Blog Archive

Αλέξανδρος Γ. Σφακιανάκης

Wednesday, September 15, 2021

Covid 19 Pandemic-Training of Healthcare Workers in Obtaining a Nasopharyngeal Swab: Our Experience

xlomafota13 shared this article with you from Inoreader

Abstract

To describe the training of healthcare workers (HCW) in nasopharyngeal swabbing during the COVID 19 pandemic. Study design: Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: One hundred and seventy eight health care workers were trained from May 2020 to January 2021. Three modules were designed to train the health care workers in the technique of obtaining a nasopharyngeal swab specimen.Training consisted of an instructional video on how to perform nasopharyngeal swabs and live demonstration followed by hands-on supervised training. The trainees included 30 doctors, 101 nurses, 31 respiratory therapists, 3 physiotherapists, 9 interns and 4 lab technicians. There were 39 male and 139 female trainees. After attending all 3 modules of training, they were confident and efficient in taking a non-traumatic nasopharyngeal swab. Good knowledge and adequate training is key to a good nasopharyngeal sampling for SARS CoV-2 testing.

View on the web

Assessment of different markers of ovarian reserve in women with papillary thyroid cancer treated with radioactive iodine

xlomafota13 shared this article with you from Inoreader

pubmed-meta-image.png

Endocr Connect. 2021 Sep 1:EC-21-0187.R2. doi: 10.1530/EC-21-0187. Online ahead of print.

ABSTRACT

Treatment with radioactive iodine (RAI) in women with differentiated thyroid cancer is associated with decreased serum concentrations of anti-Müllerian hormone (AMH); however, other markers have not been investigated. Therefore, this study aimed to evaluate the effect of RAI on antral follicle count (AFC) and the serum concentration of inhibin B, follicle-stimulating hormone (FSH), a nd AMH in women with papillary thyroid cancer (PTC) treated with RAI. We examined 25 women at a median age of 33 years treated with a single dose of RAI. We divided the participants into women over (n = 11) and under 35 years of age (n = 14). Serum concentrations of inhibin B, FSH, AMH, and AFC were assessed at baseline and one year after RAI treatment. We found decreased AFC (p = 0.03), serum levels of AMH (p < 0.01), inhibin B (p = 0.03), but not FSH (p = 0.23), one year after RAI treatment in comparison to baseline in the whole group. When we compared serum levels of AMH in younger vs. older women separately, we observed a significant reduction of this hormone's serum level after RAI treatment in both groups (p < 0.01; p = 0.04, respectively). We concluded that RAI treatment significantly impacts the functional ovarian reserve in premenopausal women with PTC.

PMID:34524978 | DOI:10.1530/EC-21-0187

View on the web

Normal anatomy, variants and factors associated with the cervical vagus nerve topography: a high-resolution ultrasound study

xlomafota13 shared this article with you from Inoreader

pubmed-meta-image.png

Surg Radiol Anat. 2021 Sep 15. doi: 10.1007/s00276-021-02832-4. Online ahead of print.

ABSTRACT

PURPOSE: To describe the cervical vagus nerve (CVN) topography at the thyroid lobe (TL) level using high-resolution ultrasound and to investigate the possible association with anthropometric data, TL size, and thyroid disease.

METHODS: We prospectively examined 550 CVNs in 275 (205 female, 70 male) individuals with normal thyroid (53/275, 19.3%), multinodular disease (167/27 5, 60.7%), and Hashimoto thyroiditis (55/275, 20%). The CVN location relative to the common carotid artery was recorded as typical (lateral position) and atypical (anterior, medial, and posterior position). The shortest distance between CVN and TL margin, the TL dimensions, and volume were measured.

RESULTS: Normal thyroid subjects had lateral-positioned right CVNs in 100% and lateral/anterior/medial left CVNs in 81.1%, 15.1%, and 3.8%, respectively. CVN types did not differ significantly bilaterally between study groups. Asymmetry in CVN topography in all subjects was found in 22.2%, of which anterior CVN was the most common atypical position (64%), especially on the left side (82%). Significant gender, age, body mass, and BMI differences among CVN types were observed on the left side only. Among CVN types, no difference in TL dimensions, volume, and CVN-TL distance was found in all study groups. A weak negative correlation was recorded between CVN-thyroid distance and TL vol ume only on the left side (r = - 0.147, p = 0.01).

