocal positive association. PMID:35207622 | DOI:10.3390/jpm12020133 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Precise fabrication of porous polymer frameworks using rigid polyisocyanides as building blocks: from structural regulation to efficient iodine capture

xlomafota13 shared this article with you from Inoreader Precise fabrication of porous polymer frameworks using rigid polyisocyanides as building blocks: from structural regulation to efficient iodine capture Via radioactive iodine Chem Sci. 2022 Jan 12;13(4):1111-1118. doi: 10.1039/d1sc05361b. eCollection 2022 Jan 26. ABSTRACT Porous materials have recently attracted much attention owing to their fascinating structures and broad applications. Moreover, exploring novel porous polymers affording the efficient capture of iodine is of significant interest. In contrast to the reported porous polymers fabricated with small molecular blocks, we herein report the preparation of porous polymer frameworks using rigid polyisocyanides as building blocks. First, tetrahedral four-arm star polyisocyanides with predictable molecular weight and low dispersity were synthesized; the chain-ends of the rigid polyisocyanide blocks were then crosslinked, yielding well-defined porous organic frameworks with a designed pore size and narrow distribution. Polymers of appropriate pore size were observed to efficiently capture radioactive iodine in both aqueous and vapor phases. More than 98% of iodine could be captured within 1 minute from a saturated aqueous solution (capacity of up to 3.2 g g-1), and an adsorption capacity of up to 574 wt% of iodine in vapor was measured within 4 hours. Moreover, the polymers could be recovered and recycled for iodine capture for at least six times, while maintaining high performance. PMID:35211277 | PMC:PMC8790772 | DOI:10.1039/d1sc05361b View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

L-Thyroxine Improves Vestibular Compensation in a Rat Model of Acute Peripheral Vestibulopathy: Cellular and Behavioral Aspects

xlomafota13 shared this article with you from Inoreader L-Thyroxine Improves Vestibular Compensation in a Rat Model of Acute Peripheral Vestibulopathy: Cellular and Behavioral Aspects Via oto-rhino-laryngologie Cells. 2022 Feb 16;11(4):684. doi: 10.3390/cells11040684. ABSTRACT Unilateral vestibular lesions induce a vestibular syndrome, which recovers over time due to vestibular compensation. The therapeutic effect of L-Thyroxine (L-T4) on vestibular compensation was investigated by behavioral testing and immunohistochemical analysis in a rat model of unilateral vestibular neurectomy (UVN). We demonstrated that a short-term L-T4 treatment reduced the vestibular syndrome and significantly promoted vestibular compensation. Thyroid hormone receptors (TRα and TRβ) and type II iodothyronine deiodinase (DIO2) were present in the vestibular nuclei (VN), supporting a local action of L-T4. We confirmed the T4-induced metabolic effects by demonstrating an increase in the number of cytochrome oxidase-labeled neurons in the VN three days after the lesion. L-T4 treatment modulated glial reaction by decreasing both microglia and oligodendrocytes in the deafferen ted VN three days after UVN and increased cell proliferation. Survival of newly generated cells in the deafferented vestibular nuclei was not affected, but microglial rather than neuronal differentiation was favored by L-T4 treatment. PMID:35203333 | DOI:10.3390/cells11040684 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular aetiology of ski-slope hearing loss and audiological course of cochlear implantees

xlomafota13 shared this article with you from Inoreader Molecular aetiology of ski-slope hearing loss and audiological course of cochlear implantees 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 Feb 25. doi: 10.1007/s00405-022-07317-7. Online ahead of print. ABSTRACT PURPOSE: A challenge for patients with ski-slope hearing loss is that hearing aids do not adequately amplify the mid-to-high frequencies necessary for speech perception and conversely, cochlear implant (CI) may damage low-frequency hearing. We aimed to describe the clinical profile of patients with ski-slope hearing loss, with a special focus on aetiology of such hearing loss and audiological course of low-frequency hearing after CI. METHODS: We recruited hearing-impaired patients who visited a tertiary referral centre and met the criteria for ski-slope hearing loss patients from 2015 to 2021. Genetic testing was performed in all ski-slope hearing loss patients unless refused. Baseline audiograms of patients who continued to use hearing aids or who finally underwent CIs were reviewed. As for CI patients, outcome and hearing pr eservation rate were rigorously analysed. RESULTS: Of 46 recruited patients with ski-slope hearing loss, 45 agreed to undergo genetic testing and causative variants were identified in 17 (37.8%) patients. The TMC1, MYO7A, and TMPRSS3 variants were the most common, while LRTOMT was newly identified as a causative gene. Twenty-five patients eventually received CI, while 13 continued to wear the hearing aid and 8 patients did not ever try hearing aids. CI in ski-slope hearing loss led to immediate and sufficient improvement of sentence recognition by as early as 3 months, however, the duration of hearing loss was inversely correlated with the sentence recognition score. The average hearing preservation rate (using the HEARRING classification) after CI was 53.0% (SD 30.0) and 45.6% (SD 31.1) at 1 year. Seventy-nine percent of implantees maintained functional low-frequency hearing (better than 85 dB at 250 and 500 Hz) eligible for electric-acoustic stimulation (EAS). A trend was fo und that patients with hair cell stereocilia-associated genetic variants may have a slightly better preservation, albeit with no statistical significance. CONCLUSION: Detection rate of a molecular genetic aetiology of ski-slope hearing loss appears to be lower than other type of hearing loss reported in the literature. Especially with short hearing loss duration, CI in ski-slope hearing loss leads to immediate and sufficient speech improvement, while preserving functional low-frequency hearing eligible for EAS as many as in 79%. A certain genetic aetiology might be associated with a trend towards better low-frequency hearing preservation. PMID:35212774 | DOI:10.1007/s00405-022-07317-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader A nomogram based on tumor response to induction chemotherapy may predict survival in locoregionally advanced nasopharyngeal carcinoma Via Head & Neck Abstract Background To evaluate the clinical significance of tumor response to induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LANPC) patients and further to develop a nomogram for predicting survival prognosis. Methods A total of 498 patients with stage III-IVA NPC applying IC and concurrent chemotherapy were reviewed (training cohort, n = 376; validation cohort, n = 122). Results Tumor response was an independent predictor for clinical outcomes. The nomogram included age, N stage, pretreatment Epstein–Barr virus DNA, lymphocyte-to-monocyte ratio, and tumor response achieved an ideal C-index of 0.703 (95% CI 0.655–0.751) in the validation cohort for predicting overall survival (OS), which outperformed than that of the TNM system alone (C-index, 0.670, 95% CI: 0.622–0.718). In addition, the nomogram could successfully classified patients into different risk groups. Conclusions We established and validated a precise and convenient nomogram based on tumor response for predicting the OS of LANPC patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Possible Rehabilitation Procedures to Treat Sarcopenic Dysphagia

xlomafota13 shared this article with you from Inoreader Possible Rehabilitation Procedures to Treat Sarcopenic Dysphagia Via swallowing exercises Nutrients. 2022 Feb 12;14(4):778. doi: 10.3390/nu14040778. ABSTRACT Sarcopenic dysphagia requires the presence of both dysphagia and generalized sarcopenia. The causes of dysphagia, except for sarcopenia, are excluded. The treatment for sarcopenic dysphagia includes resistance training along with nutritional support; however, whether rehabilitation procedures are useful remains unclear. In this narrative review, we present possible rehabilitation procedures as a resistance training for managing sarcopenic dysphagia, including Shaker exercise, Mendelsohn maneuver, tongue-hold swallow exercise, jaw-opening exercise, swallow resistance exercise, lingual exercise, expiratory muscle strength training, neuromuscular electrical stimulation, and repetitive peripheral magnetic stimulation. We hope that some procedures mentioned in this article or new methods will be effective to treat sarcopenic dysphagia. PMID:35215427 | DOI:10.3390/nu14040778 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The COVID-19 pandemic and upgrades of CI speech processors for children: part I-procedure of speech processor upgrade