CONCLUSION: Asymmetry in CVN topography is mainly due to the increased incidence of the anterior location of CVN on the left side. Age and anthropometric parameters are different on the left side possibly due to the increased prevalence of left CVN variants.

PMID:34524485 | DOI:10.1007/s00276-021-02832-4

View on the web

Clinical manifestation and treatment of temporal bone tympanic plate fracture

xlomafota13 shared this article with you from Inoreader

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):801-805. doi: 10.3760/cma.j.cn115330-20210512-00266.

ABSTRACT

Objective: To elucidate the clinical manifestations of temporal bone tympanic plate fracture and the correlation between treatment time after injury and its prognosis, and to discuss the importance of early treatment of tympanic fracture. Methods: Retrospective analysis was carried out on the clinical data of 15 patients(17 ears)with temporal bone tympanic plate fracture from March 2006 to July 2019. The course of disease was less than 1 month (initial stage) in 7 cases (7 ears), 1 month to 6 months (middle stage) in 2 cases (3 ears), and 6 months or more (late stage) in 6 cases (7 ears). The symptoms, signs, CT findings, pure tone audiometry results, surgical methods and clinical efficacy of each group were summarized. Results: Most patients with temporal bone tympanic plate fracture were r eferred to otology department by maxillofacial surgery. Fracture occured indirectly with the chin or zygomatic region as the direct stress point. Thirteen of the 15 patients had mental region wounds or scars, and 14 patients had external acoustic canal bleeding immediately after injury. In the initial-stage group, hearing was mostly unchanged, while in the middle and late-stage groups, hearing loss was mainly caused by conduction factors. In the initial stage group, 6 cases/7 cases were cured by external acoustic canal packing; External acoustic canal stenosis or atresia occurred in 2 cases in the middle-stage group and were cured by external acoustic canal plasty. All the 6 patients in the late-stage group had external acoustic canal stenosis or atresia, among whom 5 patients with external acoustic canal cholesteatoma were cured by external acoustic canal plasty, and the other one patient with middle ear cholesteatoma was cured by modified radical mastoidectomy and tympanoplasty af ter external acoustic canal plasty for three times. Conclusions: Temporal bone tympanic plate fracture is a special type of temporal bone fracture. In the early stage of temporal bone tympanic fracture, bleeding of the external acoustic canal is the main symptom, and hearing is normal mostly. Advanced conductive deafness may result from external acoustic canal stenosis and/or cholesteatoma formation later. Bleeding of the external acoustic canal and irregular bulge of the anterior wall of the external acoustic canal with mental region wound are important signs for early diagnosis of temporal bone fracture. Temporal bone tympanic fracture should be paid attention to, early detection and timely treatment can avoid external acoustic canal stenosis and atresia.

PMID:34521162 | DOI:10.3760/cma.j.cn115330-20210512-00266

View on the web

The development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children

xlomafota13 shared this article with you from Inoreader

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):812-818. doi: 10.3760/cma.j.cn115330-20200925-00771.

ABSTRACT

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing a bilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlat ion at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.

PMID:34521164 | DOI:10.3760/cma.j.cn115330-20200925-00771

View on the web

Surgical treatment of maxillary bone cyst though modified endoscopic prelacrimal recess approach

xlomafota13 shared this article with you from Inoreader

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):863-866. doi: 10.3760/cma.j.cn115330-20201118-00875.

NO ABSTRACT

PMID:34521173 | DOI:10.3760/cma.j.cn115330-20201118-00875

View on the web

Studies on efficacy of a bioabsorbable steroid-eluting sinus stent in the frontal sinus opening of chronic rhinosinusitis with nasal polyps

xlomafota13 shared this article with you from Inoreader

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):824-829. doi: 10.3760/cma.j.cn115330-20200809-00655.

ABSTRACT

Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the ne ed for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.

PMID:34521166 | DOI:10.3760/cma.j.cn115330-20200809-00655

View on the web