xlomafota13 shared this article with you from Inoreader The COVID-19 pandemic and upgrades of CI speech processors for children: part I-procedure of speech processor upgrade 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 Feb 26. doi: 10.1007/s00405-022-07278-x. Online ahead of print. ABSTRACT PURPOSE: To demonstrate the feasibility of upgrading speech processors during the COVID-19 pandemic. METHODS: Adopting concepts from "lean thinking", we optimized hospital workflows to allow speech processors to be upgraded despite the obstacles arising from national guidelines for COVID-19 prevention. The study involved 297 children, aged from 7.3 to 18.0 years, whose processors were upgraded on five consecutive Saturdays during a time of peak COVID-19 in Poland. RESULTS: The optimized workflow allowed us to conduct speech processor upgrades during a time of peak COVID-19 in Poland. The upgrades were conducted as scheduled, patient flow was smooth, appropriate social distancing was kept, and no reports of COVID-19 infection in our patients in the 2 weeks after their visit were received. CONCLUSION: Upgrading of sp eech processors in children is still feasible under coronavirus conditions. PMID:35217905 | DOI:10.1007/s00405-022-07278-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment

xlomafota13 shared this article with you from Inoreader Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment 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 Feb 26. doi: 10.1007/s00405-022-07313-x. Online ahead of print. ABSTRACT PURPOSE: Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. The main reason of voice prosthesis failure is the endoprosthesis leakage. Provox ActiValve® incorporates a magnet-based valve system to achieve active closure of the valve to treat these leakages, with the drawback of being significantly more expensive. The aim of the study was to compare the Provox Vega® and Provox ActiValve® duration and costs in patients with replacements increase due to endoprosthetic leakage. METHODS: Prospective case-crossover study in laryngectomized patients with Provox Vega® and endoprosthesis leakage to whom a Provox ActiValve® was placed. Survival and possible factors that affect voice prosthesis were studied using Kaplan-Meie r curves and Cox Proportional Hazards Regression. Cost-effectiveness analysis from the perspective of the Spanish Public National Health System with incremental cost-effectiveness calculation was performed. RESULTS: A total of 159 prostheses were evaluated. The most frequent reason for replacement was the endoprosthesis leakage (N = 129; 83.77%) in both models. The mean duration-time of Provox Vega® was 44.77 ± 2.82 days (CI 95%, 39.18-50.35; median 36 days), and 317.34 ± 116.8 days (CI 95% 86.66-548; median 286 days) for the Provox ActiValve® (p < 0.000). For every replacement not made thanks to the Provox ActiValve® there was saving of 133.97€ CONCLUSIONS: The Provox ActiValve® is a cost-effective solution in patients with increased prosthesis replacements due to endoprosthetic leakage, reducing the number of changes and cost compared to Provox Vega®. PMID:35217904 | DOI:10.1007/s00405-022-07313-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of Different Voice Rest on Vocal Function After Microlaryngeal Surgery: A Systematic Review and Meta‐Analysis

xlomafota13 shared this article with you from Inoreader Effects of Different Voice Rest on Vocal Function After Microlaryngeal Surgery: A Systematic Review and Meta‐Analysis Via The Laryngoscope Abstract Objectives To compare the results of a voice handicap index (VHI) scale and acoustic parameters in patients who underwent microlaryngeal surgery followed by either short-duration (voice rest for <7 days) or long-duration (≥7 days) voice rest. Study Design Systematic review and meta-analysis. Methods The PubMed, Embase, and Cochrane Library databases were systematically searched for articles published before March 1, 2021. Randomized controlled trials (RCTs) that measured the voice outcomes of patients after different durations and extents of postoperative voice restriction were included in the meta-analysis. Results Four RCTs comprising 112 patients were included in the quantitative meta-analysis. Compared with the long-duration voice rest group, the short-duration group exhibited comparable VHI scores (mean difference [MD], −7.01; 95% CI, −16.12 to 2.09; p = 0.13), maximum phonation time (MD, −2.58; 95% CI, −5.42 to 0.26; p = 0.07), and acoustic variables of jitter (MD, −1.25; 95% CI, −3.43 to 0.94; p = 0.26) and shimmer (MD, −0.79; 95% CI, −2.08 to 0.51; p = 0.24). Subgroup analysis for benign pathology and cold instruments studies demonstrated significantly better VHI scores (MD, −14.45; 95% CI, −26.19 to −2.72; p = 0.02 and MD, −15.98; 95% CI, −28.52 to −3.44; p = 0.01, respectively) in the short-duration group. Conclusions The limited evidence does not demonstrate benefit in voice outcomes from long-duration voice rest and suggests potential unfavorable effects on compliance and quality of life, providing a rationale for short-duration voice rest after microlaryngeal surgery. More studies are required to determine the optimal duration and extent of postoperative voice rest. Level of Evidence 1 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.